Since coming to Batesville, I’ve been asked “Doctor, do I have to? I’m doing fine!” several times by patients. This most often pops up when I discuss getting a colonoscopy for colon cancer screening. Many people dread going through with a colonoscopy and feel more comfortable thinking “maybe next time”, putting it off until later. For this reason, almost a third of our patients are still behind on their screening. We have noticed that most people don’t know about the importance of these tests or that there are alternatives to a colonoscopy. Today, I’d like to talk with you about colon cancer, why you should get screened, and the available options for testing.
Colon cancer is the 3rd most common type of cancer in the United States and generally takes around 10 years to develop from a precancerous polyp. Patients diagnosed with stage 1 colon cancer have an average 5-year survival rate of 90% which drops to 14% in widespread stage 4 cancer. Most people with colon cancer do not have any symptoms, but some may have rectal bleeding, abdominal discomfort, or changes in bowel habits. What this means is that early screening can find cancer when it’s still small and easier to treat, but that everyone should get screened as well.
Current guidelines recommend screening for all adults age 50-75, or earlier with risk factors or family history. The most accurate screening test is the colonoscopy, in which a doctor uses a flexible tube and camera to look through the entire colon for any precancerous polyps, remove, and test them. If there’s nothing found, you won’t need another for 10 years. A similar test is the flexible sigmoidoscopy, which does not look as far up the colon and needs to be done every 5 years. With both these tests, there are a few things to consider. You will need a bowel preparation to clean out your bowels the day before. You may need sedation for the procedure. In addition, complications are rare but may include bleeding, infection, or injury to the bowel wall.
Are you fearful about getting a colonoscopy? Don’t want to go through bowel prep or sedation? Non-invasive screening options are available. FIT and Cologuard are simple stool screening tests that can be arranged at your primary doctor. The best part is they can be done from home by mailing your sample in. The FIT looks for hidden blood in the stool (which can be an early sign of cancer) and needs to be done every year. Cologuard detects DNA biomarkers for colon cancer and is every three years. A positive result on one of these should be followed up with a colonoscopy. While these tests detect colon cancer, screening colonoscopy can prevent cancer by identifying and removing precancerous polyps. The American Cancer Society recommends a colonoscopy every 10 years in healthy adults with average risk.
Remember: the earlier it’s found, the easier colon cancer can be treated. No matter which test you choose, the most important thing is to get screened. Please discuss with your doctor today about your need for screening, available options, and any concerns you may have.
Dr. Eddie Liu is a 3rd-year Internal Medicine resident at White River Medical Center. He was born and raised in Tennessee and received his MD from East Tennessee State University.