UK HealthCast: Colorectal Cancer Screening

UK HealthCast is a podcast series featuring interviews with UK HealthCare experts on a variety of health-related topics.

Colon cancer remains one of the leading causes of cancer deaths in the United States, but early detection through screening significantly improves survival rates. On this edition of UK HealthCast, Dr. Avinash Bhakta, a colorectal cancer surgeon at the UK Markey Cancer Center, discusses emerging colon cancer screening options and the importance of early detection.

Here are some key takeaways from Dr. Bhakta's conversation.

When should I consider a colon cancer screening?

Dr. Bhakta encourages patients to ask their primary care providers about colon cancer screening, even if they are below the recommended age. A strong patient-provider relationship can help identify early warning signs.

Changes in bowel habits, unexplained rectal bleeding and family history are key indicators that should prompt discussions about screening options with a primary care provider.

Why colon cancer screenings are crucial

• Screenings are essential for early detection, allowing doctors to remove precancerous polyps before they develop into cancer and increasing survival rates. However, many patients avoid screenings due to barriers, such as the need to take time off work and the stigma around colonoscopies. Addressing these barriers can help patients avoid late-stage cancer diagnoses.
• In 2002, Kentucky ranked 49th in the U.S. for colorectal cancer screening. Over the years, efforts by groups like Kentucky CancerLink and community-driven initiatives have improved this ranking dramatically. Kentucky most recently ranked 15th in the nation for screening eligible individuals.
• The recommended age for screening has dropped from 50 to 45 due to an increase in early-onset colorectal cancer.

Traditional barriers to colon cancer screening

• Time and preparation: One of the biggest challenges to screening is the need to prepare for a colonoscopy, which often requires two days off work.
• Although colonoscopy procedures are less invasive with modern sedation techniques, the procedure’s nature still deters some patients.

New screening options: the Shield test

• Introducing the Shield test: A blood-based screening test known as the Shield test, recently approved by the FDA, is showing promise for early detection of colorectal cancer.
• Current limitations: According to Dr. Bhakta, the Shield test is an exciting development but is not yet recommended for all patients. While it’s effective at detecting cancer, it’s less sensitive in identifying precancerous lesions, making it more suitable as a preliminary screening tool.
• Who may benefit: The Shield test may benefit younger individuals (20s-30s) with symptoms like unexplained rectal bleeding or altered bowel habits, especially if they’re reluctant to undergo a colonoscopy. Patients at average risk for colon cancer — those without a significant family history or other risk factors — might find the Shield test or similar DNA-based tests appropriate.
• Who should avoid the Shield test: People with a family history, previous medical issues, or symptoms such as unexplained rectal bleeding should prioritize a colonoscopy over the Shield test to ensure a comprehensive assessment.

UK Markey Cancer Center’s role

• National Cancer Institute designation: The UK Markey Cancer Center’s status as Kentucky’s only National Cancer Institute-designated Comprehensive Cancer Center is pivotal for patient care.
• Access to advanced treatments and trials: This designation enables the center to offer cutting-edge treatments and clinical trials, particularly beneficial for rural patients who might otherwise struggle to access specialized care.
• Outreach and support for rural communities: Markey Cancer Center collaborates with local hospitals to ensure patients in rural Kentucky receive standard-of-care treatments and recommendations, reducing the need for long-distance travel.

Early detection of colon cancer saves lives, and Kentucky has made notable progress in its screening efforts. However, there is more to be done, particularly for younger individuals and those facing barriers to traditional screening methods. 

It's never too early to ask your primary care physician if you have concerns about colon cancer.

“It's always good to bring these things up because that's the whole relationship that we have as physician and patient,” Dr. Bhakta said. “You got to be open with us and let us know what's going on and then trust that we're going to do what's best for you.”

Click here for more information about colon and rectal cancer.