By Matthew Clayton, MD, Surgeon, Vibrant Health Family Clinics
It seems most people know that they should have colon cancer screening, but many decide not to do it. Many tell me they are afraid that we will discover a colon cancer and they just don’t want to know. Others tell me getting the screening done with a colonoscopy is not convenient because they have to take the “icky” prep the night before and then take a day off work. And many patients have told me their colon is “a one way street” and no one is going to go the wrong way!
The truth is colon cancer screening is important and everyone should do it. The American Cancer Society, the CDC (Centers for Disease Control) and the U.S. Preventative Services Task Force all recommend screening for all people starting at 50 years of age (or earlier for some people). People who have a very strong history of colon cancer in their immediate family and those who have certain diseases of the large intestine like Crohn’s disease or ulcerative colitis should have screening before 50.
Three Reasons Colon Cancer Screening is Recommended for Everyone
- When Symptoms Appear, It May Be Too Late.
The first reason is colon cancer almost never has symptoms until it has grown to a size where it is very hard to treat. On the rare chance we do find a cancer with screening and it is a small size, it is possible to remove the cancer so that no further treatment, like chemotherapy, has to happen. As a doctor and a surgeon who removes colon cancers, I like that a lot!
- Cancer is Preventable.
You do not have to get colon cancer. People who get recommended screening get colon cancer 80% less than those who do not get screened. The goal of screening is not to find a cancer, but to find a growth and remove it before it causes trouble.
- Cost Effective
Although the screening tests do cost money, it is much cheaper to be screened than to have colon cancer surgery and chemotherapy. So much cheaper that if everyone got screened, we’d save a lot of money for the health care system. This is one of the reasons that President Obama made health insurance companies pay for preventative services like colonoscopy in the Accountable Care Act (ACA or “Obamacare”).
Colon Cancer Screening Options
There are three main ways to get colon cancer screening.
The first is a simple test called FIT that looks for blood in the poop. Pretty much everyone knows that you should not have blood in your poop, so if there are tiny amounts of blood, it may mean that a large polyp or cancer is growing.
The second test is new and is called Cologaurd. This test was developed at the Mayo Clinic and it looks at the poop to detect tiny amounts of DNA that are found with polyps and cancers. The nice thing about both FIT and Cologaurd is there is no prep needed and you do not have to take any time off of work to do them. They are done at home at your convenience.
The final way to screen is colonoscopy. This is the test where you take a prep to clean out the large intestine the day before and then go to a center where the test is done. You get an IV in your arm and then sedation medication. A small, flexible tube is inserted into the rectum to look at the entire large intestine. Although it is a lot more work to get a colonoscopy than FIT or Cologaurd, the doctor who is doing the colonoscopy will remove any polyps that are found. If the FIT or Cologaurd tests are positive, your doctor will recommend that you have a colonoscopy to find out why the test was positive.
Should you have colon cancer screening? Yes! Do it for yourself, your family, and your country! Don’t fret over which is the best test, just decide to get screened and talk to your doctor about which test works best for you.
Please remember, doctors are very good at treating illness, but it is up to each and every one of us to do what we can to stay healthy and not get sick in the first place. Eat a good, balanced diet with lots of fresh fruits, vegetables and whole grains. Get regular exercise and good sleep. Be active in your community. Be healthy and be Vibrant!