The Most Unpleasant Camera

Colonoscopies: Our Guide

It used to be that most people could live 50 whole years until they became acquainted with the most unpleasant camera around. AKA, the colonoscopy.

Perhaps you know the drill. The “prep” where you drink quarts of a viscous, vague substance so you can sit on the toilet for a day getting your colon ready to be photographed. Then, the humiliation of laying on a gurney and being put to sleep while a doctor will take your least-favorite selfie.

A New Age for Colon Cancer Screening

So that sound you just heard was the collective groan from Gen-Xers around the country when the American Cancer Society announced this week that the new age for starting colon cancer screening would be 45.  About 10 million more Americans now get to undergo this joyous procedure.

So what to do now? Let’s say you find yourself in that 45-50 age group, or closing in on it.  You knew it was out there, but now this – is colon cancer screening really that important?

Yes!  A few reasons why:

  • Colon cancer screening has dramatically reduced the incidence among Americans over the age of 50 over the past two decades.
  • While the incidence of cancer continues to decline for those over 50, it has risen 51% for those under 50, including the risk of death.
  • Colon cancer screening can find precancerous lesions that can be removed before they ever turn into cancer.
  • Although the reasons are not fully understood, younger generations have a higher lifetime risk of developing cancer than those that came before us.  

Other Colonscopy Options

What are your options? Well, thankfully getting the ol’ posterior Polaroid is not the only one. (If you do choose colonoscopy, the benefit is that you are generally clear for 10 years if you are an average risk person.)  

Some other options that are approved include a fecal occult blood test (FOBT). No, this has nothing to with black magic. It just means a test of your stool to see if there is microscopic blood in there. This needs to be repeated annually.

Other tests are out there as well, like Cologuard® which is a stool DNA test that looks for DNA from cancerous lesions that is shed into the stool.  This has to be done every three years.

Finally, it should be mentioned that not everyone agrees that the age should be lowered to 45. The US Preventive Services Task Force (USPSTF) has chosen to keep their recommended age at 50 citing that the benefit in extending it by five years is only “modest”.

How Will Insurance Companies Respond?

“We don’t yet know how insurers will respond to these new guidelines, nor what the impact will be on healthcare costs,” said Dr. Harish Gagneja of Austin Gastroenterology. “However, given the rise in colorectal cancers that we are seeing among a younger demographic, we definitely agree with these new guidelines.”

And remember, that all of these recommendation pertain to Americans who are “average risk”. If you have any family history of colon cancer or have had it yourself, you should talk to your doctor about the right screening schedule for you.