March is National Colorectal Cancer Awareness Month, a time to be aware of the dangers of colorectal cancer, which takes more than 50,000 lives each year. Both the American Cancer Society and the U.S. Preventive Services Task Force have changed their guidance for regular screening exams, lowering the age from 50 to 45. Why the change? Because in recent years, a concerning number of colorectal cancer cases have been occurring in people under age 50, accounting for 11% of colon cancer cases and 15% of rectal cancer cases. The reasons for the rise in cases among younger people haven’t yet been identified, which means there is no indication the increase will be resolved anytime soon.
While colorectal cancer is the country’s second leading cause of cancer death, it is also one of the most successfully treatable—and highly preventable—when caught in its early stages. Polyps can be discovered and removed before they have a chance to become malignant, and early cancers can be treated before they have time to spread. Caught early, colorectal cancer has a 90% survival rate.
Certain factors increase the chance of developing colorectal cancer, including a personal or family history of colorectal disease, type II diabetes or an inflammatory bowel condition like ulcerative colitis or Crohn’s disease, or having undergone treatment for testicular or prostate cancer. For reasons not fully understood, Black people and Ashkenazi Jews are considered at elevated risk. Lifestyle habits including excess weight, smoking, moderate to heavy alcohol use, lack of regular exercise and a diet high in red or processed meat can also raise risk. Folks falling into the higher risk categories should have a traditional colonoscopy, ideally at age 45 or even earlier when recommended by a clinician. Because cases of colorectal cancer are rising even among people in their 20s and 30s, every adult falling into a higher risk group should talk to their medical provider about the need for screening.
Why This Preventable Disease Is So Deadly
The reason colorectal cancer takes so many lives is that it goes undetected for too long, owed to a general fear or dread of getting tested. Few people cherish the thought of the prep, followed by inconveniencing someone to drive them to and wait through the exam, and then being sedated and having a scope inserted into their bowel. After that, the day is pretty much lost to recovering from the sedation.
Actually, not all of that is necessary for everyone. For people who are considered at average risk of colorectal cancer, there are alternate options to consider. One is CT colonography, also known as virtual colonoscopy. In this quick, painless exam, highly specialized x-ray imaging is used to study the colon and rectum. Virtual colonoscopy doesn’t require insertion of a colonoscope, often making it the preferred screening method for people at higher risk of bowel perforation, such as those who are older, have narrowed bowels or are on blood thinners.
Virtual colonoscopy uses low-dose computed tomography to create highly detailed cross-sectional images designed to catch most polyps, lesions and abnormalities in the colon and rectum as accurately as standard colonoscopy, and includes imaging of nearby organs and tissues that may also be affected, all in about 15 quick, painless minutes. Because it is less invasive than traditional colonoscopy, there is no need for sedation, which may be safer if you have respiratory issues or a sensitivity to sedatives, and you can drive yourself to and from your appointment.
Virtual Colonoscopy Prep
Because both conventional and virtual colonoscopy require a clean bowel for imaging purposes, prep is the same, and—let’s be frank—it’s a chore. But remember: finding a polyp before it becomes cancer makes it worth the hassle. The evening before your exam, you will take a prescribed dose of laxative pills and drink half a gallon of liquid laxative, which is consumed in small doses at regular intervals. Years ago, this liquid laxative was chalky and hard to drink – now it’s clear and flavored, making it much easier and more pleasant to ingest. You’ll drink the remaining half gallon after waking up during the hours before your appointment. Naturally, you will be making frequent trips to the bathroom, so consider picking up some soothing baby wipes beforehand.
Yes, the prep is no picnic, but it’s just one evening and the next morning, then you have your exam. With regular colonoscopy, you’re heavily sedated and once the exam is over, you will travel home with the person who was kind enough to drive you, and then you will likely rest the remainder of the day.
Virtual colonoscopy is different. No sedation is needed. You simply drink a small glass of contrast liquid that will coat your intestine for clear imaging. You lie back on a padded table and your skilled Radiology Associates technologist will carefully guide a very thin tube inside the rectum just enough to gently expand the intestine with air. The process is quick, comfortable and minimally intrusive. Minutes later, you’re free to drive yourself wherever you want to go—there is no time lost to recovery, no burden on others to drive and wait around.
When a virtual colonoscopy discovers no signs of cancer, most people don’t need another one for five years. So, if you’re 45 or older and at average risk for colorectal cancer, talk to your medical provider about whether virtual colonoscopy is an option in your preventive care. With a clinician’s referral, virtual colonoscopy is 100% covered by insurance.
You can take steps to prevent colorectal cancer. A few hours of commitment today can prevent untold misery and peril down the road.