03/17/2023
FYI
Colorectal cancer is a highly preventable, treatable and survivable cancer, especially when screened and diagnosed early; yet, it is the third leading cause of cancer-related deaths in men and in women in the United States. Incidence and mortality rates in Louisiana are higher than national averages. One of the reasons colorectal cancer has such a high mortality rate is that an estimated 40% of all at-risk individuals have never been screened. Screening should happen for everyone between the ages of 45 and 75.
LDH has identified colorectal cancer as an area of focus because case and mortality rates are higher on average in Louisiana than the national average. In Louisiana, there are 45.1 colorectal cancer cases per 100,000; in the U.S., that number is 38 per 100,000. Mortality rates are higher for Louisianans (15.9 per 100,000) than national averages (13.0 per 100,000).
One of the reasons colorectal cancer has such a high mortality rate is that an estimated 40% of all at-risk individuals have never been screened. In the Louisiana Medicaid program, just 38.7%of recipients ages 50 to 75 have been screened for colorectal cancer.
There are also significant racial disparities. Black Louisianans have a rate of 52.9 cases per 100,000 while White residents have 42.4 cases per 100,000. Black Louisianans are also more likely to die of colorectal cancer than White residents. The mortality rate for colorectal cancer among Black residents in 2015-19 was 20.8 deaths per 100,000 compared to 14.2 per 100,000 among White residents.
There are some misconceptions that may stop people from getting screened:
Fear or embarrassment: There is a myth that colon cancer screenings are difficult or painful, but colonoscopies are performed under sedation and you will not feel anything during the procedure. There are also tests you can take from the comfort and privacy of your own home.
No family history: There is a myth that if you do not have a family history of colorectal cancer, you are not at risk and do not need to be screened. But major groups like the American Cancer Society say screening should happen for anyone at average risk between the ages of 45 and 75.
Asymptomatic: There is a myth that screenings are only for those with symptoms. Colon cancer is typically asymptomatic until it reaches the later stages, so you should be screened whether you are symptomatic or not.
Cost: Health insurance, including Medicaid, covers most costs associated with screening.
Age: Screening guidelines were changed in 2021 from age 50 to age 45 if a person is at average risk.
Screening Guidance:
Screening should happen for anyone at average risk between the ages of 45 and 75.
People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75.
For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health and prior screening history.
People over 85 should no longer get colorectal cancer screening.
A person who’s considered at “average risk” of colorectal cancer does not have a personal history of colorectal cancer or certain types of polyps; a family history of colorectal cancer; a personal history of inflammatory bowel disease; a confirmed or suspected hereditary colorectal cancer syndrome; a personal history of getting radiation to the abdomen or pelvic area to treat a prior cancer. (American Cancer Society)
People at increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 45, be screened more often and/or get specific tests.
This includes people with:
A strong family history of colorectal cancer or certain types of polyps (see Colorectal Cancer Risk Factors)
A personal history of colorectal cancer or certain types of polyps
A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC)
A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer
Different Types of Colorectal Cancer Screening
A colonoscopy is not the only type of screening for colorectal cancer. There are highly sensitive stool-based tests that can be taken yearly at home. There is also a stool DNA test that can be performed every three years, also in the privacy of your home. A flexible sigmoidoscopy, for example, can be performed every 5 years and does not require sedation. A sigmoidoscopy is less invasive because it only looks at the lower part of the colon while a colonoscopy views the entire colon.
Where to get an at-home test: A stool-based test can be obtained at a Prevention On The Go screening event or through a medical provider. Cologuard® is one of these at-home tests, covered by most insurers, which can be obtained through your medical provider or through a telemedicine provider online by visiting https://www.cologuard.com/
Where to find a community screening near you: https://marybird.org/get-screened/
Resources
American Cancer Society: cancer.org/cancer/colon-rectal-cancer.html or 800-227-2345
CDC: https://www.cdc.gov/cancer/colorectal/basic_info/
Mary Bird Perkins Cancer Center: https://marybird.org/get-screened or 888-501-4763
Ochsner Health Cancer Institute: https://www.ochsner.org/services/cancer-care or 866-624-7637
Our Lady of the Lake Cancer Institute: https://ololrmc.com/services/cancer/cancer-care/types-of-cancer/colorectal-cancer or 225-757-0343
Cologuard® is a noninvasive at-home colon cancer screening test for adults 45+ at average risk. See risk info and talk to your provider. Rx only.
