Have You Had Your Colonoscopy Yet?

11/2/2018

by: Anupamjeet Sekhon, M.D.

If you’re thinking, “A colonoscopy?! Isn’t that a test for OLD people?,” you may want to take a closer look at recent news from the American Cancer Society. The ACS this year altered their recommendation for timing of a first-time colon cancer screening from age 50 to age 45, for those at average risk of cancer. The change was directly tied to the rising number of younger adults being diagnosed with colorectal cancers – including many with no family history of the disease.

Colon cancer is the third most common form of cancer in the United States, with an expected 90,000 new cases of colon, and 40,000 cases of rectal, cancers expected to be diagnosed in 2018. The National Cancer Institute reports that an average of 113 people in the South Texas Crossroads were diagnosed with rectal or colon cancer between 2011 and 2015.

In addition to the changes in screening age, the ACS also issued some additional guidance on screening methods that patients and their doctors can consider. If a colonoscopy is not recommended at this time, or there are financial or other barriers to the procedure, talk to your physician about one of these less invasive screening methods:

• Fecal immunochemical test (FIT) – stool-based test recommended once per year
• Guaiac-based fecal occult blood test (gFOBT) – stool-based test once per year
• Multi-targeted stool DNA test (MT-sDNA) – stool-based test, once every 3 years
• CT Colonography – “virtual colonoscopy,” once every 5 years
• Flexible sigmoidoscopy (FSIG) – once every 5 years

While colonoscopy remains the gold standard, there are several diagnostic and lab tools that can screen for the presence of blood or polyps in the colon. However, an abnormal result in any of these tests MUST be followed by a full colonoscopy, in order to mitigate the increased risk of cancer, and to promptly remove any polyps. This fact should be considered by both patient and physician, before any of these lesser screening methods are used.

Finally, the new guidance includes very specific precautions for those at increased risk of colon cancer. For these patients, the physician may advise initial screening BEFORE age 45, being screened more often, and/or using specific screening methods to ensure polyps are found and removed early, before they can become cancerous. These risk factors include:

• A personal or family history of colorectal cancer, or of certain types of polyps
• A personal history of ulcerative colitis or Crohn’s disease
• A history of radiation in the abdomen or pelvis, in treatment of previous cancer(s)
• A genetic and hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome

While it is one of the most common forms of cancer, colon cancer is also highly preventable and treatable. Healthy diet and lifestyle choices, combined with proactive screening and prompt removal of any polyps, can dramatically reduce your risk of contracting this disease. Also, never ignore changes of any kind in your bowel habits – be prepared to share details with your physician, including frequency, consistency and any type of discomfort or dysfunction.

Dr. Anupamjeet Sekhon is in her second year of residency at DeTar Family Medicine Center. She is accepting new patients to her family medicine practice.

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