New age limit set for first colonscopy for African-Americans: Linda Rhodes

Dr. Linda Rhodes | Special to PennLiveBy Dr. Linda Rhodes | Special to PennLive 
on July 30, 2014 at 11:15 AM, updated July 30, 2014 at 11:18 AM

Q: I heard on the radio something about men and women needing to get their first colonoscopy when they turn 45 years of age rather than fifty. What’s that all about?

A: You likely didn’t catch the whole story. It’s now recommended that African-Americans get their first colonoscopy at age 45, while the rest of the population remains with the 50-year benchmark. Once both groups have graduated from their first screening, they’re to come back every ten years.

It turns out that African-Americans are being hit with colorectal cancer at a higher rate than all other races. Worse yet, they survive it less than their counterparts. According to the American Cancer Society, more than 50,000 people are expected to die this year from colorectal cancer and they are twice as likely to be African-American. Screenings could save more than half of those lives. Researchers believe that lack of access to care and preventive screenings with a subsequent delay in seeking care are partially to blame for the disparity.

Colorectal cancer is the second-ranked killer cancer in the United States among men and women (first is lung cancer). The number of new cases this past year was 136,830. It is the one cancer that can be prevented by screening, in fact, according to the American College of Gastroenterology, you can expect a 90 percent reduction in cancer risk following a colonoscopy and removal of polyps in the colon discovered during the procedure. Most colorectal cancers develop from polyps that are abnormal growths in the colon that make for a cancer-friendly environment for cancer cells to grow. If left undetected, that’s exactly what can happen.

The likelihood of developing colorectal cancer is 1 in 20 and the lifetime risk is roughly equal in men and women. Those are odds most of us can avoid by screening; yet, one in three of us (23 million) turn down the opportunity to dodge the colorectal cancer bullet.

Ever since “Today Show” newscaster Katie Couric underwent a colonoscopy on national television in March 2000, the aversion to getting the procedure has been chipped away. Most will tell you (me included) that the procedure, itself, isn’t all that bad. It’s the stuff you drink the day before to cleanse your colon – so the tiny camera can scope out polyps with a clear view – that’s the hard part. But given what’s at stake, my best advice is what my mom told me: “Quit your whining.”

For an excellent video on colonoscopy as to what to expect be sure to click here.

Most insurance plans cover preventive colonoscopies at the recommended ages and every ten years following. One other screening test that the American College of Gastroenterologist recommends to detect blood in the stool is a Fecal Immunochemical Test (FIT) that can be prescribed by a physician (there are also at-home tests you can purchase). An annual exam using FIT between colonoscopies can uncover hidden blood in the stool warranting further testing.

Early stages of colon cancer rarely produce symptoms. A dear friend of mine found this out by dutifully getting her first colonoscopy at age fifty feeling just fine. She was shocked when she was told that, indeed, she had colorectal cancer at Stage 2. Five years out, she’s doing just fine and that screening saved her life.

If you have symptoms of abdominal pain, blood in or on the stool, a change in the texture, color or shape of your stool (e.g diarrhea or black tarry stool) or a change in your typical bowel movements (e.g. constipation) be sure to see your primary care physician. It doesn’t necessarily mean it’s colorectal cancer but it does deserve a doctor’s attention.

A family history of colon cancer, inherited forms of colorectal polyps and predisposing chronic digestive diseases like Crohns or ulcerative colitis place you at higher risk for this stealthy cancer.

Since your colon does the heavy lifting digesting your food, be kind to it by eating vegetables, fruits and grains. Reduce a cancer-friendly environment in your colon by cutting down your consumption of red and processed meats. Belly fat and being over weight has been linked to a higher incidence of colorectal cancer – so exercise is definitely part of any cancer prevention plan.

Dr. Linda Rhodes is a former Secretary of Aging and author of “The Essential Guide to Caring for Aging Parents,” and can be reached at rhodescaregiving@gmail.com.