Amy Lightner, MD, is a nationally recognized colorectal surgeon, clinical researcher, and professor of molecular medicine at Scripps Research Institute in San Diego, California. Through her work in colorectal surgery and inflammatory bowel disease research, Amy Lightner, MD, has contributed to advancements in preventive care, clinical trials, and stem cell therapies related to gastrointestinal diseases. She also practices at Scripps Clinic Medical Group and previously served in leadership positions at Mayo Clinic and Cleveland Clinic. Over nearly two decades, she has led multiple Phase I–III clinical trials and authored hundreds of peer-reviewed publications focused on colorectal medicine and inflammatory bowel disease. Her leadership roles with organizations such as the American Society of Colon and Rectal Surgeons and the Crohn’s and Colitis Foundation reflect her long-standing involvement in advancing awareness, treatment, and prevention strategies related to colorectal health, including the importance of regular colorectal cancer screening.
How Screening Helps Prevent Colorectal Cancer
Colorectal cancer is cancer of the colon and rectum. It is a big problem in the United States, being the third most prevalent non-skin cancer and the second highest cause of cancer deaths in the country. In fact, it surpasses breast cancer and prostate cancer in mortality cases combined.
More than 140,000 people receive a colorectal cancer diagnosis each year. The lifetime risk among men is 4.4 percent and among women is 4.1 percent. Unfortunately, of the people diagnosed every year, over 50,000 die.
This does not have to be the case, though. With the right preventive measures, people can minimize their risk of developing the cancer. One of the top preventive measures they should take is screening.
Regular screening leads to early detection of precancerous colon polyps. Colorectal surgeons can remove these polyps, stopping the development of colorectal cancer. Even if the cancer had developed, screening increases the likelihood of catching the cancer early when surgery can cure up to 90 percent of cases.
ASCRS estimates that over 40,000 lives can be saved annually if people take up regular screening for colorectal cancer. And there are several types of screening tests available, starting with colonoscopy, the gold standard for colorectal cancer screening. This test involves passing a small tube with a camera at the tip through the rectum and colon of a patient, allowing surgeons to analyze the lining of these organs. They can even take samples of abnormal parts and send them to the lab for testing.
Other types of screening tests are fecal occult blood testing which involves testing stool samples for hidden blood from colorectal polyps and stool DNA testing which tests for cancer/precancerous cells in stool. There is also flexible sigmoidoscopy (an examination of only the lower portion of the colon through a tube with a camera), barium x-ray, and digital rectal examination.
ASCRS recommends starting screening at age 45. From that age, people should get a colonoscopy every 10 years or stool DNA testing every three years. Another alternative is a flexible sigmoidoscopy every five years coupled with yearly stool occult testing.
Certain people are at a higher risk of developing colorectal cancer and will need to start screening earlier or do it more frequently. For example, people who have a parent or sibling who developed colorectal cancer should start screening at 40 years or 10 years before the date when their close relative received their diagnosis, whichever is earlier. Once they start, they should undergo screening every five years.
A personal history of colorectal polyps also increases the likelihood of the cancer’s development. ASCRS recommends that these people should do a colonoscopy every three to five years, depending on the type and size of polyps found. If a person had actually developed colorectal cancer but it was successfully removed, ASCRS recommends that they do a colonoscopy within one year of the cancer’s removal. If the colonoscopy is normal, then they should do screening every three to five years.
People who have Crohn’s disease or ulcerative colitis are also at higher risk of colorectal cancer. ASCRS recommends they do colonoscopy with several biopsies annually or biennially.
Colorectal cancer screening is covered by Medicare and many types of commercial health insurance. Following ASCRS’s screening guidelines is important, especially for people who are high risk, because colorectal cancer often develops without exhibiting any symptoms. By the time symptoms like stool in blood, rectal bleeding, changes in bowel habits, weight loss, and gas pains appear, the cancer has developed to an advanced stage where treatment is harder.
About Amy Lightner
Amy Lightner, MD, is a colorectal surgeon at Scripps Clinic Medical Group and a professor of molecular medicine at Scripps Research Institute. Her work focuses on inflammatory bowel disease research, stem cell therapies, and colorectal surgery. She has led numerous Phase I–III clinical trials and authored more than 350 peer-reviewed publications. Lightner has also served in leadership positions with the American Society of Colon and Rectal Surgeons and the Crohn’s and Colitis Foundation. She earned degrees from Stanford University, Boston University School of Medicine, and the University of Texas at Austin.
