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Why are 3 in 10 adults never screened for Colon Cancer?

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ColonCoverColon cancer is the second-leading cause of cancer deaths in the United States. Unlike many other cancers, however, we have sophisticated, effective methods of detecting colon cancer early and preventing deaths. So why are so many people still dying from this detectable, treatable disease?

The headline above is somewhat misleading. It’s true that about 31% of adults over 50 never screened for colon cancer, but what’s equally troubling is about 33% of adults between ages 60 and 70 have only been screened once in their lifetimes.

Colon cancer is a threat that persists throughout our lifetimes. Screening guidelines approved by the CDC state that most people should start screening at age 50 and repeating every 10 years even if no signs of cancer are found. Many people are not getting their first colonoscopy at 50, and even fewer are bothering to repeat the test at age 60 and 70, despite the risk for developing precancerous polyps increasing over that time span.

So what’s causing people to skip these exams completely? As it turns out, a lot of different factors, carrying surprisingly even weight. Fear of the procedure and preparation, embarrassment, lack of time, poor physician awareness, lack of knowledge that follow-up exams are necessary, lack of health insurance, and poor access to medical care all play major roles in peoples’ decision making with regards to colon cancer screening.

The good news is that there is room to improve. The CDC estimates that 60% of current colon cancer deaths could be prevented with better screening. Considering that we’re already catching a large percentage of colon cancers through existing screening habits, this means we could potentially knock colon cancer several rungs down the ladder in terms of cancer deaths. It also means we need to fight to overcome some of those reasons people are skipping out on their exams.

A lot of that comes with better education for patients. While doctors have a responsibility to educate their patients on important screening tests and procedures, the only way to ensure that you receive the proper tests and the proper point in your life is to keep your physician informed on your medical history and what you have and have not had done. Making sure you get your colonoscopy scheduled at the right age can save your life. Missing it could kill you.

Remember, colon cancer doesn’t care why you missed your colonoscopy.

The Stool Test: How a fecal test can help detect colon cancer, and where it falls short

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Colorectal Cancer Cells. Source: NCI Center for Cancer Research

The Stool Test, also known as a Fecal Occult Test, is sometimes given to patients for aid in screening for colon cancer. While it can help aid in detecting colon cancer, it is important to understand why it, and other tests like it, are only supplemental tests and not a replacement for more accurate and rigorous screening procedures – in this case, colonoscopy.

The reasons for a stool test are simple: it is easy and quick enough to conduct at home, and much less invasive than a colonoscopy. You receive a simple card kit, and you smear a fecal sample on each card before returning them to your doctor. The most up-to-date versions of the test are designed to successfully detect tiny, microscopic bits of blood in the stool. Since this is one of the major warning signs of colon cancer, this can help give early warning to patients who will then need to get a full colonoscopy as a follow-up.

The downsides, however, are very real. Stool tests are not very accurate, and have a high chance for either a false positive (where blood is present but does not come from colon cancer or pre-cancerous polyps) or false negative (where no blood is detected, but colon cancer is present). In the case of the false positive, you’re still going to need to undergo a full colonoscopy to confirm the presence of cancer or polyps. And in the case of a false negative, you may have been able to detect the cancer early if you had undergone a colonoscopy instead of the quicker and easier stool test.

Like many screening tests that have issues with accuracy, the recommendations for taking the stool test vary depending on the organization. The CDC lists it as a “recommended” test, saying you should take it once a year. The American Cancer Society specifically recommends the more modern, accurate version of the test.  And the USPSTF gives the test an “Inconclusive” rating, meaning there is not enough evidence to recommend the test as a primary screening tool.

The good news is that tests like this are always been improved, and newer versions of the stool test have shown more and more promise in accurate detecting colon cancer. It is possible that in the coming years, we may see an accurate enough version of the stool test that it replaces regular colonoscopies as the primary means of early detection in patients. But for now, it’s important you talk to your doctor about when to schedule your first colonoscopy – remember, if you catch it early, colon cancer is a beatable disease!