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If you have a family history of colon cancer, get screened

Posted by Sabina Khan, MD, Gastroenterology, Ridgeview Specialty Clinic on Dec 4, 2018 1:30:00 PM

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At age 48, my grandfather died from colon cancer. He had never been screened for the disease. My sister Nighat, also was never screened. Then, at age 59, she was admitted to the hospital for a bowel obstruction and nearly died during surgery. That’s what led to the discovery of her cancer. It was localized, removed and she is doing fine eight years later.

Pictured: Dr. Sabina Khan (left) was screened for colon cancer before she had symptomsa decision that saved her life. Her sister Nighat also survived colon cancer. Both were fortunate that their cancer was discovered before it was too advanced and difficult to treat. Sabina and Nighat are pictured with their mother. 

Though I am a physician who specializes in cancer of the colon, my sister’s diagnosis certainly was the wake-up call for me. While I had no symptoms, I scheduled my first colonoscopy at age 48 because of my family history. A large polyp with localized cancer was discovered. The colonoscopy saved my life.

Colon cancer is the second leading cause of cancer-related deaths in the U.S. One person dies from colon cancer every nine minutes. While the statistics sound daunting, the good news is that both the incidence and mortality rates have been declining—fewer people are dying from the disease because more people are getting screened.

But we’re not where we need to be. One might expect that everyone would be getting screened and yet, screening rates are well below where they should be. Unfortunately, 20 percent of colon cancers discovered have already metastasized (spread to other sites in the body)—in other words, it’s too late.

I understand that people have fears and concerns about having a colonoscopy. As a gastroenterologist, I’ve performed more than 40,000 colonoscopies and I have heard all the hesitations and excuses, but the overwhelming consensus with my patients has been “that it’s really not that bad.” The temporary discomfort and inconvenience are a small price to pay for a procedure that could save your life.   

Screening options

Colonoscopy

A colonoscopy is not the only screening option available, but is my recommendation because it is truly the gold standard for screening. This is the only test in which the diagnosis is made and treatment (removal and biopsy of the polyp) can be performed concurrently. You do not have to schedule another exam to get answers or treatment. But there are other less invasive options to consider for the average risk patient (i.e., no family history or other risk factors).

Cologuard

Cologuard, is a relatively new screening option. It is a do-it-yourself kit that allows you to collect stool in the privacy of your own home. Cancer and precancerous polyps shed abnormal DNA in the colon which can be detected in a stool sample. A Cologuard can identify 90 percent of cancers and 40 to 50 percent of precancerous polyps. Its down side is that it can miss half of small polyps and if you test positive, you still need to have a colonoscopy.

CT Colonography

Another screening tool is a CT Colonography, which is an X-ray of the colon using low dose radiation CT scanning to view the interior of the colon. While this screening does require a laxative prep, it is noninvasive and the results are comparable to a traditional colonoscopy. But again, if polyps are discovered, you still need a colonoscopy to remove them.

These are the top and most effective preventive screenings for colon cancer. Everyone age 50 and older should be screened. Those with a family history or other risk factors should consult with their gastroenterologist about earlier or more frequent screening.

Colon Screening

Medical and health information presented here is intended to be general in nature, and should not be viewed as a substitute for professional advice. Please consult with a health care professional for all matters relating to personal medical and health care issues. In case of an emergency, please call 911. 

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