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During colon cancer awareness month, let’s focus on the little things

Little things truly matter. This is especially true in our fight to prevent colon cancer. Colon cancer almost always starts as tiny mushroom-looking, pre-cancerous growths called “polyps”.  Over a five- to 10-year period, these little 1mm-10mm nothings may evolve into something…cancer. Fortunately, these can be easily removed during a colonoscopy. 

A sigh. A decimal point. A nail in a tire. On the surface, these all sound like little things, but if they go unnoticed, they cause big problems.

Yes, the little things truly matter. This is especially true in our fight to prevent colon cancer. Taking the time to prep for and complete a colonoscopy procedure sometimes feels like more trouble than it’s worth. It might feel like another little thing you can push back on your to-do list. Yet, colon cancer will impact about one out of every 24 individuals in their lifetime. It’s also the second leading cause of cancer deaths in the U.S., resulting in about 50,000 deaths in the U.S. every year.

But this isn’t a “gloom and doom” message – colon cancer is almost completely preventable! That’s right, preventable—as in you never get it.

This is where the little things come in. Colon cancer almost always starts as tiny mushroom-looking, pre-cancerous growths called “polyps”.  Over a five- to 10-year period, these little 1mm-10mm nothings may evolve into something…cancer. Fortunately, these can be easily removed during a colonoscopy.  A colonoscopy not only serves as a cancer finding technique, but also a cancer prevention technique! I think of it as preventive maintenance rather than a cancer screening. There are other simple steps you can also take for colon cancer preventive maintenance, such as moderating alcohol consumption, eating less red meat, and maintaining a healthy weight.

Too many Americans put off colonoscopies and other preventive care during the pandemic. Roughly 20 percent of U.S. adults who were polled about health care during the coronavirus pandemic said that they or their household members delayed receiving medical care or were unable to get care at all due to the crisis, according to a recent study from Harvard T.H. Chan School of Public Health, the Robert Wood Johnson Foundation, and National Public Radio. Part of the reason was that some hospitals and surgery centers suspended elective procedures to help manage the flood of Covid patients. However, others simply didn’t feel safe or were overwhelmed.

As we roll through Colon Cancer Awareness Month (March), I encourage everyone over 45 years of age to consider getting screened. Screening for colon cancer can take on many forms or strategies, including:  a colonoscopy, a CT scan-based procedure called a virtual colonoscopy, testing your stool for the DNA commonly found in colon cancer, or testing your stool for blood.  Colonoscopy is considered the gold standard for colorectal cancer (CRC) screening.  It involves the insertion of a very small flexible tube called a colonoscope into the rectum and colon.  The scope has a number of go-go-gadget-like tools built into it such as a camera, a water gun, tweezers, and little probe that stops any bleeding that might occur.  It’s a high-tech piece of equipment that’s used to identify and pluck out any polyps that are found before they every have a chance to become a cancer.

A virtual colonoscopy is an imaging technique that doesn’t require any sedation but still requires the insertion of a tube into the anus (to inflate the colon) and, like a standard colonoscopy, must be preceded by a day or so of ‘bowel prep’ (induced diarrhea to empty the bowels).  Any polyps that are identified would likely require removal by a standard colonoscopy—a second procedure.  But for those who aren’t candidates for a colonoscopy this can be a valuable test.

DNA stool testing and stool-for-blood have become fairly well known due to recent marketing campaigns and requests from patients for less invasive screenings.  These tests don’t require any sedation, tubes in your body, or bowel prep. But they aren’t as accurate as a colonoscopy.  The stool testing can find cancers at a pretty good rate but don’t always pick up the precancerous polyps, the tiny things.  Therefore, if this is the test being used, they’re often done much more frequently than a colonoscopy.  Additionally, it is not uncommon to get a positive test when there’s no cancer or polyps to be found.  So have a conversation with your healthcare provider to determine a screening and prevention strategy that works best for you.  To find more information about colon cancer risk factors, prevention, and diagnosis, visit the American Cancer Society’s website.

And for our clinical providers out there: This is a good time for you to highlight another little thing to the patients you see this month: The United States Preventive Services Task Force (USPSTF) recently moved the colorectal cancer screening age down from 50 to 45. So, start those conversations a little earlier!

Photo: Natali_Mis, Getty Images

Terry Layman, MD serves as the Senior Vice President, Corporate Medical Director of Marathon Health. He is a board-certified family physician with more than 20 years of experience as a primary care provider, having worked in major hospital systems and private practice before joining Marathon Health. He is a graduate of the Indiana University School of Medicine and is also a member of the American Medical Association, the Indiana State Medical Association, and the American Academy of Family Physicians.

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