I am 41 years old, so I have not had my first colonoscopy yet. Fortunately, colon cancer does not run in my family, and I don’t have other factors that would increase my risk for the disease. I know the day will come, though, and I am looking forward to a colonoscopy about as much as I am looking forward to a root canal.
The U.S. Preventative Services Task Force recommends that men and women be screened for colon cancer beginning at age 50. The gold standard for colon screening is the colonoscopy because it allows the doctor to view the entire length of the digestive tract and inspect it carefully for growths called polyps. If polyps are discovered during the colonoscopy, they can be immediately removed before they develop into cancer.
A new study in France suggests that colon screening should begin at a younger age because the rate of abnormal colon growths increases dramatically at age 45. The study examined over 6,000 patients who underwent colonoscopies. Among patients between the ages of 40 and 44, 13 percent showed precancerous polyps called adenomas, which could eventually develop into cancer. The adenoma rate doubled among 45 to 49-year-old patients, increasing to 26 percent.
There was also a dramatic increase in the rate of new, uncontrolled growth of abnormal tissue called neoplastic polyps. The rate of neoplastic growths among patients who were 40 to 44 years of age was 0.8 percent, compared to almost 4 percent among patients who were 45 to 49 years old.
This study is so important because colon cancer is the third-leading cause of cancer death in the United States, affecting 1 out of every 20 individuals. However, it is preventable through routine screening. Many experts still disagree about the ideal age to begin screening for colon cancer in order to offer the best protection against the disease. Colon cancer is over 90 percent treatable when it is diagnosed at an early stage, so early intervention is crucial. When the cancer spreads beyond the intestinal wall and into neighboring organs, however, it becomes increasingly difficult to treat. So timing is everything when it comes to detection and intervention.
It does not seem logical that a preventable disease poses such a threat. One of the main reasons is that men and women are still not choosing to be screened for colon cancer. Lack of education and awareness about colon cancer means that thousands of Americans forego screening year after year. Another reason is that the rate of young-onset colon cancer incidence is increasing. Most insurance companies will not cover screening colonoscopies for individuals who are under the age of 50, so many new cases of colon cancer go undiagnosed. This is not surprising, as colon cancer often has no symptoms in the early stages.
For Dr. David Karsenti, the lead researcher of the French study, these findings support the argument for earlier colon cancer screening. He believes that lowering the age for baseline colon screenings could make a significant impact on the survival rate of colon cancer patients.
Many medical professionals advocate the use of stool tests for people under 50, but not all doctors and organizations agree. According to Dr. Otis Brawley, Chief Medical Officer for the American Cancer Society, using less invasive screening methods like stool tests can produce “false positive” results and lead to invasive follow-up procedures. Before putting younger people through screening tests, Dr. Brawley thinks that it is important to assess the risks and benefits.
There is at least one point on which Dr. Brawley and Dr. Karsenti would agree: earlier screening for individuals with a family history of colon cancer. Having a family history of colon cancer or colon polyps puts you at increased risk for colon cancer. If you have a first-degree relative (parent, sibling or child) who was diagnosed with colon cancer before the age of 60 or two first-degree relatives diagnosed at any age, you should have your first colon screening at age 40, or 10 years before the earliest diagnosis in the family. There are also two genetic conditions called Lynch Syndrome and Familial Adenomatous Polyposis (FAP) which significantly increase the risk for colon cancer and require early screening (source: CBS News).
Talk to your family to get details about your family history so you know if you are at elevated risk for colon cancer. Knowing your personal risk will help you and your doctor decide when you should begin colon cancer screening. Take some time to peruse the Prevention section of the Butt Seriously blog to learn more about how you can prevent colon cancer.