Over 45 And Haven’t Had A Colonoscopy? Here’s Why You Should

Whenever we get a new patient at Westchester Health over the age of 45, one of the first questions we ask is, “Have you had a colonoscopy?” If the answer is no, we then explain what a colonoscopy screening test is, what it’s looking for, and why it’s so important.

If the person still balks at getting a colonoscopy, what usually convinces them is when we tell them that colon cancer is one of the most curable forms of cancer, that there are reliable screening tests that can detect it early at a very treatable stage, and that, since colon cancer is relatively slow-growing, it can be intercepted before it has reached an advanced stage, if a person gets regular screenings.

Elie M. Abemayor, MD, Sc.M.

This is usually enough to convince them to put up with a day of colon cleansing and get the test. For those persons who have questions about whether they should get a colonoscopy and how often, we offer this blog containing important information and hopefully, answers to their questions.

Colorectal cancer: the facts

According to Cancer.net:

  • Colorectal cancer is the third most common cancer diagnosed in both men and women each year in the United States, excluding skin cancer.
  • An estimated 145,600 adults in the United States are diagnosed with colorectal cancer each year.
  • Men have a slightly higher risk of developing colorectal cancer than women.
  • The risk of colorectal cancer increases as people get older. It can occur in young adults and teenagers, but the majority of colorectal cancers occur in people over 50.
  • For colon cancer, the average age at the time of diagnosis for men is 68 and for women is 72.
  • Colorectal cancer may run in the family if first-degree relatives (parents, brothers, sisters, children) or other family members (grandparents, aunts, uncles, nieces, nephews, grandchildren, cousins) have had colorectal cancer.
  • When colorectal cancer is found early, it can often be cured.

At what age should you get a colonoscopy?

For people at average risk

The American Cancer Association recommends that people at average risk* of colorectal cancer start regular screening at age 45 and continue through age 75.

For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health and prior screening history.

People over 85 should no longer get colorectal cancer screening.

*People are considered to be at average risk for colorectal cancer if they DO NOT HAVE:

  • A personal history of colorectal cancer or certain types of polyps
  • A family history of colorectal cancer
  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
  • A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer

For people at increased or high risk

People at increased or high risk of colorectal cancer might be told to start colorectal cancer screening before age 45, be screened more often, and/or get other specific tests, says the American Cancer Association. This includes people with:

  • A personal history of colorectal cancer or certain types of polyps
  • A strong family history of colorectal cancer or certain types of polyps
  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis or Lynch syndrome
  • A personal history of radiation to the abdomen or pelvic area to treat a prior cancer

Why is a rectal exam not enough to screen for colorectal cancer?

In a digital rectal examination (DRE), a healthcare provider examines your rectum with a lubricated, gloved finger. Although a DRE is often included as part of a routine physical exam for both men and women, it is not recommended as a stand-alone test for colorectal cancer. It can find masses in the anal canal or lower rectum but is not a good test for detecting colorectal cancer because it only checks the lower rectum.

How is a colonoscopy performed?

During a colonoscopy, you will be given sedatives through an IV in your arm, which put you to sleep. Then your physician will insert into your rectum a tube-like instrument with a light and video camera on the tip (colonoscope) so he/she can see the lining of your colon and detect if there is a problem. The colonoscope also includes a tube that lets your physician pump in air and inflate your colon, giving him/her a better view of your colon and its lining.

During the procedure, your physician also uses the colonoscope to remove tiny samples of your colon for testing, and to remove any polyps that might have attached to the wall of your colon/rectum.

Getting a colonoscopy is the best way to prevent colon cancer

The American Cancer Society strongly believes that preventing colorectal cancer (not just detecting it early) is the most important reason for every person to get a colonoscopy at the appropriate age.

Most colorectal cancers start as polyps which can be easily removed, and the progression from precancerous polyp to cancer is believed to take 10 years or more. Whenever physicians find polyps during a colonoscopy screening, they remove them before they can become cancerous. Screening also identifies colon cancer early, when it is most treatable.

Read our blogs on the subject

We’ve written several informative blogs focusing on conditions and disorders of the digestive system, which you can read here.

Helpful websites we recommend

Concerned about colon cancer? Please come see us.

If you’re over 45 and have never had a colonoscopy, or it has been more than the recommended timeframe to have another one, please call (914) 232-1919 to make an appointment with one of our Westchester Health gastroenterologists. We’ll examine you, talk about your family history and colorectal cancer risk, and together with you, decide on the best test options, given your individual health needs. Whenever, wherever you need us, we’re here for you.

By Elie M. Abemayor, MD, Sc.M., a gastroenterologist with Westchester Health, member of Westchester Health Physician Partners