Did you know that colon cancer is responsible for about 50,000 deaths a year in the U.S.? Many of these deaths could be prevented with earlier detection.
Colon cancer develops slowly over a period of several years in the form of polyps or lesions. When you remove the abnormality, you remove the source of cancer. Yet the screening rate for colon cancer nationwide is estimated to be about 60 percent among adults 50 years of age and older, according to the Centers for Disease Control.
In Alaska, people face unique challenges with getting screened. Providers are spread out. There are only 12 gastroenterologists in the entire state. Distance, access, and weather all work against people seeking care.
We sat down with Anchorage-based gastroenterologist Dr. Douglas B. Haghighi of Internal Medicine Associates to talk about the most important things to know about colon cancer risks.
When should you get screened?
One of the most important things to know is how and when you should get screened. Just this last September in the span of 2 days, Dr. Haghighi saw 2 new patients for their routine screenings, neither showing any symptoms, and both had colon cancer.
Most people should begin screening at age 50. We asked Dr. Haghighi if you should ever start earlier than that.
Family history can dictate an early screening. If a parent or sibling has had colon or rectal cancer, your doctor may suggest screening before age 50. Similarly, early screening is advised if multiple grandparents or aunts and uncles have had colon cancer.
Your doctor may want to review a full family history if there is a clustering of other cancers, such as breast, ovarian, or gastrointestinal cancer.
What are some of the warning signs?
Beyond a family history of colon cancer there can be early warning signs. These include:
- Bleeding from the rectum
- Abdominal pain
- Changing bowels
- Lower iron count/blood count
Normal bowel movements may look different for everyone. Dr. Haghighi encourages you to take note if something doesn't seem normal and ask yourself these questions:
- Have there been changes to the routine appearance or frequency of your stool? If so, have you changed your diet or exercise habits?
- What is your baseline and how have things have changed?
- Then, talk to your doctor or healthcare provider.
How can you reduce your colon cancer risks?
Diet and physical activity are among the risk factors you can control. So are avoiding excess alcohol and smoking.
One of the simplest things you can do is to eat an apple with skin on it every day, says Dr. Haghighi. An apple contains 8-10 grams of dietary fiber. Too much fiber gives you a tummy ache. But the right amount can help clean bacteria and other buildup in your colon.
Other ways to get more fiber include chasing a meal with fruit or adding chia seeds to your diet, for example, as a topping on yogurt.
Some evidence suggests that vitamin D and low-dose aspirin can help prevent colon cancer. Talk to your doctor before taking any supplements.
How do you find the right doctor?
Scheduling a colonoscopy may feel scary. Talk to your primary care provider about where to go or ask friends and family for a recommendation.
When you find a gastroenterologist that might be a good fit, don't be afraid to ask questions. Dr. Haghighi recommends asking them:
- How many colonoscopies have you done?
- What is your adenoma detection rate (ADR)? This is the national quality benchmark for screening colonoscopy. This measure should be at least 25% for men and 15% for women.
- What is your average withdrawal time for a colonoscopy? 7 minutes is a good benchmark.
What if you're worried about having a colonoscopy?
There are several tests to screen for colorectal cancer. Dr. Hahghighi suggests you talk to your doctor about your options and choose the screening that's the best fit for you. Sometimes people are embarrassed or afraid to talk openly about their fears or questions when it comes to colonoscopies but Dr. Haghighi says you shouldn't be. “Your doctor has most likely heard it all,” he said. “Just be honest and forthcoming.”
One popular alternative to colonoscopies is the fecal immunochemical test (FIT) that can detect abnormal cells shed from polyps or cancer. It's not right for everyone, but the benefit is you can do it in the privacy of your own home.
While considering your options, it's also important to research and understand how the test you choose is covered by your health plan. Premera customers can log in or create an account online to review a summary of their benefits and coverage. This includes details about the share of costs they will pay for preventive screenings and diagnostic tests.