It’s a bird…it’s a plane…it’s a colonoscopy

Newswise – Among the TV superheroes of the virtual home care era is a smiling, anthropomorphic box.

The animated character sells a brand of do-it-yourself colon cancer screening tests. While these over-the-counter tests and others like them provide results that can prevent life-threatening disease, they’re best thought of more as the real hero’s sidekick: colonoscopy, Batman to the Robin of the home test.

“Most experts agree that colonoscopy is still the gold standard,” said Dr. Audrey Kulaylat, colorectal surgeon at Penn State Health Milton S. Hershey Medical Center.

This does not make home testing unnecessary. Some products check stool for DNA markers that indicate cancer. Other less expensive home tests look for blood in feces. But at best, these tests may set up the Bat Signal that it’s time for a colonoscopy.

This may sound like bad news for those who have postponed testing. Instead of welcoming a hero like the Dark Knight, procrastinators often worry more about the dark night – the cleanup they need to do before the actual procedure. Practitioners have taken steps to make the preparation less unpleasant. Gone are the gallon canisters of medicine-flavored liquid you have to drink the night before. Some doctors instead instruct patients to add a 64 oz bottle of MiraLAX laxative to a variety of flavored drinks, such as Gatorade.

“The actual cleaning – it’s going to be miserable,” Kulaylat said. “But that’s the key.” If residual material remains, part of the colon containing precancerous growths called polyps or, worse, tumors, may not be visible.

And this vision is always crucial. The American Cancer Society estimates that the United States will see 106,180 new cases of colon cancer in 2022, and 52,580 people are expected to die from it. Although the numbers have been declining since the mid-1980s, it is still the third most common form of cancer in both men and women. And this decline hides a worrying trend: the numbers are rising for people under 50.

Kulaylat says the spike in colon cancer cases among young people is likely linked to the Western diet, which emphasizes less fiber, fruits and vegetables, and more fat. Gut health — specifically the varieties of bacteria that live in the stomach and intestines — plays a role that doctors are constantly studying. In 2018, given the alarming increase in the number of younger people with the disease, the American Cancer Society lowered its recommendation for who should have a colonoscopy from age 50+ to age 45+.

According to Kulaylat, the frequency of screening depends on several factors. “It all depends on your basis risk,” she explained. Has a member of your immediate family developed colon cancer? Do you have a condition that makes the disease more threatening? It is more common in people with ulcerative colitis or Crohn’s colitis. During a previous colonoscopy, did the doctors find and remove any polyps? A yes to any of these questions may mean that you need frequent screenings.

Doctors might recommend that people without risk factors and a clean colonoscopy wait several years between screenings — possibly up to a decade. However, anyone with any of these symptoms should not delay discussing it with a gastroenterologist:

  • Rectal bleeding
  • Any change in bowel habits
  • Stool narrowing
  • Frequent abdominal discomfort
  • Feeling like your bowels are not completely evacuated

The gain from early detection can be significant. When cancer is detected and removed from the colon before it has a chance to spread, the five-year survival rate is 90%. “We can remove it with minimally invasive techniques,” Kulaylat said. “That means less time away from work and less time away from family.”

But that starts with catching the disease before it gets too far. And for that you need a trustworthy superhero.

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the medical minute is a weekly health report produced by Penn State Health. Articles feature the expertise of faculty, physicians, and staff, and are designed to offer relevant and timely health information of interest to a broad audience.