Colorectal Cancer Screening Works

Don’t Delay Your Colonoscopy or FIT Test

By DR. CARMINE CATALANO

All doctors must occasionally have conversations with their patients about unpleasant things, but I think my field might take the cake. As a gastroenterologist, I have to routinely ask patients for colonoscopies and stool samples to screen for deadly disease. It may seem scary, unpleasant and gross—but I love what I do. I love helping people through routine processes that literally save lives.  

March is Colon Cancer Awareness Month. Monitoring your colon’s health to catch any problems early is something we all need to do when we reach a certain age. Despite the bad reputation colonoscopies have, the process is very simple, safe and it really works.

Screening Works

Let’s start with some good news: Colon cancer rates have dropped steadily over the last 20 years, according to data from the Centers for Disease Control and Prevention. In 1999, the colorectal cancer rate in the U.S. was 56 cases per 100,000 people; by 2019 it had dropped to 36.3 cases. That is incredible!

This 1-2 percent drop each year for two decades is largely attributed to greatly improved screening. In 2020, about 71 percent of adults over 50 were up to date on their cancer screenings. That’s more than twice what the numbers were in 1999. Screening catches and removes polyps (or small growths) before they become cancerous. It also allows people showing signs of high risk to make positive health decisions about diet and exercise.

Screening Is Needed—At a Younger Age

Although screening has served us well, there are still plenty of reasons to be vigilant. To start, even at our reduced rate, colorectal cancer remains the third most common non-skin cancer in the United States.

Second, though the overall rate is down, that’s not the case for all demographics. Specifically, earlier this year the American Cancer Society announced that the colorectal cancer rate among people under 55 is increasing. Researchers are not sure about the cause of this rise, but the consensus is that screening should start younger. The recommended age for starting regular colonoscopies has been lowered to 45. And patients of any age should discuss any concerning symptoms with their doctor. These include rectal bleeding, unusual stools, changes in bowel movements and low energy.

Finally, although there isn’t hard data about this yet, we all know anecdotally that many people put their routine health appointments on hold during the pandemic. It is time to get back into good routines, if you haven’t already. 

Screening Is Easier Than You Think

One of the biggest obstacles to getting screened for colorectal cancer is the stigma that comes with it. Joking aside, thanks to anesthesia, pain meds, and improved instruments, colonoscopies are not painful. If anything, they are inconvenient, requiring some fasting beforehand and then part of a day for the procedure itself.

For some eligible patients who are considered low-risk for colon cancer, you may be a candidate for a fecal immunochemical test. These FITs are simple and 100 percent painless: Pick up a kit, collect a very small sample at home, and drop it off at your practitioner’s office. The lab checks the sample for traces of blood which can indicate a problem. Talk to your family practitioner about whether this may be an option for you.

Screening Is Nearby

Though March is Colon Cancer Awareness Month, colon screenings do not require a special time of year. They can and should be part of your regular annual wellness visits. If you’re overdue, make the appointment to get back on track. It could save your life.

Dr. Carmine Catalano is a gastroenterologist and the chief of the Division of Digestive Diseases at Bassett Medical Center in Cooperstown.