Beth Carlson, a gastroenterology physician assistant at Highland Gastroenterology, offered some background on colon cancer.
In Good Health (IGH): When should people start receiving colonoscopy?
Beth Carlson (BC): There is a standard answer for most, age 45, but there are more things that go into the decision, like personal health history and family health history. Colonoscopy isn’t the only option. How and when a person should receive screening is really between the patient and a trusted medical provider.
IGH: What about fecal immunochemical test (FIT)?
BC: These test for blood in the stool, which is a possible sign or symptom. FIT can be an adequate test based on the patient. That one only tests if there’s blood, but blood can happen for a lot of reasons. A pregnant woman who has hemorrhoids or anyone else who has them may make a false positive. If you do have a positive FIT, they will recommend a colonoscopy.
IGH: How about Cologuard?
BC: If it’s positive, you’ll need to have a colonoscopy.
IGH: What is virtual colonoscopy through CT scanning like?
BC: It’s less invasive, but you will still have to do the prep. If people don’t mind drinking all that liquid, most would rather just do the colonoscopy. But CT can be an option if they’re OK with the prep but they don’t have someone else to provide transportation. People are sedated to do colonoscopy. It may be a better option to do CT as it will show large masses and they won’t be sedated for that. It can be a good screening option. In GI, we see people in clinic and talk about what’s the best option for that person. We go through the risks and tests and what the patient is hoping for with their care and the best way to screen for colon cancer.
IGH: Why is colonoscopy a good option?
BC: Colonoscopy is the hope we can prevent the cancer from forming. Most cancers come from a polyp. The hope is we can remove them before they turn into cancer.
IGH: The age recommended to do a colonoscopy used to be 50. Why has it lowered for starting screening?
BC: We are seeing an increase in colorectal cancer in younger people which is why the screening age is lowered from 50 to 45. There are many reasons for that increase, like a lot of the risk are lifestyle, environmental exposures, and diet. Sometimes, it’s the location of the colon cancer. Depending on how good the prep is, right side is harder to see than the left side. Some have had a colonoscopy and the prep side isn’t easy.
IGH: What are the risk factors for colon cancer?
BC: The risks include obesity, low fiber diet a diet high in red meat, especially meat with char. That can increase risk. Also, smoking and alcohol use increase risk. If you see something that’s concerning like a change in the caliber of your stool, evidence of bleeding, and you used to have a bowel movement once a day and now it’s two times a week. Talk with a provider and see if there’s something else you should do. We can typically catch it early with low mortality risk.