CTUpdates

Add colorectal cancer screening for 50+ women

If your practice includes women ages 50 and older, be sure to remind them to be screened for colorectal cancer, advises the American College of Obstetricians and Gynecologists (ACOG).

Colon and rectal cancer, which affects the large intestine and rectum, is the third-leading cause of cancer death among women in the United States and the second-leading cause of cancer deaths overall for all adults. In most cases, the disease develops slowly over time, often beginning with tissue growth (polyps) in the colon or rectum. Routine screening helps detect these polyps so that they can be removed before they turn into cancer. While the disease may be asymptomatic, educate your patients to look for the following symptoms: change in bowel habits, bleeding from the rectum, blood in the stool, stools that are more narrow than usual, abdominal discomfort (bloating, cramps, or frequent gas pains), loss of appetite, and weakness and feeling tired.

ACOG recommends that all women age 50 and older be screened for colorectal cancer by one of the following methods:

  • annual patient-collected fecal occult blood test (FOBT) or fecal immunochemical test (FIT);
  • flexible sigmoidoscopy once every five years;
  • annual patient-collected FOBT or FIT plus a flexible sigmoidoscopy once every five years;
  • double-contrast barium enema once every five years;
  • colonoscopy once every 10 years.

Some women may need to be screened for colorectal cancer before age 50 if they:

  • have a first-degree relative younger than age 60 with colorectal cancer or colon polyps;
  • have two or more first-degree relatives of any age with colorectal cancer or colon polyps;
  • have had colorectal cancer;
  • have had colon polyps;
  • have had inflammatory bowel disease (IBS), chronic ulcerative colitis, or Crohn's disease;
  • have a family history of familial adenomatosis polyposis or hereditary nonpolyposis colon cancer.

In early 2006, the National Colorectal Cancer Roundtable published an evidence-based guide, How to Increase Colorectal Cancer Screening Rates in Practice. It is available free. Go to the National Colorectal Cancer Roundtable web site, www.nccrt.org, and click on the link, How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician's Evidence-Based Toolbox and Guide. The guide offers current screening guidelines and features checklists, chart prompts, tracking sheets, and other practice tools.