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New guidelines for cancer screening

Dr. Deb Dittberner1 / 2
Dr. Bruce Evink2 / 2

Dr. Deb Dittberner, Alomere Health physician and chief medical officer, was well aware of the alarming numbers when it came to colon cancer.

Since 1995, colon cancer cases with people under the age of 50 had increased by 51 percent.

New guidelines released last week from The American Cancer Society call for screenings to begin at age 45 for people at average risk, based in part on data showing growing rates of colorectal cancer in people who are young and middle-aged.

Although there is no definite answer as to why, Dittberner believes that diets high in fats and meats might have something to do with the increase.

Dittberner and Dr. Bruce Evink, physician and medical director at Sanford Health Broadway Clinic in Alexandria, both noted that the U.S. Preventive Services Task Force has yet to change its recommendations. The task force recommends clinical preventive services such as screenings that physicians typically follow.

"The task force hasn't followed suit yet, but they usually will," said Dittberner.

Regardless of the source of the recommendations, Dittberner and Evink agree that getting screened for colon cancer is a good idea. Although a colonoscopy is what they both called the "gold standard" of testing, there are other options, such as the fecal immunochemical test (FIT), which tests for hidden blood in a patient's stool.

It doesn't matter what test is used, Dittberner said. The best one is the one that gets done.

"The FIT is simple and easy and I push a lot of these," she said.

Evink said the emphasis should be on getting screened, regardless of what type of test is being used. He also uses the FIT.

"Colon cancer is preventable," said Evink. "By getting screened, we should catch the vast majority of cases. The earlier detection the better as it can be removed."

Evink and Dittberner couldn't stress enough the importance of getting screened.

Dittberner said Alomere Health has a direct access lab that patients can just walk into and they don't have to make an appointment. Many lab tests can be done, including the FIT, and she said the test only costs $25.

Every year in the U.S., 140,000 patients are diagnosed with colon cancer, said Dittberner, and 50,000 of those patients die. She said it is one of the top five cancers.

"We need to stay on top of our health. Pick a test and get screened," she said.

New guidelines

The updated recommendations from the American Cancer Society are:

• Adults ages 45 and older with an average risk of colorectal cancer undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) exam, depending on patient preference and test availability.

• As a part of the screening process, all positive results on non-colonoscopy screening tests should be followed up with a timely colonoscopy.

• Average-risk adults in good health with a life expectancy of greater than 10 years should continue colorectal cancer screening through age 75. Clinicians should individualize colorectal cancer screening decisions for individuals ages 76-85, based on patient preferences, life expectancy, health status and prior screening history. Clinicians should discourage people over age 85 from continuing colorectal cancer screening.

• The recommended options for colorectal cancer screening are: fecal immunochemical test (FIT) annually; high sensitivity guaiac-based fecal occult blood test annually; multi-target stool DNA test every three years; colonoscopy every 10 years; CT colonography every five years; or flexible sigmoidoscopy every five years.

The new guideline does not prioritize among screening test options. Given the evidence that adults vary in their test preferences, the guidelines development committee emphasized that screening rates could be improved by endorsing the full range of tests without preference.

Celeste Edenloff

Celeste is a reporter for the Alexandria Echo Press and has lived in the Alexandria Lakes Area since 1997. She first worked for the Echo Press as a reporter from 1999 to 2011, and returned in June 2016 to report on the community she calls home. Besides writing articles for the Echo Press, she has a blog, “Newspaper Girl on the Run.” Celeste is on a continuous healthy living journey and loves to teach bootcamp fitness classes and run. She has participated in nearly 200 races with her husband, Al, covering the 5K, 10K, 10-mile and half-marathon (13.1 mile) distances.

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