By Jeanne Novas, MD 

While we all worry about Covid, don’t delay your preventive care, especially Colon Cancer Screening. March was colon cancer prevention month.

The age has CHANGED:  As of October 2020, U.S preventative services task force recommends all patients start colonoscopy cancer screening at age 45, not 50.  That means insurance should pay for these earlier screens, finally!!  Screening typically stops after age 75-85.  Also, you can directly call to schedule a colonoscopy with a Gastroenterologist.  You do not need to see a primary care doc first, or the GI doctor.

If you are low risk, no symptoms, start at 45.  Many higher risk patients should start earlier, age 40 or 10 years before relative diagnosed: family history of polyps/cancer, African American race, smoking, rectal bleeding, obesity, anemia, diabetes, abdominal pain, constipation/diarrhea/stool changes, other cancers.  High fiber diets protect your colon.  Red meats/processed meats with nitrates increase your risk.  “Colon cleansing” does not really prevent bowel cancers or undesirable symptoms.

In between yearly you should have a rectal exam and a “hemoccult” – that is a test you take home, put 3 separate stool samples on it and send back to your doctor.  Not very good compliance on this test.  We prefer the “FIT” test-done with your in-office rectal exam with results in 3 minutes.  You can buy this test for $25-$50, our office charges your insurance and typically gets paid less than $20.

Colonoscopy is the best option despite the “prep” bowel clean-out the day before – if polyps are seen they are removed thus preventing cancer.  Complication rates are extremely low. It is done with IV sedation with a pencil thin flexible scope while you are on your side. Other colon problems can be detected like hemorrhoids, diverticulosis, colitis/Crohn”s disease.  Low risk normal studies typically recommend a 10 year follow up.  “Cologuard” is an at home alternative that combines the “fit” stool test plus a genetic marker for colon cancer, done every three years.  Your doctor needs to order it.  If positive, you will need a colonoscopy.  This test, for what you get, is expensive at $500.

Finally, our office does offer genetic cancer screening if you have a strong family history or have polyps/cancer. Maximum out of pocket cost is $250.  The best person to get genetic testing is the person who HAS cancer and/or polyps.

Don’t delay your preventive care, see us yearly, get your testing done!