Colonoscopy is still the best way to detect and prevent colorectal cancer, explains Justin Michael

Despite newer options available for detecting the presence of colorectal cancer, including non-invasive stool tests that detect blood and, in some tests like Cologuard, cell DNA changes linked to cancer, colonoscopy is still the gold standard, according to Justin Michael, MD. MD.

“It has definitely been shown to prevent colorectal cancer,” said Dr. Mickle Joseph M Streeter and Mary Streeter Devudis Chair in SurgeryProfessor of Surgery and Head of the Division of Colon and Rectal Surgery.

The U.S. Preventive Services Task Force recommended in 2021 that adults ages 45 to 75 be screened for colorectal cancer, lowering the previously recommended starting age from 50. Studies dating back to the 1990s show that screening in people who Those aged 50 or older have resulted in a lower incidence of colorectal cancer in that age group. But rates of colorectal cancer increase in people under the age of 50.

In fact, one in 10 colorectal cancer patients at UMass Memorial Health is younger than 50, Michael said. And when patients younger than 50 do develop cancer, the cancer tends to grow faster and be more aggressive.

Michael said a colonoscopy, in which a thin, flexible scope is inserted into the rectum and entire colon, can detect cancers but can also detect and remove precancerous polyps. Stool tests do not have this protective power.

“We estimate that 90 percent or more of colon cancers are preventable, despite the fact that it is the third most common form of cancer in the United States,” he said.

Colorectal cancer is the second leading cause of cancer deaths. However, the survival rate for stage 1 cancer is greater than 90 percent, which is why early detection is key.

Michael opposes a paper recently published in a newspaper New England Journal of Medicine which notes that the benefits of having a colonoscopy weren’t clear, calling the study “poorly designed.”

The study compared colorectal cancer rates among people who were offered a colonoscopy with a control group who did not undergo a colonoscopy. But only about 40 percent of those actually had colonoscopies Receive One.

“Basically, the conclusion of the study is that we need to do a better job of educating people and convincing them to get tested,” said Mickle.

The hurdle for many people is the commitment to prepare for the exam, which includes fasting and bowel cleansing so the lining of the colon can be seen. Another is the fear of discovering cancer. According to Michael, the procedure itself, which is performed under anesthesia, is “really simple and low risk.”

UMass Chan physicians also report discrepancies in screening rates depending on socioeconomic background and race.

Maykel and his colleagues launched an effort to educate UMass Chan and UMass Memorial Health employees in all job categories about the importance of colorectal screening.

“We’ve had great success contracting staff for their bids, and we’ve identified several staff members with precancerous growths,” he said. “Through the program, a patient has been identified with early-onset colon cancer,” which is more treatable than in the advanced stages.

Michael urged anyone with symptoms related to colorectal cancer to tell their primary care provider and have a colonoscopy. Symptoms include blood in the stool, changes in bowel habits, unexplained weight loss, and abdominal pain that does not go away.

Science for Living presents UMass Chan School of Medicine experts’ perspectives on the research behind the health headlines. If you have ideas for topics you want to explore, please send them in

Related UMass Chan news stories:
UMass School of Medicine researchers ramp up their COVID-19 study on convalescent plasma
2019 Honors Ceremony honoring four appointed professors and their benefactors

Leave a Comment