Despite encouraging trends amongst those aged 50+ over the last few decades, colorectal cancer (CRC) remains the second leading cause of cancer death in the US. Alarmingly, for the past 2 decades, the death rate from CRC has been increasing at a rate of 1.3% per year, and, screening exams such as colonoscopies, which are largely credited with the reduction in death rates among those 50+, are now recorded beginning at age 45, or earlier depending on one’s medical and family history in men.
As we age, many of us develop small growths, called polyps, in the lining of our colons. These polyps, which tend to grow fairly slowly, are precursors to CRC – left unchecked, over the course of 5-10 years, a small percentage of them continue to grow and ultimately transform into CRC.
While there are several options available for CRC screening, colonoscopy is the only one that allows for both the detection and removal of polyps and is, therefore, considered the gold standard. During a colonoscopy, a specially trained physician, usually a gastroenterologist, closely examines the lining of the colon, identifying and removing polyps before they have a chance to develop into CRC. As with any procedure, colonoscopies are not without risk; however, complications are exceedingly rare and are far outweighed by the benefit of reducing mortality from CRC.
There are a number of other methods for CRC screening that may be an option depending on your circumstances, ranging from stool tests to radiologic imaging studies. While none of these provide the same level of prevention as a colonoscopy, they are alternatives to consider depending on your individual circumstances. It should be noted that those with a family history of CRC, a personal history of colon polyps, or those who report symptoms that can be attributable to CRC (such as rectal bleeding or a change in bowel habits, for instance) are not candidates for alternative screening methods and should instead be referred to a gastroenterologist for a colonoscopy.