Early detection is vital, because there is a higher success rate of eradicating the cancer in its early stage, thus yielding a better prognosis.
At what age should we commence colorectal cancer screening?
In general, it is recommended that we start colorectal cancer screening at the age of 50. However, this screening guideline only applies to the general population.
For the general population, if your first colonoscopy is normal, your follow up colonoscopy will be recommended 10 years thereafter.
However, if your colonoscopy detects one or more polyps –the polyp will be removed during the colonoscopy. A routine colonoscopy would be recommended in 3-5 years, depending on the number of polyps removed.
Know thy family……..
The impact of family history on colorectal cancer screening recommendations
If you have a first degree relative, defined as a parent, a child, a brother or sister, who was been diagnosed with colorectal cancer; you have an increased risk of developing colorectal cancer.
Likewise, if you have at least two (2) second degree relatives, defined as aunts, uncles, nieces, nephews, grandparents and grandchildren, who have been diagnosed with colon cancer; you also have an increased risk of developing colorectal cancer.
If your family history of colon cancers aligns with any of the categories outlined above, your first colonoscopy should be performed at age 40, not at 50 years old.
Thus, the general population screening guidelines do not apply to you.
In addition, it is imperative that you follow up with routine colonoscopies every 1-3 years thereafter, depending on the results of the prior colonoscopy.
Some patients with a very strong family history of colorectal cancer may have a genetic disorder such as Familial Adenomatous Polyposis, otherwise called FAP; or another genetic disorder known as Hereditary Non-Polyposis Colon Cancer, abbreviated HNPCC.
If you and family members have been diagnosed with either of these genetic disorders, screening should commence as early as 20 years of age.
Know thyself and thy own history…..
Your own medical history can also dictate the timing of colorectal cancer screening.
If you have been diagnosed with gastrointestinal diseases such as inflammatory bowel disease or ulcerative colitis; you have a very high risk of developing colorectal cancer, and should therefore undergo your first colonoscopy as young as 25 years old.
Knowing is half the battle in conquering your fears…….
The Colonoscopy Procedure: How it is performed and what you should expect before, during and after …..
Before the colonoscopy: Bowel preparation (emptying colonic contents) is required.
You will be provided with detailed instructions on the use of enemas or laxatives, which induce bowel movements. You are allowed to drink clear liquids such as water, ginger ale and broth, up to 3-4 hours prior to colonoscopy. You will likely be sedated for the actual procedure, therefore you should not experience any pain.
During the colonoscopy: The scope –which is simply a tube fitted with a light source, will be utilized. It is inserted into the rectum, and air is directed through the tube.
It is very flexible and can therefore be repositioned to adjust to the contours of your colon.
The light source allows the gastroenterologist (the physician specialist performing the colonoscopy) to visualize and identify any abnormalities within the colon and rectum.
The entire duration of the procedure, including the sedation process, is less than 1 hour.
After the colonoscopy: You will need to be monitored for a few minutes after the procedure, to ensure that you are stable to go home.
You should arrange for a family member or friend to accompany you to and from the procedure.
Screening is revealing...
Possible findings on a colonoscopy
Your colonoscopy may show no abnormalities.
However, polyps-small growths or out-pouchings inside the colon can be detected by the colonoscopy. These polyps are usually benign, but they can transform into cancerous growth.
As such, they are usually removed during the colonoscopy.
Colonoscopy also detects cancer in the colon and rectum; which, if suspected, would be biopsied during the colonoscopy.
Summary: Key Points
Knowledge is power:
Know which screening guidelines apply to you based on your own, and your family’s medical history.
Experience teaches knowledge and reduces anxiety and fear:
The entire colonoscopy procedure lasts less than 1 hour. You will be sedated, and will not sense any pain. After your first colonoscopy experience, you will undoubtedly be more prepared for subsequent colonoscopies.
Screening saves lives
Early detection is the key: When detected early, the chances of completely obliterating cancer increases significantly.
By Sophia Edwards-Bennett MD PhD DABR