The Importance of Early Colonoscopies

The incidence of colorectal cancer is on the rise. We've all heard that before but what many don't know is that this is especially true among younger people. In fact, the numbers are startling. Those born in 1990 are twice as likely to develop colon cancer and four times as likely to develop rectal cancer than those born in 1950, according to the American Cancer Society. As a result, more people under the age of 50 are being diagnosed than ever before. This has prompted the American College of Physicians (ACP) to update its guidelines for colorectal screening.

People at average risk for colon cancer should receive fecal testing every two years and a colonoscopy every 10 years between the ages of 50 and 75. At-risk individuals should be tested more often. Let's look at how to lower risk and who may be at risk even though they never thought they were.

New Colorectal Screening Guidelines

The ACP released new colorectal cancer screening guidelines for individuals at average risk. This includes individuals who are asymptomatic, without a family history of cancer or any previous diagnosis of inflammatory bowel disease, genetic syndrome, adenomatous polyposis or adenomatous polyps.

According to the new guidelines, physicians should screen for colorectal cancer beginning at age 50 (although they say 45 is better) and ending at age 75. The type of test performed should weigh all aspects, including benefits, risks, costs, availability and patient comfort. The ACP recommends fecal immunochemical testing every two years and a colonoscopy every 10 years.

Alternatives to Invasive Tests

If you’ve been putting off getting a colonoscopy, you’re not alone. It’s estimated that about 40% of at-risk individuals who should get screened do not do so. Why not? It often comes down to cost and the perceived discomfort of the test itself. The prep is uncomfortable and many people are embarrassed by or uncomfortable with the invasive nature of the test.

Fortunately, there are alternatives that claim to be very effective at detecting colon cancer—though not as effective as a full colonoscopy. These tests are only recommended for people at average risk. One of the most popular tests is the fecal immunochemical test. It involves giving a stool sample and detects approximately 73% of colorectal cancers. When taken annually, these tests may be just as effective as a 10-year colonoscopy. Other testing options include barium enemas, fecal occult blood tests, stool DNA, CT colonoscopy and sigmoidoscopy.

How to Reduce Possible Colorectal Cancer Risk

The American Cancer Society says most of us can lower our risk of developing colorectal cancer by making several lifestyle changes, including:

• Limiting alcohol
• Avoiding tobacco
• Maintaining a healthy weight
• Exercising regularly
• Eating fruits, vegetables and whole grains
• Eating less red meat and processed meats

In addition to these, be sure to speak to a doctor about any family history and ask for a customized plan to both prevent and screen for colorectal cancer.

The ACP new colorectal cancer screening guidelines encourage younger patients to be screened but there are so many options and combinations of options that even test-averse people have options that they may not be aware of. While fecal tests and other non-invasive tests should be performed every two years, it’s important to follow through with a colonoscopy at least once a decade to reduce the risks and ensure early detection. No matter what, it's time to talk about it, and ask a doctor to get these tests scheduled. Putting things off out of fear of discomfort only makes everything more difficult.

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