Doctor performing a colonoscopy

If someone told you that the 20-minute medical test literally could save your life, wouldn’t it be foolish to refuse it? Unfortunately, millions of Americans are doing just that when they fail to get periodic colon cancer screening. As a result, each year, up to 57,000 American die unnecessarily from the disease.

Here’s what you must know to protect yourself against colon cancer.

Screening Works       Almost all malignancy of the large intestine and rectum start as premalignant polyps, flat or mushroom-shaped growth that is harmless but may become cancerous. If a polyp is detected and removed, cancer will not develop. Screening and regular exams are crucial to detect polyps or cancer in the earliest stage.

The most recent screening guidelines, published by the US multi-society task force on colorectal cancer in May 2021, recommend screening in average-risk adults aged 45 to 49. The task force strongly recommends colorectal cancer screening for individuals aged 50 to 75 who have not already initiated screening.

For screening, average-risk people are those who do not have:

  • A private history of colorectal cancer or premalignant polyps
  • A private record of colon cancer in closest relatives.
  • Own medical history of inflammatory bowel disease (ulcerative colitis or Crohn’s sickness)
  • A suspected hereditary colorectal cancer syndrome, including familial adenomatous polyposis (fap) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
  • a previous personal history of having radiation to the stomach (stomach) or pelvic place to treat a previous cancer

For individuals aged 76 to 85, the decision to start or continue screening should be individualized based on screening history, comorbidity, life expectancy, colorectal cancer risk, and personal preference.

The task force doesn’t recommend screening after age 85.

if you have already had surgery for polyps or column cancer, or inflammatory bowel diseases, such as ulcerative colitis or Crohn’s disease, your risk for colon cancer is increased, and you should have a colonoscopy on a schedule determined by your doctor.

People with a close relative, parent, sibling, or child who had colon cancer or polyps should start regular screening with colonoscopy at age 40 (or five years earlier than the youngest diagnosis in the family). If you have two close relatives with the disease, have a colonoscopy every five years. If you have three relatives, you should have genetic counseling and possibly start colonoscopy screening at age 25 or younger.

Screening Option For Colorectal Cancer

Stool-Based Tests

  • Susceptible fecal immunochemical test (FIT) every year
  • Fecal occult blood test (gFOBT) every year
  • Multi-targeted stool DNA test (mt-sDNA) every three years

Visual (structural) Exam of the Colon and Rectum

  • Colonoscopy every ten years: this screening test is the most accurate and has a sensitivity of 85% to 94% to prevent colon malignancy.
  • CT colonography (virtual colonoscopy) every five years
  • Flexible sigmoidoscopy (FSIG) every five years
    • This test is invasive but less than a colonoscopy and requires less preparation (an enema the previous night and the morning of the procedure) and no sedation. Because the procedure is less thorough than colonoscopy, it identifies only 50% of colon malignancy.
    • It involves a flexible tube, like that used in a colonoscopy, which passes through the lowest third of the large intestine (sigmoid colon), where half of all tumors occur.
    • Sigmoidoscopy appeal to people who don’t want to be under sedation. The procedure costs about $400 and is also less expensive than colonoscopy.
    • Important: On a subsequent day, you should return to take a barium enema, followed by an X-ray, to view the remaining two-thirds of the colon. A barium X-ray costs about $500.

Many health insurance plans now pay for a screening colonoscopy, as does Medicare. Without health insurance, the procedure costs about $3,000.

Unfortunately, colonoscopy has a reputation for being embarrassing and painful. Both criticisms are overblown. Most patients say colonoscopy is not nearly as bad as they have expected.

What’s Involved     While you are under sedation, a flexible, 1/2 inch diameter tube that employs digital video optic is threaded through the Anus and passed through the large intestine, enabling the doctor to see your entire colon lining on a video monitor. The colonoscopy procedure usually takes no more than 20 minutes.

Many people find the preparation, which involves laxatives to empty the bowel, much more unpleasant than the colonoscopy.

Until recently, the standard bowel preparation method involved drinking 4 liters of a lousy tasting: cleansing solution, such as GoLYTELY, the night before. Never products now making the process less unpleasant.

  • Phospho-soda also tastes terrible, but you only take several tablespoons dissolved in liquid the night before and the morning of the procedure.

Helpful:  While you can mix it with any clear liquid, most patients prefer to mix it in a ginger ale to make it more palatable.

  • Visicol contains the same ingredient but is in tablet form. Instead of downing a liquid solution, you swallow 40 tablets in multiple doses.

Helpful:  Whatever bowel prep method you use, consume at least three eight-ounce glasses of fluid the night before to prevent dehydration. You can drink any liquid, but a sports drink that contains electrolytes is preferred.

Although sigmoidoscopy combined with a barium X-ray screens the entire colon, It is still less accurate than colonoscopy.

Fecal Occult Blood Test Once a Year     People who don’t want to undergo colonoscopy or sigmoidoscopy can opt for this test. The least accurate screening option only reduces the colon cancer rate by 1/3. Typical cost: $10

What’s Involved:  A chemical applied to a stool sample detects traces of blood which would suggest the presence of polyps or tumors. No preparation is required, but you must avoid certain foods (red meat and broccoli) for three days and medications (such as aspirin) for a week to ensure accuracy. Since the test detects blood, taking aspirin, which can cause internal bleeding, could trigger a false positive.

Some people find the procedure unpleasant because it involves using a small wooden stick to smear small bits of your stool on specially treated cardboard. If blood is detected, you’ll need to have a colonoscopy.

New Test Virtual colonoscopy uses computed tomography (CT) to provide detailed radiographic pictures of the colon. It is non-invasive, requires no sedation, and can be done at your radiologist’s office. It does require the same kind of preparation as colonoscopy.

This test is less accurate than conventional colonoscopy; it detects 75 to 80% of polyps larger than 1 centimeter. By just 40% or 50% of smaller ones. Health insurance will not pay for it. Typical costs are $900. It is a good option for people with heart or lung disease for whom sedation can be risky.