Colorectal cancer (CRC) is dangerous if left unchecked. It is one of the deadliest forms of cancer in the United States. Thankfully, early testing is highly effective in preventing this cancer from developing, so those who catch it early tend to have good outcomes.
There are several forms of screening you can do. Common forms include a stool-based test and a colonoscopy. Typically, it’s recommended that screening starts at 45 years old, with the timing of the next test determined by the results. Starting at this stage is important because CRC rates have been on the rise for younger populations. According to the Cancer Research Institute, 20% of those being diagnosed with it now are younger than 55, and numbers for younger groups (20-39) have been increasing since the 1990s.
The stool sample is a simpler form of screening than a colonoscopy, but if the result indicates that you could benefit from additional testing, a colonoscopy will be recommended. During a colonoscopy, you are not only screened, but other processes also take place that reduce your risk of developing cancer, in many cases before it even begins. Most polyps, small clusters of cells in the colon, can be removed during a colonoscopy. Many polyps are harmless, but some of them can develop into cancer.
You should always check with your insurance before any procedure. Under the Affordable Care Act, CRC screening is typically covered without out-of-pocket costs, but there may be restrictions on which types of tests are available to you based on your age and level of risk.
In certain cases, you may need to get screened before the age of 45. For example, you may have potential symptoms of this disease. The National Cancer Institute lists the most common: abdominal pain, rectal bleeding, diarrhea and iron deficiency anemia.
Other indicators that show you may have higher risk according to the American Cancer Society include family history of it or of certain types of polyps, inflammatory bowel disease, a personal history of colorectal cancer and/or of certain types of polyps, particular hereditary syndromes, having had your gallbladder removed, and previous radiation treatments near your colon.
Depending on your risk level — including what polyps the doctor sees during a colonoscopy — you may be asked to get tested with greater frequency than the typical amount, which is every 10 years for colonoscopies, but more often for stool tests. Likewise, if you are at higher risk, a colonoscopy will probably be recommended instead of the stool sample test.
You have likely heard from friends and relatives about the preparatory day before a colonoscopy, when your bowels need to be cleared to enable the testing to take place. Some people will exaggerate how bad this day is, but it’s true that it’s not a pleasant experience. Before these stories discourage you from taking care of your health, remember this: one day of difficulty every 10 years or so is worth the certainty that you’re doing what you can to avoid developing a deadly disease.
March is Colorectal Cancer Awareness Month, a reminder to all of us to get screened if we haven’t gotten to it yet, and to continue getting tested if it’s time for the next one. If you are between the ages of 45 and 75, regular testing is typically advised. If you are 76 or older, you will want to consult with your doctor about whether to continue testing. Your primary care provider can also give you details about the testing types and the risks of not screening. If you are looking for a new provider, please reach out to Eskenazi Health Connections at 317-880-7666. Keep in mind that good lifestyle practices — such as good nutrition and regular exercise — can also reduce your chances of developing CRC.
Ananda Kannappan, M.D., primary care physician and Lifestyle Medicine practitioner with Eskenazi Health Center Grande