Colon Cancer Screening: Lifesaving Conversations
September 27, 2018 | Preventive Care
As a primary care provider at Iora Primary Care, I spend the bulk of my time working with patients on their long-term health issues, including things like heart disease, asthma, chronic obstructive pulmonary disease, diabetes and blood pressure. Helping people make the lifestyle, diet, and medication changes they need to stay well is professionally satisfying and crucially important. Oftentimes, though, we are working to manage problems after they’ve already occurred.
One of the things I find most satisfying about working in my field is helping my patients prevent problems later on in life. This includes maintaining a healthy, well-balanced diet, staying physically active, and helping my patients stay up to date with vaccinations and cancer screenings.
One important area of health maintenance and prevention is colon cancer screening.
Colon cancer is a common and serious form of cancer. It is the second most common cause of cancer deaths in the United States, and it accounts for almost 10% of all cancer deaths annually.
Over the years, we’ve learned a lot about colon cancer and how it develops. At its root, colon cancer develops when an adenoma, or benign glandular tumor, grows into a polyp, then eventually progresses to become cancer. The great news is that when adenomas are identified early, they can be removed, and removing these is proven to prevent cancer! What’s more, in recent years rates of death from colon cancer have been dropping; some studies suggest that about half of the decrease in colon cancer deaths may be related to improved screening efforts.
Screening for colon cancer takes place by a few different means, each with their own advantages and disadvantages.
These procedures evaluate the internal structures of the colon and rectum for any abnormalities. Most commonly, this is done by colonoscopy, a procedure in which a very small scope and camera are passed through the colon. While these tests are more invasive, they allow a definitive view of a person’s anatomy. This means that if the test is negative, a person may be able to wait as long as 10 years for their next colonoscopy!
Stool based tests:
These are convenient, can be done in the comfort of your own home, and are non-invasive. However, because they don’t take a direct look at your gastrointestinal tract, they need to be done more frequently (usually once per year). If a test is positive, it will still need to be followed up with a colonoscopy.
The U.S. Preventive Services Task Force recommends that for most people, colon cancer screening should start at age 50 and continue until age 75. Citing a recent increase in the incidence of colon cancer among young people, the American Cancer Society has updated their own guidelines to suggest starting colon cancer screening at age 45. There’s likely to be some disagreement between these organizations in the short term. People with a family history of colon cancer may be advised to start screening even before age 45. Regardless of where you fit on this spectrum, I recommend making time to talk with your primary care provider about your cancer risks, your questions about testing, and what’s right for you when it comes to screening. It’s a conversation that could save your life!