North Dakotans, Take the First Step: Early Detection for Colon Cancer

by Zach Sebens

December 2023

Colorectal cancer (CRC) ranks as the second most diagnosed cancer affecting both men and women in North Dakota, according to a recent North Dakota Burden of Cancer report. Another recent report from the Centers for Disease Control and Prevention said that in 2020, over 300 new cases of colon cancer were diagnosed in North Dakotans and around 120 people died from CRC.

The good news about these numbers? Compared to previous years, they represent a downward trend. Fewer people are dying from CRC. This shows that doing things to prevent the disease and checking for it early really makes a difference.

The North Dakota Department of Health and Human Services, with a goal to save lives and detect colon cancer earlier in North Dakotans, has signed on to the National CRC Roundtable 80% in Every Community initiative because in recent years only about 75% of those who could be tested for CRC were tested which means there is still some room for improvement. Understanding what increases the risk of CRC, the available testing options, and identifying those who may benefit most from testing is essential for improving early detection.

Starting with things that increase risk, age is the most important, with the majority of cases occurring after the age of 50. In the past few years, a concerning rise in CRC rates among younger individuals has led many health organizations, like the American Cancer Society, to now recommend screenings to start at age 45 instead of 50.

In addition to age, experts know that other risks include a family history of colon cancer or certain inherited conditions, as well as excessive weight, smoking, and a diet high in red and preserved meats Individuals with these risks should be particularly vigilant about screening.

If someone has already been screened and abnormal growths were found, screening needs to continue. Three options are available. The first option, considered the highest standard for CRC screening, is colonoscopy. This procedure involves examining the entire colon using a long, flexible tube with a camera. Colonoscopy allows for a thorough look at the entire colon and the removal of any suspicious growths that might turn into cancer. It is generally recommended every ten years if the first test is normal. If a suspicious growth is removed and actually found to be precancerous, a colonoscopy might need to be repeated more often.

The second option, now growing in popularity, is the Fecal Occult Blood Test (FOBT). This test detects hidden blood – blood that can't be seen by the naked eye but is leaking from an early cancer – in fecal samples collected at home and taken back to the provider for processing. It can be done without surgery or without entering the body and should be performed yearly. If blood is detected, further evaluation with colonoscopy is necessary.

The third option is a DNA test. This newer screening option is also done on feces collected at home. It actually detects genetic material being shed by early CRC. It currently is recommended every three years. It also may be recommended for high-risk individuals who aren't candidates for the preferred colonoscopy.

Remember: Colorectal cancer is North Dakota's second most diagnosed cancer, but early detection can turn the tide using various testing methods from colonoscopy to non-invasive tests like FOBT and stool DNA tests. While age and lifestyle factors can elevate risk, the push for earlier screenings at age 45 has also grown. Also remember this, North Dakotans: Seize control of your health. Schedule your screening today. Safeguard your future health.

This article also appeared in the December 28, 2023 issue of the Oakes Times.

About the Author

Zachary Sebens is a fourth-year medical student at the University of North Dakota School of Medicine & Health Sciences. As a participant in patient care experiences offered in Oakes, North Dakota, he chose to participate in the Targeted Rural Health Education program, or TRHE. The program focuses on teaching student doctors the importance of rural newspapers as a way to share health information with rural community members. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed practitioner.