Forty percent of FOFs still aren’t getting colonoscopies. Dr. Michael Kreines thinks he knows why…
Colorectal cancer is the most preventable and curable type of cancer. In fact, when it’s caught early, the five year survival rate is over 90 percent. And here’s more good news: colonoscopy, the most effective means of prevention, is fully covered under the new Affordable Care Act–you don’t even need a copay!
Yet 30-40% of adults over 50 still don’t get screened. What’s up, FOFs?
We spoke to Dr. Michael Kreines, a gastroenterologist and medical advisor for the Colon Cancer Alliance, about why women aren’t getting screened and what you can do about it. (Hint: It’s no big whoop. Just do it.)
- Okay, why aren’t women getting colonoscopies?
- They have to go somewhere and do something that they think is going to be uncomfortable, embarrassing and may result in bad news.
- They’re afraid of the results.
- Yes. They think, ‘gosh, if I’ve got cancer, I don’t want to know about it. I’m gonna die anyway.’ They associate getting a colonoscopy with finding cancer. But that’s not really what it’s about. Colonoscopies prevent cancer. We find polyps–which are little growths that can become cancer. And we remove them before they become cancerous.
- So it’s like a pap smear? Or removing a mole?
- Yes! That’s the analogy I use all the time. You’re detecting precancers.
- Who should get a colonoscopy and and when?
- If you’re 50 or older and you’ve never had a colonosopy, get one now. Your first one should be at age 50. If someone in your immediate family had colon cancer, then get your first one at age 40. If your immediate family member had colon cancer at a young age–for example, if your sister had it at 40–then have your first colonoscopy at 30. Just subtract 10 years from the age of your relative when he or she was diagnosed.
- What if you have an aunt, uncle or grandparent who had colon cancer?
- The data shows that your risk is a little elevated, but not as high at it would be with a first-degree relative. Still, if your aunt was young–for example, she was 40 when she was diagnosed–then we would start you a little bit younger. And if you have several second-tier relatives who’ve had it, then we would probably start you at 40.
- How often should you get a colonoscopy?
- Every 10 years. If you have a family history, have it done every 5 years. If we find polyps, then we encourage you to come back in 3 years.
- If it’s been less than 10 years since your last colonoscopy, what sort of symptoms should send you back to the doctor early?
- The most common symptom of colon cancer is no symptom at all, and that’s why colonoscopy is so important. You can’t wait for symptoms to be screened! But you can watch out for bleeding or blood mixed with your stool, abdominal pain that you haven’t had before, or a change in your bowel movements, such as unusual bouts of diarrhea or constipation.
- What exactly happens when you get a colonoscopy? Does it hurt?
- No–it really doesn’t. The night before, the patient drinks a bowel cleanser. Many people describe that as the worst part of the whole procedure because it basically gives you diarrhea. The day of the colonoscopy, you come in, put on a gown and are sedated.
- Some people are nervous about being sedated. What kind of sedation do you use?
- It’s called twilight sleep. You’re sedated, but you can still respond to questions and commands…you just don’t remember anything afterwards. While you’re sedated, we insert a flexible fiber optic scope into your rectum and up through your colon to look for polyps. If we find anything, we remove it right then.
- Are there any alternatives to colonoscopy?
- One alternative test checks your stool for evidence of microscopic blood. It’s based on the theory that any lesion or cancer will bleed. The problem with that test is that it’s not very accurate. There are a lot of tumors that don’t bleed, or they bleed intermittently, so you might be falsely reassured that you’re okay, when you’re not. There’s also a CAT scan, which is called virtual colonoscopy. It uses a fancy computer program to digitally make a picture of the colon. The problem with that test is that it’s very expensive, most insurance companies don’t pay for it, and it exposes you to a lot of radiation. Also, if polyps are found during the virtual colonoscopy, the patient will still need a regular colonoscopy to remove them.
- Which test do you recommend?
- The colonoscopy. It’s just the best test.
- What else do you think would encourage women to just get screened?
- It would be nice if the colonoscopy gown was more attractive. In fact, if you have any members who would like to design a more appealing gown, I’d love to talk to them.
Here’s something else that might inspire you. Right now, Olympus is donating $1 to The Colon Cancer Alliance for every woman over 50 years old who makes the commitment to get screened. Visit www.FinditFirst.com to commit right now!
GastroenterologistDr. Michael Kreines is a gastroenterologist with the Ohio Gastroenterology and Liver Institute in Cincinnati, Ohio, and a Member of the Medical Science Advisory Committee for the Colon Cancer Alliance