Health take-Away: Regular screenings could cut colon cancer deaths by half

Colonoscopy is the most strongly recommended option for colorectal screening. From start to finish, including anesthesia recovery, the process takes a little over an hour.

In the fight against colon cancer, the No. 1 goal is not making the diagnosis and treating the disease. It is prevention.

Although it is one of the easiest types of cancer to prevent through routine screening, over 50,000 people die from colon cancer every year in the U.S., making it the second-leading cause of cancer death in men and the third most common in women.

More than half of those deaths could be prevented by a relatively simple, painless screening examination called a colonoscopy — and yet, one in every three Americans over the age of 50 chooses to never undergo any type of colorectal cancer screening test.

Why are so many people deliberately risking their lives? Unfortunately, many of them are wrong in assuming that because they are feeling well, they are not experiencing any symptoms and they have no family history of colon cancer, that they are not at risk.

What they don’t realize is that by the time the more pronounced symptoms of colon cancer appear — which may include rectal bleeding, abdominal pain, changes in bowel habits and unexplained weight loss — an undiagnosed colon cancer may have already have moved to an advanced stage.

That is why we are so adamant about our patients following the prescribed recommendations for colon cancer screening.

Under the current standard guidelines, even without the risk factors listed below, all adults should begin routine colon screening at age 50 and continue through age 75, and Black Americans should start at age 45.

Based on an increased incidence of colon cancer in the younger population in recent years, several of the leading cancer health organizations already are recommending that screenings begin at age 45 for everyone. It is likely that this will become the standard guideline in the not-too-distant future.

You are at higher risk for colon cancer if you have:

• A personal history of colorectal cancer or advanced colon polyps;

• A family history of colorectal cancer or genetic syndrome predisposing you to an increased risk;

• Inflammatory bowel disease.

People with those risk factors and others may require screening at an earlier age and will have to be screened more frequently.

With aging, it is very common for small tissue growths, called polyps, to appear along the colon wall. By age 50, between 25 and 30 percent of people have polyps. By age 70, more than 50 percent do.

Some polyps are benign, but others that are precancerous (called adenomas) can evolve into cancer over time. A gastroenterologist can easily remove polyps during a colonoscopy, which are then examined by a pathologist for cancer risk.

Colonoscopy is the gold standard screening test for colon cancer prevention. As preparation for this outpatient procedure, you will be asked to consume a special type of laxative — usually consuming two small bottles of a prescription liquid, with some additional water — the night before and morning of the procedure.

In performing a colonoscopy, you will be asleep under anesthesia and a gastroenterologist inserts a thin tube fitted with a miniaturized camera, called a colonoscope, into the colon. It shows your doctor images of the inside walls of your colon as the tube moves through.

Several different small instruments can be inserted through the scope to completely remove any polyps seen during the examination. From start to finish, including anesthesia recovery, the process takes a little over an hour.

After a year in which many people postponed elective procedures due to the COVID-19 pandemic, primary care doctors and gastroenterologists everywhere have turned up the volume on an important public message: regular colonoscopies are an essential, highly tolerable tool for preventing a form of cancer that needlessly costs far too many lives every year.

Jason Bratcher, M.D., is chief of the Division of Gastroenterology and Hepatology at Berkshire Medical Center. Ketisha De Roche, M.D., is a board-certified gastroenterologist and hepatologist within the division.