Hello. I'm Dr. Kathleen Martin from CHI Saint Joseph Health – Gastroenterology, and I'd like to welcome you to Let's Break to Educate.
Today's topic is colorectal cancer screening, and a lot of my patients ask me, "Why should I get a colon cancer screening? I don't need to have this now." What I would like to tell you is that colon cancer is very common. It's the second leading cause of cancer death in the United States, behind lung cancer, and it's so preventable. We can screen you for colon cancer and prevent it by taking out polyps so that you never have to get colon cancer.
Who Should Get Screened for Colorectal Cancer?
Who should get screened? Well, colon cancer happens in all ethnicities, in both men and women, and most people don't have any symptoms until it's too late. So, we want you to get a screening so that we can prevent the cancer from ever happening, or at least catch it at an early stage when it's very curable. If we catch it at an early stage, 90 percent of people survive.
So, you may say, "Well, I don't have any family history of colon cancer. I don't need to get screened." And what I'd like to tell you is that 80 percent of the people that we find who have colon cancer have no family history, so we don't want you to use family history as the only reason to have a screening. Most people don't even have symptoms until it's a pretty advanced cancer. So, we don't want you to wait for symptoms to develop, and we certainly don't want you to limit it to just if you have family history.
When Should I Begin Screening?
So, when should you begin colon cancer screening? What we used to say is, ‘begin at age 50’, but now they've found that colon cancer is starting even at younger ages. You may have heard of some famous people, such as Chadwick Boseman, who had colon cancer at a young age. So, now we recommend beginning screening at age 45.
If you do have a family history of colon cancer, we'd recommend that you begin screening earlier and your doctor can help you figure out the timing. But, if you had a family member who is over 50, we would start the screening at age 40. If they were under 50, let's say they were 45 when they were diagnosed, we'd start screening you at age 35.
What Does Screening Look Like?
How do you do screening? Well, there's two types of screening. There's a one-step screening, which is colonoscopy, and then there's some two-step screenings. That's where you do a stool test, and then if it's positive, we then recommend that you get a colonoscopy.
The colonoscopy is the procedure where we have you do a bowel clean-out. You come in and we sedate you for the procedure. You don't feel anything, and you're not on a ventilator. You're just resting comfortably, breathing on your own, and then when we do the colonoscopy and can find these little polyps that look like a little mushroom growing in the colon. We can remove those and that prevents colon cancer because those polyps eventually could grow into cancer one day.
The screening tests that don't involve colonoscopy are mostly stool-based tests. So, what we do with that is we have you get either a kit called Cologuard that gets sent to you in the mail, and then you send a sample into the company. The company runs testing on it, checking for abnormal DNA in the stool, as well as blood, and then they send a report to your doctor. If the test is positive, then they recommend you get a colonoscopy to check on it.
The other one is a FIT test. The FIT test is a check that really is only checking for blood, but it makes sure that it is blood from a human and not from some beef or something like that that you ate. And, that test also, the result goes to your doctor, and then if it's positive, we recommend a colonoscopy.
How Often Should I Get Screened?
Colonoscopy is done every 10 years if it's negative. A FIT test is done every year. We need you to do it every year because it's really just checking for blood. It's not preventing the cancer, so, if there's a little cancer starting to form, we have to wait for it to bleed to show up.
And then the Cologuard test, where it's checking for abnormal DNA, that test is recommended every three years. So, 10 years for colonoscopy, three years for the Cologuard, every year for the FIT test.
Screening and COVID-19
Maybe you're afraid ofgetting COVID-19 if you go in for your colonoscopy. Well, I want to reassure you that everybody at the hospital is wearing masks and gowns. We've been sterilizing - we actually do this all the time anyway - we've been sterilizing all of our surfaces. We're making sure that people are kept far away from each other and only one family member or friend is allowed in the area. So there aren't a lot of people in the procedure area. Also, most of the staff is immune. We've all had the vaccine if they haven't had the disease.
How Do I Prepare For Screening?
A lot of people say, "There's no way I can do that bowel prep. I can't drink a whole gallon." Well, I have good news for you on that front too, because they've got some better preps. And these have been around for a little while, but there's one where you just drink two bottles.
So, it comes like this - two little bottles. You drink the bottle and then you drink five cups of whatever you like that's a clear liquid. You could do tea, you could do lemonade, Crystal Light, Powerade, Gatorade, something like that, any kind of clear liquid drink, and then your prep is done. You do that twice with two bottles, but it's only five ounces. So, you can drink that.
And then some people say, "Well, I can't even drink five ounces of that liquid. It just makes me sick." Well, a new thing that's come out is this prep where it's just pills. So, it comes with a box and a little bottle of 12 pills. You take the pills, drink a lot of water with it, and then you can drink again. You have to drink more liquid. It all mixes in your system and that does a bowel prep. So, you don't have to do the whole big gallon anymore. Don't let that stop you from having your colonoscopy.
When we do the colonoscopy, we now use air that is CO2, so you won't feel so bloated afterwards. The sedative wears off very quickly, so people feel good afterward. We don't want you to drive and you need to have a driver to take you home, but you'll actually feel pretty good for the rest of the day. Also, you can eat whatever you want when the procedure is over.
So, I hope I've explained colon cancer screening, and I hope everybody is thinking about having their screening done because we really can prevent colon cancer by screening everyone. And if you'd like to schedule, you should talk to your primary care doctor or you can call our office to schedule.
Thank you for joining us today for Let's Break to Educate. I'm Dr. Kathleen Martin. If you have additional questions, please don't hesitate to call our office. Our phone number is 859.278.8400, or you can visit our website at www.CHISaintJosephHealth.org. Thank you.