This year, 140,000 people in the U.S. will be diagnosed with colorectal cancer and nearly 51,000 people will die from the disease, according to estimates published by the American Cancer Society. This includes nearly 98,000 new cases of colon cancer and more than 43,000 cases of rectal cancer. Colorectal cancer, also called CRC, is the third-most commonly diagnosed cancer in the U.S.
Overall death rates from CRC have declined over the past decade, due in large part to improved screening rates. The “gold standard” for detecting CRC is the colonoscopy, a procedure that allows the physician to inspect the colon for polyps, which can develop into cancer, and remove them.
Despite the tremendous strides that have been made, many people who should have a screening colonoscopy do not. “People give a lot of reasons why they don’t need or don’t want a colonoscopy,” says Lexington Clinic gastroenterologist Matthew Ashmun, M.D. “Most of those reasons are based on misinformation or a misunderstanding of their risk and the benefits of the procedure.”
Dr. Ashmun shared some of the most common reasons people give for not undergoing a screening colonoscopy:
No one in my family has ever had colon cancer, so my risk is low.
Of the 140,000 people who will be diagnosed with CRC this year, approximately 85 percent will have no family history of colon cancer, Dr. Ashmun noted. Although heredity plays a role in some cases of CRC, it is not the primary risk factor. Diets high in fat and red meat, consuming meats cooked at high temperatures, being overweight, physical inactivity, alcohol use and smoking/tobacco use are all risk factors for developing colon cancer.
My insurance won’t pay for it.
The U.S. Preventive Services Task Force recommends screening for colon cancer in all adults beginning at age 50 and continuing until age 75. Because of this recommendation, most health insurance plans cover the cost of screening colonoscopy with little, or no co-pay, including Medicare and Medicaid.
My mother/brother/friend had a screening colonoscopy and said it was a terrible experience.
While this may at one point have been true, the process of getting a colonoscopy has come a long way. The prep prior to the procedure is typically the worst part for most patients, as you are required to abstain from eating or drinking anything but clear liquids for 24 to 48 hours before the exam. The evening before and morning of the procedure, patients drink a bowel prep solution, which aids in cleansing the colon. While this part of the process can be unpleasant, Dr. Ashmun noted that it is not painful. “The bowel prep can be inconvenient but for the actual colonoscopy most patients are sedated; however, it’s not a requirement and some patients choose to forgo sedation.”
The risks of the screening outweigh the benefits.
This reason is usually given by folks who’ve done some internet research. “Every procedure carries with it some risk,” Dr. Ashmun said, “but there are also risks in not taking an action.” Colon perforation is the most serious risk associated with colonoscopy. Still, it very rarely occurs. “When you balance that risk with your risk for developing colon cancer, it’s easy to see that the greater risk is in not being screened.”
Many of the things society once thought of as taboo or embarrassing are now openly discussed. It wasn’t that long ago that people didn’t talk about cancer in any form. Today, we talk about a wide array of medical conditions with openness and honesty, which has led to better awareness and more informed patients. Talking about colonoscopy and colon cancer will help alleviate some of the embarrassment people feel about the topic. “And speaking for the medical professionals who perform the screening, there is absolutely no reason to be embarrassed,” Dr. Ashmun said.
Matthew D. Ashmun, M.D., is board-certified in Gastroenterology and Internal Medicine. He provides services in diagnostic and therapeutic endoscopy in-cluding: colonoscopy with biopsy and polypectomy; upper endoscopy with biopsy; band ligation of varices; dilation of esophagus and pylorus; argon plasma coagulation/ablation angiodysplasia; wireless small bowel capsule endoscopy (Pillcam®); flexible sigmoidoscopy with biopsy and polypectomy. To learn more about your individual risk for developing colorectal cancer or to schedule your own colonoscopy, please call (859) 258-4362 today or visit LexingtonClinic.com.