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Why Colonoscopy is Critical

Mention going to get a colonoscopy to a friend or loved one and you’ll likely get either a grimace or a snicker, or maybe both. Actually, you should get a huge high five.

Colonoscopy is a painless and highly effective screening for a very serious disease, and not getting one leaves you at risk for not finding a potentially deadly disease at an early, more treatable phase. Here’s what you need to know about colon cancer and why getting a colonoscopy is critical to your health.

The prevalence of colon cancer in the United States among both men and women is high, affecting one out of every 22 people. Equally disturbing is the fact that the incidence of colorectal cancer in people under age 50 is increasing. However, we know that more than 60% of deaths from colorectal cancer can be prevented by screening. And the earlier the disease is detected through screening, the higher the chances of survival. For those whose colon cancer is detected at Stage 1, the survival rate is 92%.

The good news is that death rates from colorectal cancer have been decreasing over the last several decades due to screening and early detection of polyps (benign growths that can turn in to colorectal cancer if not removed.) More advanced treatment approaches also contribute to the fact that today there are one million colorectal cancer survivors in the US.

The disconcerting news, however, is that only 50 to 60 percent of people in the US who should be screened for colon cancer actually get a colonoscopy. This means we could potentially double these survivorship statistics if more people got screened.

So, who should get screened, and when?

  • An average risk Caucasian individual (i.e. no family history of colon cancer in a first degree relative; no history of inflammatory bowel disease; no family or personal history of other genetic conditions; no personal symptoms) should get a colonoscopy starting at age 50.
  • Individuals who have a family history of colon cancer in a first-degree relative should start getting screened 10 years before the relative’s age at diagnosis, but no later than age 40.
  • African Americans should get initial screening at age 45.

Depending on your personal and family health history and your screening results, your doctor will advise on how frequently you need follow up colonoscopies after your initial screening.

And importantly, especially given the fact that we are finding more colon cancer in younger people, the following symptoms should never be ignored, despite your age and whether or not you’ve had a colonoscopy:

  • Abdominal pain
  • Change in bowel movement shape
  • Rectal bleeding

There are also other methods of screening for colon or rectal cancer, including fecal occult blood tests, fecal DNA tests, CT colonography and barium enema. However, the only method that is both diagnostic and therapeutic is colonoscopy.  If these other methods identify an issue, then the next step is colonoscopy.

The bottom line—colonoscopy gets a bad rap despite being a critical life-saving screening. It is painless (patients are sedated) and highly effective. So, start giving your loved ones and yourself a “high five” when you schedule your screening. You could be adding years to your life.


By Anthony Firilas, MD, Roper St. Francis Physician Partners – Colorectal Surgery

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