Follow-up Colonoscopy Critical for CRC Diagnosis



Colorectal cancer (CRC) is a leading cause of cancer death in the U.S., but it is preventable through timely screenings.

Healthcare agencies recommend people at average risk for developing the disease get their first screening at age 45.

Many individuals choose a noninvasive, stool-based CRC screening option they can do at home. These tests are convenient, but they cannot diagnose polyps or tumors, and they cannot prevent colon cancer development.

Experts advise anyone who receives an abnormal stool-based test result to follow up with a colonoscopy within six months to diagnose colorectal cancer.

CRC Risk, Complications Increase

In a study published in JAMA Network Open, the results showed low follow-up screening rates in patients who had a stool-based screening test for CRC. In fact, 49 percent of the patients who received abnormal screening results did not complete the recommended follow-up colonoscopy within six months.

The mixed-methods cohort study used data collected between June 1, 2015, and June 30, 2021. The study included 32,769 individuals who were Black, White, Asian and Hispanic aged 50 to 75 years.

The results show 51.4 percent received a follow-up colonoscopy after a positive stool-based test within six months. The follow-up rate was 56.1 percent within 360 days.

Follow-up rates were lower with individuals who were Black or Asian, those on Medicare or Medicaid, and those who chose a FIT screening test (vs. mtDNA).

Jeff T. Mohl, PhD, from the American Medical Group Association in Alexandria, Virginia, and colleagues conducted the study and commented on the results.

“At-home stool-based testing offers a useful tool to supplement routine colonoscopy and reach a wider patient population. Nonetheless, it is important to emphasize that all positive stool-based tests must be followed by a timely colonoscopy to complete the screening paradigm,” the authors advised. “Not completing a colonoscopy after a positive [stool-based test] is associated with a significantly higher risk of CRC complications and mortality.”

When CRC is found at an early stage — before it has spread to other organs — the five-year survival rate is about 90 percent. If colorectal cancer is found early, it often allows for more treatment options, according to the American Cancer Society. It is important to note only about 4 out of 10 colorectal cancers are found at an early stage.

Get Screened at Age 45

If you are 45 and at average risk for CRC, it is important to ask your doctor about getting screened for colorectal cancer. Earlier screening is advised for patients with a family history of CRC or polyps as well as those with digestive symptoms that may be caused by CRC.

Several options are available, but colonoscopy is the only screening method that can both detect and prevent colorectal cancer. Although it is more invasive than other screenings, colonoscopy includes a complete examination of the large intestine. CRC often begins as a growth, called a polyp, inside the colon or rectum. Doctors can find and remove polyps during a colonoscopy before they become cancerous.

If you receive an abnormal stool-based test result, schedule a colonoscopy within six months. Failing to follow up or delaying the procedure may increase your risk of colon cancer and result in an advanced stage of the disease at diagnosis.

Quality care is available at our surgery centers around the country for your first CRC screening or a follow-up colonoscopy.