You may need a colonoscopy earlier than you think, NC doctors say. What to know
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- People at average risk should receive a colon cancer screening at age 45.
- Family history of cases that appeared under age 55 requires screening 10 years earlier.
- Primary care dismissal can delay diagnosis when patients report abdominal pain
Millennials need to get a colon cancer screening younger than their parents did, especially in the face of sharply rising colon cancer rates in younger people.
The Charlotte Observer spoke to North Carolina doctors about how to mitigate your colon cancer risk by eating less red meat, less ultraprocessed food and more fiber.
Those doctors, Novant Health Oncologist Keithe Shensky and Nicholas DeVito, a medical oncologist at Duke researching immunotherapy for colon cancer, also stressed the importance of getting a colon cancer screening.
Colon cancer screening ages
People of average risk for colon cancer should get a screening or colonoscopy at 45. People with a family history of colon cancer cases that appeared under the age of 55 should get screened 10 years before their family member’s case appeared.
“You need to be screened 10 years before (your family member) got colon cancer. So if you have an uncle, or your dad was 50 or something like that when he got colon cancer. Well, buddy, you’re getting a colonoscopy at 40 now,” DeVito said.
Shensky said many of those young people will also be tested for genetic markers that indicate colon cancer.
The screening recommendation was changed from 50 to 45 in 2021, as colorectal cancer rates have skyrocketed. Colorectal cancer rates have gone up 51% in people younger than 50 since 1994, climbing about 3% per year since 2011 for people aged 20 to 49, according to University of Chicago Medicine.
You may also need a colonoscopy or other screening if you are showing unexplained symptoms associated with colon cancer.
Symptoms include:
- Abdominal pain
- Rectal bleeding
- Change in bowel habits
- Weight loss
- Low hemoglobin
It is easier to treat early-stage colon cancer. If the cancer has spread to other parts of the body, like the lymph nodes, not only surgery but chemotherapy will likely be required.
Different types of screening
Shensky said that people are sometimes intimidated by colonoscopies, even though they are low-risk and common.
“If there’s any fear at all about having a procedure like a colonoscopy — which, by the way, is low risk, and I would highly encourage it — but if there’s any fear at all, there are other options as well,” Shensky said. “Colon cancer screening saves lives, and I and people should really have it done.”
A colonography CT, sometimes called a virtual colonography, will show a detailed accurate image of the colon and any polyps or irregularities.
Another option is a stool-based home test, which looks for blood and DNA changes. If a home test comes back positive, a colonoscopy will still be needed to confirm.
Access to screening
Both Shensky and DeVito said that patients sometimes are not evaluated for colon cancer despite showing symptoms.
Shensky said young people should be careful not to brush these symptoms off as just stress or anxiety.
“I have a particular patient in mind, who had just turned 30; she developed abdominal pain and changes in her bowel habits. Primary Care said, ‘Oh, maybe you’re just stressed because you’re getting married soon,’” Shensky said. “But she saw a GI doctor. The first GI doctor told her to just monitor. The second GI doctor said ‘Let’s scope you,’ because she had gotten a second opinion, and thank goodness she did, because she had colon cancer.”
DeVito said that sometimes the symptoms are attributed to other problems, or a colonoscopy isn’t performed when it should be.
“The audacity of a lot of primary care and other physicians to be dismissive of patients is not lost on me, and I’ve heard a lot of patients who struggle to get diagnosed because not because they didn’t recognize that rectal bleeding or pain or changes in their bowel habits were a problem, but they either couldn’t get access to a colonoscopy or the correct kind of provider in time or their symptoms were simply ignored,” DeVito said.
DeVito said he recently lost a patient whose cancer was diagnosed late because she was not adequately screened.
He said it is important to pay attention to your body and advocate that your symptoms be adequately addressed, including journaling or documenting abnormalities with pain and stool.
