Over 50 and Avoiding Colon Cancer Screening? Here’s Some Good News

colon cancer screening

By Jessica Ellsworth, MD –

Health Screenings—What You Need to Know 

It’s no secret that as women age, their list of health concerns grows longer. But because not all health issues arrive with clear symptoms to alert you that something is wrong, screening is essential to the early detection and even prevention of disease.

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In general, women tend to be very proactive when it comes to their health. Data show that 75 percent of women are up to date with breast exams and mammograms, while 80 percent are in compliance with the recommended screening for cervical cancer. These high rates of compliance are true success stories—mammograms and Pap tests have saved countless lives.

But if you’re over 50 and avoiding colon cancer screening, you’re not alone…and it’s a big problem.

Colon cancer will kill more than 50,000 Americans this year alone—more than breast cancer and cervical cancer combined—and yet only about 40 percent of those who should get screened actually do.

Screening is critical because most colon cancers develop slowly over several years. In fact, before cancer develops, a polyp—or non-cancerous growth—usually appears on the inner lining of the colon or rectum. These polyps may take 10 to 15 years to become cancerous, so early identification and removal of them can effectively prevent cancer from ever forming. In addition, because most polyps and early-stage cancers cause no symptoms, the only way to detect them early is through regular screening.

The American Cancer Society recommends that men and women get screened for colon cancer beginning at age 50; however, 23 million Americans in this age group are not getting screened. As a result, more than 60 percent of colon cancer cases are detected in the late stages when treatment is difficult and survival rates are low.

So why are so many women who diligently follow through with other types of cancer screening so quick to put off testing for colon cancer?

One of the key reasons is that screening options for colon cancer often are considered unpleasant and undesirable. Many physicians still look to colonoscopy as the preferred method to screen for and diagnose colon cancer. What makes colonoscopy so effective is that doctors are able to visually inspect the colon for signs of cancer and then, during the same procedure, remove any potentially problematic tissue or polyps. While highly effective, many patients are unwilling or unable to undergo the procedure because it’s invasive and requires bowel preparation, sedation and time off of work to complete.

Alternative tests, such as a fecal occult blood test (FOBT) and fecal immunochemical test (FIT), were developed as noninvasive options. Both are designed to detect blood in stool that is not evident to the naked eye. However, there are unrelated conditions that can cause blood in stool, and not all polyps or lesions consistently bleed—or bleed at all—so these tests many not be reliable on their own.

Testing for Colon Cancer—Your Call to Action 

If you’re someone who has avoided colon cancer screening, we have good news.

Approved by the FDA last year, Cologuard® is a noninvasive screening test that can be done in the comfort of home with no prep. The concept behind the test is simple: every day during the digestive process, normal cells, as well as abnormal cells associated with cancer and precancer, are shed from the colon wall and picked up by the stool as it passes through the colon. Cologuard is designed to analyze stool samples for the presence of both blood (similar to FIT and FOBT) and abnormal DNA known to be associated with cancer and pre-cancers.

The process couldn’t be easier. Once you get a prescription from your healthcare provider, a Cologuard kit arrives at your front door. You collect a stool sample at your convenience and return the kit via a prepaid mailer. In about two weeks, your healthcare provider will provide you with the results. If the test comes back positive, you will be referred for a diagnostic colonoscopy. If the test is negative, you should continue to participate in a screening program at an interval and with a method appropriate for you based on a discussion with your doctor. 

A study in the New England Journal of Medicine found that Cologuard was accurate in identifying 92 percent of cancers and 69 percent of the most advanced precancerous polyps in average risk patients with 87 percent specificity. The test is covered by Medicare and a growing number of private health insurance companies.

Colon cancer is preventable and treatable if caught early. Women today are fortunate to have a growing number of screening options available to them and, as physicians, we are hopeful that the availability of new tests like Cologuard will encourage patients previously hesitant about or resistant to screening to get tested. Ultimately, the best test is one that gets done, so whatever method you opt for, what’s most important is that don’t put it off screening any longer. Today is the day to call your physician and check colon cancer screening off your to do list…it could save your life.

 

Jessica Ellsworth, MD is a Family Medicine Board Certified physician at Family Medicine of Scottsdale, AZ.

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Over 50 and Avoiding Colon Cancer Screening? Here’s Some Good News
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