by Bret Hanna
olorectal cancer is the third-leading cause of death in the United States, and the risk of developing it is 1 in 20. Although colorectal cancer can be very deadly, it is also very preventable and treatable. Prevention and treatment require screening, which often necessitates a colonoscopy. A properly performed colonoscopy can identify precancerous polyps or cancer itself that can be readily treated in the early stages. And since 90% of colon cancer is contracted by those 50 and over, 50 has long been considered the gold standard age for the first colonoscopy. Assuming there are no signs of concern, the protocol then calls for repeat colonoscopies every ten years. But is this long-established age 50 protocol still the magic age protocol? The answer is, it depends. One can, in consultation with a qualified medical professional, determine your “colonoscopy age.” Age 50 is certainly the high-age benchmark, but colonoscopy age can be lowered as individual risk factors are considered.
Family History. A family history of colon polyps or colon cancer is a significant risk factor because somewhere between 5 and 10 percent of colorectal cancers have a genetic/familial link. If there is a family history, it could be the result of an inherited cancer gene that dictates earlier screenings for.
First-Degree Relative History. If a parent, sibling or child has a history of pre-cancerous polyps or colorectal cancer, your colonoscopy age may drop significantly, depending on the age they were diagnosed. The rule is that a colonoscopy should be had 10 years before the youngest first-degree relative was diagnosed. As such, if a first-degree relative is diagnosed at age 30, the colonoscopy age for the rest of the immediate family is 20.
African American Descent. Statistics show that there is a higher incidence of colorectal cancer for those of African American descent, and the recommended colonoscopy age is 45.
Non-Genetic/Non-Family History Factors. Upwards of 80 percent of colorectal cancer cases have no connection to genetics or family history. Also, in many if not most cases there are no symptoms until late stages, when it is often too late for a cure. In addition to the genetic and familial history risk factors, other risk factors should be reviewed with a qualified physician to determine whether a specific individual’s colonoscopy should be lowered (it goes without saying that this review should occur before the age of 50). Such factors include alcohol use, tobacco use, history of radiation for other types of cancer, high-fat diet, sedentary lifestyle, obesity, diabetes, history of inflammatory bowel diseases (Crohn’s disease, ulcerative colitis, etc.), and history of polyps in the rectum or colon.
Since the five-year survival rate for early detection of colorectal cancer is 90%, risk-factors and screening should be considered by everyone as they move into and through adulthood. There are screening options available, such as fecal occult blood test, double-contrast barium enema, flexible sigmoidoscopy and virtual colonoscopy. The reality, however, is that colonoscopy is the most comprehensive screening tool available. In addition to detection, colonoscopies have the added benefit of being able to prevent colorectal cancer through pre-cancerous polyp removal. A colonoscopy may not be all that appealing, but having one at the right age can be a lifesaver.