Age 50: Time for a Colon Cancer Screening

with Vasanth Siddalingaiah, M.D., Gastroenterologist, Advanced Healthcare

Posted: March 1, 2004

Privileges and responsibilities often come with ages attached. Age 16 signals a driver’s license, 18 means voting, and reaching the age of 21 means you can legally sit in a bar and have a beer.

While we don’t usually think of 50 as an age anything in particular happens, perhaps we should. At 50, every person should be screened for colon cancer. Dr. Vasanth Siddalingaiah, an Advanced Healthcare physician with a specialty in gastroenterology, said the importance of screening for colon cancer cannot be overestimated.

Vasanth Siddalingaiah, M.D., Gastroenterologist, Advanced Healthcare "We could reduce the morbidity rate for colon cancer by 60 percent to 80 percent if everyone would have a colonoscopy at age 50 and then every ten years."

He said that 30 percent to 35 percent of the population age 50 and older has colon polyps. Some benign polyps will progress to cancer if left untreated. Age 50 was determined as the starting age for screenings because that is the age that the risk for colon cancer begins to increase substantially. People with a history of colon cancer in their family should come in for a screening at age 40 rather than 50.

Colonoscopy
Dr. Siddalingaiah said the colonoscopy is the best type of screening available for colon cancer. A colonoscopy is done with sedation and allows the entire colon to be visualized. A colonoscopy enables a doctor to examine the lining of the colon (large intestine) for abnormalities by inserting a flexible tube into the anus and slowly advancing it into the rectum and colon.

Dietary restrictions must be followed beforehand. In general, the preparation consists of either consuming a large volume of a special solution or clear liquids and special oral laxatives. The colon must be completely clean for the procedure to be accurate and complete. The procedure itself takes about thirty minutes.

Two other types of screenings include fecal occult blood testing, where fecal matter is examined, and a flexible sigmoidoscopy, a test involving a camera attached to a tube that looks over about a third of the colon. Both of these tests are less invasive than a colonoscopy, but don’t have as high of a rate of detecting polyps.

Dr. Siddalingaiah stressed, however, that any type of screening is better than no screening at all.

“A colonoscopy is generally viewed as being unpleasant and uncomfortable, but Katie Couric has done a good job of helping people to realize it’s not so bad,” he said. He added that colonoscopies are covered by almost all health insurance plans.

When giving a patient a colonoscopy, the doctor will immediately remove any pre-cancerous polyps during the exam. A patient who has polyps removed will need to come back for another colonoscopy in three to five years, rather than ten.

Reducing cancer risk
Dr. Siddalingaiah said that while screening is important at age 50, a diet high in fruits, vegetables and whole grains can significantly reduce the risk of colon cancer. Areas of the world with a population that eat diets high in fiber have proportionally lower rates of colon cancer than does the population of the United States.

Additionally, people who have had polyps taken out who then begin taking calcium supplements have a lower rate of recurrent polyps than those who do not take calcium. Smoking increases the risk of colon cancer and regular exercise lowers the risk.

Dr. Siddalingaiah said that unfortunately, by the time a person notices the symptoms of colon cancer — rectal bleeding or irregular bowel movements — the cancer is often already too advanced to cure. Colon cancer has a low rate of cure once it has moved beyond the colon.

Patients concerned about an uncomfortable colonoscopy should consider the pain of the disease once it spreads. Over 90 percent of patients tolerate colonoscopy without any discomfort because the test is done with sedation. Treatment of colon cancer includes chemotherapy, radiation and/or surgery, and is often only successful at slowing down, rather than stopping, the disease.

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