“Have you been screened for colorectal cancer?”
Don’t be surprised if your primary care provider asks you this question the next time you see them. If you are 50 or older, getting screened for colon cancer is vitally important.
A Look at Colorectal Cancer Data
According to the American Cancer Society’s latest statistics, colorectal cancer is the third most common cancer diagnosed in men and women in the United States, and it is the second leading cause of cancer deaths. It does not have to be, however. Colorectal cancer is preventable with screening. Despite that, 1 in 4 eligible people in Lancaster County still have not been screened for colorectal cancer.
Nearly 150,000 people are diagnosed each year with this disease. Local data from Lancaster County shows that 36% of women and 50% of men have a pre-cancerous polyp found during their first screening colonoscopy. Given these statistics, you can see why primary care providers like myself are not shy about encouraging patients to get screened.
It’s hard to have a discussion about healthcare without talking about costs, but there is good news on this topic. After the passing of the Affordable Care Act, screening examinations are considered “covered” services, which can mean little to no out-of-pocket expenses. You have a choice of how you are screened, which I will discuss in detail below.
Colonoscopy: The Best Way to Prevent Colon Cancer
The first and best colorectal cancer screening I recommend for patients is colonoscopy which can discover 99% of problems. This is the only screening test that can not only find polyps, but allow for them to be removed at the same time. Since the vast majority of cancers start off as polyps, removing polyps can protect you from colon cancer down the road.
Patients will sometimes share with me that they don’t want to go through the preparation, which includes drinking a liquid that cleans out your colon. Over the years, this drink has come a long way; now it is odorless and tasteless, and can be mixed with Gatorade or another clear beverage, such as apple juice, soda, or tea.
Another concern patients sometimes share with me is that they do not want to be awake, or feel any discomfort. Colonoscopy is performed with deep sedation, which means you will get a great nap while the test is being done! Depending on the results, colonoscopy is performed every three, five, or 10 years.
Other Options: The FIT Test and Cologuard
If you are not ready for a colonoscopy, the next best option is a Fecal Immuno-histochemistry test (FIT), which can detect about 80% of problems. This test is done in the convenience your home, and requires no preparation, time off from work, or sedation. You simply gather a sample of your stool to send back to the lab for processing. If the test results are normal, you will not have to repeat the test for at least one year, possibly two. If the test results are abnormal, the next step is having a colonoscopy to diagnose the problem.
A positive test does NOT mean you have cancer. The important thing to remember is that the FIT test will count as your free screening exam. This means the colonoscopy, if needed, will be considered “diagnostic,” and carry with it some costs. Every insurance company is different, so it is best to connect with them to see what costs would look like with your plan.
Another good option for screening, a test called Cologuard. Similar to FIT, this is a test done in your home, and your stool is then sent to a lab for processing. Some patients prefer this method because it is repeated only every three years. The same is true of a positive Cologuard test as with FIT – the next step would be a diagnostic colonoscopy. Cologuard is much costlier than FIT testing, although it is generally covered by insurance. While it does pick up a few more problems, it also has more false positive tests than the FIT.
Regardless of what method you choose, colorectal cancer screening remains a vital component of good health. If you have questions, I would encourage you to have this discussion with your primary care provider. We are here to help you stay healthy!
To learn more, visit LGHealth.org/colon.