After a decade of awareness, news publications and referrals for colonoscopies, I think most Americans are now aware of the need for colorectal cancer screening beginning at age 50. And indeed, many patients that come to my office are repeat “screeners” who have had prior exams one or more times before.
And yet, surprisingly, an estimated 40 percent of people who qualify for a screening colonoscopy in this country have not been tested. The reasons for this are numerous and run the gamut of excuses from simple denial that anything “bad could happen to me,” to lack of symptoms, lack of insurance coverage or fear of the “unknown.”
However, here are the realities:
• Colorectal cancer is the second-leading cause of cancer death in this country, behind lung cancer. Yes, colorectal cancers claim more lives than breast cancer and prostate cancer!
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• In 2014, more than 136,000 Americans were diagnosed with colorectal cancer. That year, 50,000 Americans died of the same cancer.
• When detected early, colorectal cancer death and morbidity may be prevented in many cases.
People often ask me what is the best colorectal screening test?
The simple answer to that question is: The best test is the test that gets done.
Currently, there are at least three different tests for detecting colorectal cancers that are highly effective. (Standard colonoscopy, standard sigmoidoscopy plus yearly FOBT or fecal occult blood test, FIT or fecal immunochemical test, and the latest is fecal DNA testing). All tests have their merits and limitations, so it is important to discuss with your gastroenterologist the best option for you. And now, with the implementation of the Affordable Care Act, many Americans can receive high-value, preventive services, such as colorectal cancer screening without cost-sharing.
I once had a patient who came in for a screening colonoscopy consultation. I recommended a colonoscopy and scheduled him for the procedure within a few weeks. However, when the time came for the test, he called and canceled because he was too busy at work. This delay went on several more times until I finally told him that he simply get tested or find another doctor. To make a long story short, this man ended up having colon cancer, but by then, it was too late for a cure. Don’t be this man! Nothing at work or office is more important than your health.
In summary, colorectal cancer screening has been shown to save lives. If you are between the ages of 50 and 75, you should be screened regularly as deemed necessary by your physician. If you are over 75, and have never been tested, it is still recommended to have one screening colonoscopy if your life expectancy is 10 years or more.
And remember: The best test is the test that gets done.
Peter S. Kim, M.D., MPH is a board-certified gastroenterologist in the Highland/Greenville area, specializing in diseases of the digestive system. To date, he has personally performed well over 30,000 colonoscopies and endoscopies.