Colorectal cancer is now the third most-diagnosed cancer in the U.S., not including skin cancer, and it’s the second leading cause of cancer-related deaths. The American Cancer Society predicts there will be 106,590 new cases of colon cancer and 46,220 new cases of rectal cancer in 2024. While cases among younger adults are growing, the vast majority of colorectal cancer is in those aged 65 to 84. The median age of diagnosis is 69 years for women and 66 for men.
Screening Guidelines
Colorectal screenings such as colonoscopies can reduce the chance of getting colon cancer by up to 80%. However, according to the American Medical Association, nearly one in three individuals eligible for a colonoscopy in the U.S. has never had one. This is unfortunate as early screening is critical to identifying risk factors so individuals can take proactive steps to lower their risk.
It is up to physicians to determine a patient’s risk, how often they should be screened, and what screening options should be used. According to guidelines put forth by the American Cancer Association, colonoscopies should be completed every ten years, and stool-based tests should be performed every three years for individuals at average risk. Regular screening should continue through age 75. After that, screening should be “based on a person’s preferences, life expectancy, overall health, and prior screening history.” The guidelines indicate that those over age 85 no longer need to be screened as the risks may outweigh any benefits.
Choosing the Right Screening Method
Colonoscopy is the gold standard for detecting colorectal cancer and identifying risk factors such as polyps. This is especially important for seniors as they are the group most likely to develop polyps, and the risk of polyps rises with each passing decade.
During a colonoscopy, physicians can identify polyps that are most likely to develop into cancer. Those can then be removed and sent for evaluation, giving colonoscopies a significant advantage over at-home fecal occult blood and DNA screening kits. While these at-home stool sample kits are better than no screening at all, they can miss more than half of pre-cancerous polyps and up to eight percent of colon cancer. They are also shown to have a 12% false-positive rate.
One of the challenges of getting individuals to have a colonoscopy is the anxiety around the pre-procedure preparation. As anyone who has had a colonoscopy knows, prep day can be uncomfortable and embarrassing for those who have others living in their household. However, there are steps that can be taken to make the process a bit less uncomfortable.
According to the FIGHT Colorectal Cancer website, individuals can eat smaller meals with food that is more easily digested in the days leading up to the procedure. This can include food like soup, steamed vegetables, pasta, and rice. The website offers a number of other suggestions on simple ways to make pre-day more tolerable.
Education is key to removing patient anxiety and fear around colonoscopies and providing resources to help make prep day easier.
Reducing Risk for Seniors
Older individuals typically have more chronic, complex health conditions, as well as comorbidities, which can make managing colorectal risk more challenging. “Age-related factors such as multiple medications, the presence of other chronic conditions, and the general frailty associated with aging can complicate both the diagnosis and treatment process.” Therefore, physicians must take a more customized approach for their older patients. This means screening and care plans need to be created based on “health status, potential risks, and personal preferences.”
We now know that lifestyle, along with heredity, plays a significant role in preventing and treating colorectal cancer. This is particularly true for diet since the colon is a part of the digestive system. Obesity, too, has been found to increase risk due to weight-related issues like insulin resistance and increased levels of insulin in the blood. A healthy diet is estimated to prevent half to three-fourths of colorectal cancers. Other ways to reduce risk include exercising 30 minutes a day, quitting smoking, reducing alcohol consumption, and increasing intake of vegetables and healthy fats.
Keeping Seniors Safe
The good news is that more people are being screened for colorectal cancer and taking steps to address risk factors. It’s a trend driven primarily by increased awareness and more convenient screening options. For seniors, education and personalized care plans are vital in preventing, reducing, and effectively treating colorectal cancer.
