Screening Can Be Simple

I have not seen all the Marvel movies, but I have seen several. I also have family and friends who have seen them all. What’s great is that the ranking of them is an area where there seems to be no disagreement.

Hands down…Black Panther is the best. It is a wonderful example of a great story mixed with outstanding special effects. Another reason for its remarkable success was the actor who played the lead role of T’Challa, Chadwick Boseman.

Like many, I was saddened to hear that Mr. Boseman died on August 28, 2020 from colon cancer at the age of 43. He had been diagnosed in 2016 and apparently continued to work while going through surgery and treatment. Remarkable.

I began to look at other well-known people who have had colon cancer, or as it is referred to in the medical world as colorectal cancer. The list included Charles Schulz, Darryl Strawberry, Audrey Hepburn, Ruth Bader Ginsburg, Ronald Reagan, and others. Some died directly due to the cancer, some died of a secondary illness, and some beat it.

March is National Colorectal Cancer Awareness month. Apparently, this is now the third most common cancer in both men and women.

As a former primary care provider, I often thought about prevention and screening for colon cancer, or any condition for that matter.

In the area of prevention for colon cancer, just like other cancers, I think about risk factors. There are two buckets of risk factors. Basically, there are ones that are changeable and those that are not. The ones that are not modifiable are family history, genetics, and age. The modifiable risk factors include obesity, tobacco use, excess alcohol intake, lack of activity, and excess consumption of red or processed meats.

Generally, screening for any condition is most helpful if 1) there are effective methods of screening and 2) finding the cancer (or other condition) early significantly improves survival.

Colon cancer screening should be a slam dunk. Why? If this cancer is found while it is still in the colon alone, and not spread, you have a 91% chance of surviving five years out. On the other hand, if the cancer is distant (i.e. spread beyond the colon to distant organs), your survival at five years falls to 14%. So, finding this cancer early in its course is lifesaving.

Yet, one out of three eligible adults have NEVER been screened. What are the available methods? The best thing is to talk to your provider about the options, but generally, the two most used are colonoscopy or FIT (Fecal Immunochemical test). The colonoscopy, if negative, can be done every 10 years, while the FIT test is an annual screen.  Again, the best is to discuss this with your provider, because other options are available as well.

The other topic that comes up is when to start screening. This is another reason to talk to your provider, who can advise you based on your individual and family history. For most “average risk” people, screening generally starts at age 50, with Black people starting at age 45. If you have a positive family history of colon cancer, this may prompt your provider to start screening at an earlier age.

Finally, if you are having unexplained bleeding from your rectum, new or changing abdominal pain, unexplained iron deficiency, or a significant change in your bowel habits…talk to your provider.

Let’s use the strength of those who have gone before us to face these challenges head on!

 

Resources:

https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

https://www.sciencedirect.com/science/article/abs/pii/S0016508517355993?via%3Dihub