Screening at 45 Helps the Colon Survive

by Heidi Bau

January 2022

People often associate a trip to the clinic with being sick. However, going to the doctor isn't just for those who are ill; it can also prevent major diseases from occurring in the first place – diseases like colon cancer. While North Dakota may be one of the lesser populated states in the nation, it has a high rate of colon and rectal cancer (CRC). In Adams and Hettinger counties alone, three or more people will develop CRC each year. These people could be neighbors, coworkers, or relatives. The best way to prevent CRC is to be checked for it before it happens, a process called screening. Getting screened can prevent cancer and help patients stay healthy.

Colon cancer develops in a predictable pattern. It often starts out as a small growth on the colon wall called a polyp. Over 10 years, this polyp can grow and develop into cancer. Screening for colon cancers every 10 years enables identification of the polyps before they become cancerous and allows for their removal. Other preventive screenings like mammograms, pap smears, and prostate exams also utilize this idea of early cancer detection.

There are several different methods used to check for CRC. The stool-based test involves collecting a sample of feces in the comfort of your own home then returning it to the healthcare laboratory. There, it is analyzed to detect blood or cancer cells. This testing must be repeated every 1-3 years, depending on the specific test. If the test is positive, then it must be followed by a colonoscopy.

A colonoscopy is a procedure in which a specially-trained physician looks at the inside of the colon using a long, narrow hose with a camera attached to the end, called a colonoscope. This procedure is often done while the patient is sedated to make it more comfortable. By directly looking at the walls of the colon, the doctor can hunt for signs of disease like cancer. If any suspicious areas are identified, a sample is collected and sent to a lab for testing. This is a way to follow up on the abnormal stool tests.

Preparing for a colonoscopy involves doing a bowel preparation process which requires drinking a special solution to help empty the colon of any stool that prevents the camera from getting a clear view of the colon wall. Rather than stool tests, some individuals prefer to do this prep and have the colonoscopy done as the first step in screening since it combines both polyp detection and removal in one procedure. If the results of a screening colonoscopy are normal, the procedure would be repeated in 10 years.

For a patient who wonders, "When should I take charge of my health and start screening for colon cancer?" the U.S. Preventive Services Task Force (USPSTF), an organization that focuses on illness prevention, recently gave new advice. In May 2021, the USPSTF recommended to start CRC screening at age 45, rather than the prior recommendation of age 50. This change occurred because CRC is increasingly being seen at a younger age. While the reason for the earlier development of colon cancer is yet to be understood, scientists agree that screening is the best way to prevent CRC.

Certain individuals at higher risk of CRC may need to be screened more frequently, starting at an even earlier age. People in the high-risk category for CRC include those with family history of CRC and men. American Indians, Alaska Natives, and Black adults are also in the high-risk category. However, even those who do not fall into the high-risk category still need to be screened. Public health experts state that there is no low-risk group for CRC, only average and high risk.

CRC is a serious, but preventable cancer. Waiting to be checked until problems like blood in the stool develop may lead to worse outcomes, such as an untreatable cancer. Don't let any obstacles stand in the way of screening; there are local providers trained to do CRC screening. Talk to a medical professional about when to start screening and finding the best test. Remember – screening at 45 helps the colon survive!

This article also appeared in the January 13, 2022 issue of the Adams County Record.

About the Author

Heidi Bau is a third-year medical student at the University of North Dakota School of Medicine & Health Sciences. She was selected as the Hettinger participant for the school's ROME program, or Rural Opportunities in Medical Education. Because the program includes teaching student doctors about the importance of how rural newspapers can deliver health information, she has written this column for her ROME community. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed practitioner.