A colon cancer tsunami

Should I have a colonoscopy before I turn 50?

It used to be that when a person hit the age of fifty, having a colonoscopy became a rite of passage. It wasn’t like turning twenty-one and being able to drink legally. This rite was no fun at all and that is why many of us put it off for a few years. Inevitably, someone would shame us, or a proactive doctor would gently nudge us and we would make an appointment and have the procedure.

It wasn’t pleasant but it really wasn’t that horrible. First you drink something akin to poison. You are highly advised to be very close to a bathroom for numerous hours and not eat much the day before. Chew a lot of gum between the gulps of the liquid, so you don’t taste it, and when you walk in to see the doctor, just know that you will be knocked out with something truly divine. When you awake hopefully all will be well and you won’t have to go through this ritual again for, maybe, another ten years.

Katie Couric went on live TV and had the procedure done in front of the world. (She was awake but was sedated with something so that she would feel no pain but could talk to the doctors and her audience). She brought awareness to people that this cancer was extremely serious. Her husband died in 1998 at the age of forty-two from colon cancer. Too young. People aren’t supposed to be screened for this cancer until 50. Unfortunately, not anymore.

The older population has seen a decrease in colon cancer cases for the simple reason that widespread screening can catch early-stage cancers and pre-cancerous polyps. A study was done at Vanderbilt University that showed these new colon cancer cases in younger people were from cancers at the far side of the colon and rectum rather than in other parts of the colon. This is a different area from the cancer that is found in older adults. Scientists think that the cause might be environmental exposures that started in the 1950s. Our gut biome has changed due to ultra-processed foods, microplastics and antibiotics.

Doctors are not certain what causes CRC (colorectal cancer — a combination of the colon and the rectum). Some people have no symptoms and others do. Symptoms can be constipation or diarrhea, persistent abdominal discomfort, cramps, gas, pain, rectal bleeding, dark or bright red blood in the stool, fatigue or unexplained weight loss.

If this happens to you, and you’re thirty years old, a doctor might dismiss your concerns with cancer and not screen you. You must be a very tough advocate for yourself. Catching a problem in the early stages may be the only way some of these cancers can be conquered.

The risks for people over sixty-five have decreased but that might change, which is something researchers are saying. Black people have a 20 percent higher rate of getting CRC and a 40 percent higher mortality rate. Other things that can contribute include family history, whether you previously had a polyp, a low fiber or high fat diet, diabetes, not exercising, obesity, smoking and drinking. Your socioeconomic status, access to insurance and geographic location play a big role. And again, our water, food and everything that floats in the air we breathe matters.

Cologuard is an at-home colon cancer screening test that many people use. (Anything not to drink that liquid doctors give you). I tried it and was told that I needed to have a colonoscopy right away. I did. I was fine. Cologuard, I have been told, does not give proper data much of the time; many false positives are involved. The best way to check for CRC is still the colonoscopy.

While the cancer rates have gone down for older adults, they still may not be out of the woods. The risk of cancer may rise with each generation. The risk for younger people has grown three percent each year. The only way to protect yourself is to be aware of your body and any changes you feel you may have. Make your doctor listen to you. And if you are feeling great, still get tested at forty-five. Don’t wait. People that know about CRC say that there could be a tsunami of cases. We don’t need more young people dying. (Chadwick Boseman was 43 years old. James Van Der Beek was 48 years old). This is no longer just your grandparents’ disease.

Sources: Mayo Clinic, Katie Couric, The New York Times, The American Cancer Society

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