Colon Cancer Screenings

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Why 45 is the new 50

Your first few birthday milestones are pretty exciting:

  • At 16, you can drive.
  • At 18, you can vote.
  • At 21, you can (legally) drink.

The next few? Not so much:

  • At 30, you need to get serious about your future.
  • At 40, you’re suddenly over the hill.
  • At 50, you need to schedule your first colonoscopy.

Despite the anxiety of thinking about a colonoscopy, they are the smartest decision you can make for your health. So much so that health experts are pushing the clock back on when you should get one.

What is Colorectal Cancer?

Colorectal cancer, also known as colon cancer,  is a disease where cells in the colon or rectum grow out of control. The colon is the large intestine or large bowel, and the rectum is the passageway that connects the colon to the anus.

Sometimes abnormal growths, called polyps, form in the colon or rectum. Over time, some polyps may turn into cancer. Screening tests can find polyps that can be removed before turning into cancer. Screening also helps find colorectal cancer at early stages, when treatment works best.

Getting to the Bottom of Your Health Earlier

The American Cancer Society recommends people at average risk of colorectal cancer start regular screenings at 45. “Average risk” means you do not have:

  • A personal history of colorectal cancer or certain types of polyps
  • A family history of colorectal cancer
  • A personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
  • A hereditary colorectal cancer syndrome
  • A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a previous cancer

Why the Rebuttal

The recommended age was lowered from 50 to 45 because colorectal cancer cases are increasing among young and middle-aged people, and the mortality rate for people under age 55 increased 1% per year from 2008 to 2017.

The American Cancer Society also reported that colorectal cancer is expected to cause about 53,000 deaths in 2021.

Light at the End of the Tunnel

Colon cancer is a sobering topic, but it’s preventable with regular screenings and treatable if found early. A colonoscopy is the best way to detect the disease, and it can also prevent cancer because precancerous polyps can be removed during the procedure.

A Timeline for Colon Cancer Screenings

Along with the American Cancer Society and the U.S. Preventive Services Task Force, Adena recommends starting regular cancer screenings at age 45 and following this timeline:

  • Age 45: Begin your regular screenings with either a sensitive test that looks for signs of cancer in your stool (a stool-based test) or with an exam that looks at the colon and rectum (a visual exam).
  • Ages 50-75: People who are in good health should continue regular colorectal cancer screening through the age of 75. The frequency of these tests will be determined by your primary care provider.
  • Ages 76 -85: Screenings are based on personal preferences, life expectancy, overall health and prior screening history.
  • Over 85: Screenings are no longer necessary.

Screening Options

There are several test options available for colorectal cancer screenings. Your doctor will determine which one is right for you based on your risk factors.

Here are the six tests available and how often they should be taken:

  • Stool-based tests
    • Highly-sensitive fecal immunochemical test (FIT) every year
    • Highly-sensitive guaiac-based fecal occult blood test (gFOBT) every year
    • Multi-targeted stool DNA test (mt-sDNA) every 3 years
  • Visual (structural) exams of the colon and rectum
    • Colonoscopy every 10 years
    • CT colonography (virtual colonoscopy) every 5 years
    • Flexible sigmoidoscopy (FSIG) every 5 years

What to Expect

During a colonoscopy, a long, flexible tube (called a colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows a doctor to view the inside of the entire colon.

Before a colonoscopy, you'll need to clean out (empty) your colon. Residue in your colon can skew the view of your colon and rectum during the exam.

Most people will tell you that the worst part of a colonoscopy isn’t the procedure itself; it’s the preparation. You will be given a sedative before your procedure, helping to make it relatively painless. The preparation includes:

  • Diet - You won't be able to eat solid food the day before the exam. Drinks may be limited to clear liquids, such as water, tea and coffee (without milk or cream), broth and carbonated beverages. You may not be able to eat or drink anything after midnight the night before the exam.
  • Laxatives - Your doctor will usually recommend taking a laxative, in either pill form or liquid form. You may be instructed to take the laxative the night before your colonoscopy, or you may be asked to use the laxative both the night before and the morning of the procedure.
  • Enemas - In some cases, you may need to use an over-the-counter enema kit — either the night before the exam or a few hours before the exam — to empty your colon. This is generally only effective in emptying the lower colon and is usually not recommended as a primary way of emptying your colon.

Preventive Care is Always Smart

As with most routine medical procedures, technology has made colonoscopies easier and more convenient. Yes, they can be a pain in the butt to schedule and prepare for, but no one ever regrets getting it done – especially when it can prevent serious and potentially deadly health issues down the road.