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Colonoscopy: Is it Worth it?

Publication: Healthy Magazine

There are several things on my “to do” list that I’m really good at putting off. They need to be done, but I don’t like disrupting my routine or taking time away from other activities to make them happen. However, when it comes to cancer screenings, it’s worth a little disruption.

We often think it won’t happen to me. I’m healthy. My family doesn’t have a history of cancer. But, cancer isn’t always predictable. For common cancers, like colorectal cancer, getting regular screenings can make the difference between being diagnosed at stage I or at stage IV, at which point the chances of survival decrease dramatically. In fact, approximately 90 percent of colorectal cancer could be prevented by removing colon polyps, which can turn into colon cancer.

In the United States, colorectal is the third most commonly occurring cancer, with an estimated 140,250 new cases and 50,630 deaths expected in 2018. One reason for the high number of deaths is that colorectal cancer often displays no symptoms in early stages, meaning most cases aren’t diagnosed until the disease is more advanced or is found through screenings. Fortunately, with early detection, the five-year survival rate could increase to more than 90 percent.

Know Your Screening Options

Men and women age 50 and older with an average risk for developing colorectal cancer should discuss the most appropriate screening test with their physician. Below are the options:

Colonoscopy is the preferred screening test. A colonoscopy is a great example of something many would prefer not to do and often delay. Colonoscopies get the worst reputation of all of the cancer screenings, and it’s not hard to see why. We generally don’t discuss it at the dinner table, and it might be a bit embarrassing. Between the prep and the procedure, you have to invest a bit of time. But at the end of the day, it is worth it.

Colonoscopies are a great investment of your time. We spend a lot of time protecting our health by staying active and eating right, and it only makes sense to protect our health in this way too. Unlike screening for other cancers that need monthly self-exams, most people only need a colonoscopy once a decade. As an added bonus, a colonoscopy is unique as it is the only test that can be both a screening and a preventive exam, since precancerous polyps could be removed during the same procedure.

A colonoscopy simply isn’t as bad as its reputation. Yes, you have to prep, which is probably the worst part. Yes, you’ll definitely want to be home the afternoon before your procedure. However, we are confident that if you asked our patients, most would tell you that the prep wasn’t as bad as expected; the procedure itself is a piece of cake – after all, you are asleep; and the peace of mind makes it all worthwhile.

For those who decline or cannot get a colonoscopy, other screening tests include:

Flexible sigmoidoscopies allow physicians to see inside the lower colon and rectum through a narrow tube with a small camera attached to one end, called a sigmoidoscope. This is also an effective tool for finding the cause of unexplained symptoms, such as anal bleeding, unusual bowel activity, and abdominal pain. A large part of the colon, however, is not screened with this procedure.

Virtual colonoscopies enable physicians to see inside the body using X-rays and a computer to create images of the colon and rectum. A virtual colonoscopy, or CT colonoscopy, can see ulcers, polyps, and cancer. If polyps are seen, a regular colonoscopy is needed to remove them.

Double-contrast barium enemas also enable doctors to view the colon and rectum using X-rays.

Stool DNA (sDNA) test identify abnormal sections of DNA from cancer or polyp cells, as cancer cells often show DNA mutations in certain genes.

Guaiac-based fecal occult blood test (FOBT) or fecal immunochemical test (FIT) tests that detect blood hidden in the stool. If the results are positive for hidden blood, a colonoscopy will be needed to investigate further.

Risk Factors

Age: People age 50 and over have a higher risk of developing colorectal cancer. However, colorectal cancer in people under 50 is rising, accounting for 10 percent of cases.

Family History: People with a family history of colorectal polyps along with a family history of colorectal cancer are at greater risk. Those with a family history of polyps or colorectal cancer should consult a doctor about screening frequency.

Inflammatory Bowel Disease: People with inflammatory bowel disease have a higher risk of colorectal cancer.

Diet: Diets that contain large amounts of red and processed meats can increase risk.

Personal Health: Overweight and inactive people are at a higher risk. Type 2 diabetes has been linked to an increased risk of colorectal cancer. People with a history of polyps are also at an increased risk, and may need earlier or more frequent screening. Long-term smoking and heavy alcohol use raise the risk as well.

Lynch Syndrome (HNPCC): This inherited condition affecting the body’s genes increases risk of colorectal cancer. Lynch syndrome is responsible for 3 percent of colorectal cancers, and those with the condition have a lifetime risk of up to 80 percent of developing colorectal cancer. Genetic testing can determine if a person has the gene mutation associated with Lynch syndrome.

Although all men and women over the age of 50 should be regularly tested, certain risk factors, like personal history of inflammatory bowel disease or family history of colorectal cancer, may impact the screening frequency or starting age.

Bite the Bullet

March is colon cancer awareness month. If you’re due for a screening, schedule an appointment with your physician to discuss prevention and get a colonoscopy if necessary. Now that you know your options, it’s time to move it from your “to-do” to your “done” list. You won’t regret the decision.

Daniel Farray, M.D. and Habib Ghaddar, M.D., FACP are medical oncologists and hematologist at Texas Oncology–Weslaco, 1330 E. 6th Street, Suite 204 in Weslaco, Texas. To learn more about exciting advancements in cancer treatment, visit www.TexasOncology.com or call 1-888-864-I CAN (4226).

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