Have You Had Your Colonoscopy Yet?

3/20/2023

Abdul H. Qureshi, M.D., General Surgeon
Carlsbad Medical Center

If you’re thinking, “A colonoscopy?! Isn’t that a test for OLD people?,” you may want to think again. In 2018, the American Cancer Society 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.

March is Colorectal Cancer Awareness Month, and colon cancer is the third most common form of cancer in the United States, with an estimated 153,020 new cases of colon, and 46,050 cases of rectal, cancers expected to be diagnosed in 2023.

There is the potential for false perceptions regarding the changing data on colon cancer. While mortality rates from colon cancer have been declining over the past 30 years, the number of new diagnoses is actually increasing. This is both good news and bad news – we are doing a better job of screening for and removing polyps before they become cancerous, while lifestyle and diet choices are driving up the risk and incidence of these cancers in general.

A colonoscopy is performed using a long, thin, flexible tube, which is inserted through the rectum into the lower digestive tract, while the patient is sedated or asleep. The tube is equipped with a light and a tiny camera that transmits images of the patient’s intestinal lining to a computer screen located at the bedside. This enhanced view allows the doctor to see inflamed tissue and any abnormal growths.

If polyps (growths) are found during the exam, they are quickly and painlessly removed at that time, and later tested in a laboratory for signs of cancer. Polyps are common in adults, and usually harmless. However, most colorectal cancer begins as a polyp, so removing polyps early is an effective prevention method. Your doctor can also take samples from abnormal-looking tissues – a biopsy – during the colonoscopy, so that any suspicious areas can be examined for signs of disease and treated, if necessary.

Depending on your age, a colonoscopy screening may be a covered “wellness” test under your insurance plan – and most plans cover a colonoscopy completely as a follow-up test or diagnostic tool. Check with your insurance provider and your doctor’s office for help in scheduling a screening exam.

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, patients should be aware that 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.

There is also updated guidance regarding 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.

Your primary care provider can advise you about the right time to begin screening as well as the frequency of testing, but industry guidelines suggest that a repeat screening be conducted every 10 years for adults with normal risk.

Your risk level for colon cancer varies according to your age, gender and ethnic background, as well as your overall health and lifestyle. Factors that affect your risk level include:

• Advancing age (over age 45)
• Male gender
• African American ethnic status
• A family or personal history of polyps (growths inside the rectum or colon), or colorectal cancer
• A high-fat diet
• Certain digestive diseases, diabetes, Crohn’s disease, ulcerative colitis

Don’t delay - talk to your primary care provider about scheduling your colonoscopy. If you need a provider, visit www.PecosValleyDocs.com today.

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