Recently, researchers have noted a significant increase in colorectal cancer — the second deadliest cancer in the United States — in people under 50.
In 2018, the American Cancer Society lowered its recommendation for colorectal screening to age 45 in response to rising rates of colorectal cancer in younger people. In addition, those who live in the Midwest are statistically more likely to get colon cancer than in some other parts of the country.
The key to better colorectal cancer outcomes is early detection, with a survival rate of almost 89% when diagnosed early. If diagnosed at a later stage when the cancer has spread outside the colon, the survival rate falls to 16%.
These numbers are sobering. With preventive screening, however, it’s possible to catch colon cancer at an earlier stage when it’s most treatable.
To make it easier and more convenient for patients to complete their recommended screenings, Sanford Health launched an initiative to mail stool-based screening kits to patients. The tests allow people to check for potential signs of colon cancer in the privacy of their own home.
Finding cancer
Since launching this initiative in 2024, Sanford Health has mailed 40,000 kits to patients, resulting in the removal of precancerous polyps in more than 300 patients and diagnosing 10 patients with early-stage cancer.
“Those people wouldn’t have known they had colon cancer until it was at the incurable stage if we had not rolled this out,” said Jeremy Cauwels, M.D., Sanford Health’s chief medical officer.
Sanford rolled the project out in waves, to average risk patients who were overdue for colorectal screening. Sanford did not send kits to those who were high-risk and only eligible for a colonoscopy or those whose screenings were up to date.
“We were left with a bucket of people in the right age group who were of normal risk and needed to be screened,” Dr. Cauwels said. “We were able to reach out to a vast majority of people in that group. In subsequent years we will make sure we reach out to the people we missed this year. We will continue to try to help them out.”
Sanford Health offers two stool-based tests: the FIT test, which checks for blood in the stool, and Cologuard, which checks for both blood and cancer DNA biomarkers.
Photo by Exact Sciences
Taking the test
Stephanie Bladow, a 48-year-old from Bagley, Minnesota, was one of the thousands of people who took advantage of the convenience of an at-home screening and is now healthier because of it.
“I got a message back that I should have a colonoscopy to make sure I didn’t have cancer,” Bladow said. “It all came back fine after that. I was a little nervous when they said they had found something — I just didn’t know what to expect. But after they explained it to me and I went through the process it was like, ‘Well, this is a piece of cake.’”
Most patients who take a stool-based test will have normal results, meaning they can wait one to three years to test again. However, if the test returns an abnormal result, the patient will be contacted for follow-up testing, usually a colonoscopy. A colonoscopy can help detect and remove polyps, which are abnormal growths in the colon or rectum, before they become cancerous.
Janet Christianson is a nurse practitioner in family medicine at Sanford Bagley Clearbrook Clinic where Bladow had a colonoscopy after her stool-based test returned an abnormal result. Christianson says Bladow did all the right things to maintain her health.
“What Stephanie did is a very important part of cancer prevention and detection,” Christianson said. “Oftentimes the tests like Stephanie took don’t just tell you if there is presence of colon cancer, they can actually detect precancerous polyps.”
Patients may feel some anxiety if they need additional testing. Christianson often takes these calls and explains why there is not necessarily cause for serious alarm.
“It just means that we need to do a more sensitive screening test, like a colonoscopy, where we can actually visualize the lining of the colon to see if there are polyps here or anything more serious,” Christianson said. “I give that disclaimer ahead of time to alleviate any of that anxiety that might occur with a positive test.”
Smart starting point
Though stool-based tests are not always intended to replace colonoscopies, the kits identify potential issues by detecting blood in stool, which then can then prompt additional diagnosis.
The kits are convenient, non-invasive and do not require the preparation that accompanies a colonoscopy.
Screening kits can be a wise starting point for people who do not have:
- Symptoms of colorectal cancer, such as blood in your stool, abdominal pain, changes in your bowel habits or unplanned weight loss.
- A family history of a parent or sibling having colon polyps or colorectal cancer.
- A personal history of inflammatory bowel disease like Crohn’s disease or ulcerative colitis, colon polyps or colorectal cancer.
Home testing can also be a practical option for those who live in remote areas.
“It can be a more accessible, more affordable way to be assured you don’t have signs of colon cancer,” Christianson said. “And when you have a positive test, then you know you should make it more of a priority to get a colonoscopy.”
A kit in the mail
Denise Winters of Windom, Minnesota, had been postponing a colonoscopy because it would mean a 10-day break from taking Eliquis, her prescribed blood-thinning medication she had been taking for atrial fibrillation.
She received her stool-based kit from Sanford Health, took it out of her mailbox, submitted a sample as instructed and sent it back.
She then got a message via MyChart that she had blood in her stool.
“I was very thankful that I got the kit in the mail,” Winters said. “I was curious about why I got it, but I made a call and then it all made sense. They then informed me that it was in my best interest to have a colonoscopy, even though it would mean a break from taking Eliquis. My doctor found some polyps and another area he wants to continue to monitor.”
Winters will return in a year for another colonoscopy at the Windom clinic to make sure everything is OK.
Staying safe and healthy
“I didn’t really like the idea of needing a colonoscopy, but it was all very professional,” Winters said. “It was a lot easier than I was expecting it to be.”
For Winters, the road to better health began with checking the mail.
“The Cologuard kit is a very easy test to complete effectively,” Dr. Cauwels said. “You put a sample in the box, and you ship it back to Cologuard. They then communicate directly with us and your medical record. That’s important because some who send out these kits do not communicate directly with a patient’s medical record. Doing this through Sanford is the best way to ensure you get the right follow up and the right treatment.”
Learn more
- Colorectal cancer screening: Check out the options
- New colon cancer screening test goes to Sanford Labs
- Younger age for colon screening catches polyps early
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Posted In Cancer, Cancer Screenings, Digestive Health, Healthy Living
