Colorectal cancer is a preventable disease that is still the third-leading cause of cancer-related death in the United States. A study published in the New England Journal of Medicine showed that of participants who received a colonoscopy, the procedure decreased the risk of developing colorectal cancer by 31% and lowered the risk of dying from colorectal cancer by 50%.
The bottom line: Colonoscopies save lives!
Understanding Prevention Versus Screening
Most cancers cannot be prevented. Physicians can detect them only after they have reached a certain size and can be visible, whether through a physical exam or in computed tomography, magnetic resonance and others. Screenings are usually meant to identify individuals who already have cancer.
Colorectal cancer is among the few cancers that can actually be prevented in most cases. Colorectal cancer starts as a polyp. Polyps are small lumps or moles that grow inside the large intestine or rectum. When small, they are considered precancerous, but as they grow, they can become cancerous and spread to other organs. Treatment in these scenarios may include major surgeries, chemotherapy and radiation therapy, among others. As cancer progresses, the risk of dying from colorectal cancer increases.
When a polyp is found during a colonoscopy, the physician can remove it and have it tested for cancer. If found and removed early, during the precancerous stage, that patient may have just avoided developing colorectal cancer altogether. That means colonoscopies are useful not just as a screening tool for cancer, but also to help prevent it. The success rate of a colonoscopy finding a polyp, when present, is approximately 95%.
Fecal occult tests (stool tests), even the new highly advertised DNA-based ones, are great screening tests (they will find cancer, if present, in most cases), but they miss detecting polyps approximately 50% of the time or higher. These polyps then have the potential to develop into cancer.
When it comes to cancer, any test is better than no test! However, tests that increase prevention should be preferred over those that just detect cancer. Would you buy a car with an engine that fails to run 50% of the time? Probably not. When your life is on the line, don’t settle for less. Colonoscopies are the only test that can detect and remove precancerous polyps before they turn into colorectal cancer.
A Symptomless Cancer
It may take a polyp five to 10 years to develop into cancer. Most patients experience no symptoms. By the time patients develop symptoms, precancerous polyps may have already progressed to cancer. Further, the cancer may already be in a later stage, making it harder to treat.
Prevention or even screening should be important to all of us, especially as there are numerous tests available. Higher-risk individuals, such as those with a family history of colon polyps or cancer, a personal history of inflammatory bowel disease, and/or an inherited syndrome, are at increased risk. Being overweight, having a diet high in red meats and processed foods, using alcohol or smoking also increase a person’s risk.
The American Cancer Society recommends that people with an average risk begin regular screenings at age 45. We should all learn to advocate for ourselves, it is our life at risk – ask your doctor questions about screening and prevention.
Stopping an Epidemic
Colorectal cancer has dramatically increased in individuals between age 40 and 50, to the point that some news outlets are calling this an epidemic. On the contrary, colorectal cancer in the U.S. is decreasing in those 50 years old and older. This is thanks to the extensive screening programs in place and significant efforts from medical societies to educate our population and physicians.
It cannot be emphasized enough that colonoscopies save lives. If you’re eligible for a screening colonoscopy, talk with your physician about colorectal cancer prevention. In many cases, insurances cover 100% of the cost of a screening colonoscopy. Talk with your family or friends who tell you they are opting for an easier stool test. Share your knowledge about the importance of colonoscopies; you may be saving a life.