I'm Not at Risk for Colorectal Cancer — Do I Still Need to Be Screened?
Chadwick Boseman, the actor, director, and writer who achieved international cinematic fame as Marvel Comics’ “Black Panther,” was only 43 years old when he died from colon cancer. An athlete and an intellectual, full of youth and vigor, Boseman was diagnosed with stage 3 disease in 2016, which had progressed to stage 4 by the time he died in 2020.
The sooner colon and rectal (i.e. colorectal) cancers are caught, the more likely they are to be curable. However, once colorectal cancer progresses to later stages, as it did in Boseman’s case, it’s more difficult to treat and could become terminal.
Colorectal cancer is among the most common cancers in the United States, apart from skin cancer. Every year, more than 52,000 women and men in the US lose their lives to CRC. Death rates have been dropping, mostly due to increased screening and precancerous polyp removal during colonoscopy.
With all the emphasis these days on biological “hacks,” supplements, and technologies that claim to extend your lifespan, it’s important not to forget that one simple test may make the difference between a long life and a short one. A colonoscopy not only can catch CRC as soon as possible, it also helps determine your risk for disease and even serves as treatment.
At Colon and Rectal Surgeons of Greater Hartford, we recommend regular colonoscopies so you can stay cancer-free. Nobody has a zero risk for CRC, even if they eat a fiber-rich, whole-foods diet and get plenty of exercise. However, your risk factors do determine how often you need to screen for colon cancer.
What’s your risk and how often should you undergo colonoscopy? This brief guide can give you an idea.
Are you at average risk?
The lowest risk you can have for colorectal cancer is to be at “average risk.” Lifetime risk is about 1 in 23 for men and 1 in 26 for women in the US. While that may not sound like much, even those potential deaths are preventable with regular screenings.
To be considered at average risk, you have to meet certain exclusion criteria. According to the American Cancer Society, average risk women and men do NOT have the following in their personal or family history:
- Personal history of colorectal cancer
- Personal history of certain types of polyps
- Family history of CRC
- Personal history of inflammatory bowel disease (IBD)
- Confirmed or suspected hereditary colorectal cancer syndrome
- Personal history of radiation treatment to abdomen or pelvis
If you’re at average risk, you should begin screening at age 45. As long as your colonoscopy is clear (i.e. no cancer or polyps), you may not need to re-screen for another 10 years. If you’re in good health and have a life expectancy of at least 10 more years, you should continue screening until you’re 75 years old.
Are you at increased risk?
In the US, when compared to other racial groups, American Indian and Alaska Native people have the highest incidence and mortality rates for CRC, followed by African Americans. Worldwide, Ashkenazi Jews have one of the highest rates of CRC. You’re also more likely to develop CRC, and have a poorer prognosis, if you have type 2 diabetes.
You’re also at increased risk for CRC if you DO have the following:
- Family history of CRC
- Personal history of colon polyp removal
- Personal history of CRC
- Personal history of radiation treatment to abdomen or pelvis
You may need to start your screenings before age 45 if you’re at increased risk. You may also need more frequent colonoscopies than someone at average risk. Your doctor determines your schedule after testing, exams, and taking a personal and family history.
Are you at high risk?
When you’re at high risk for CRC, you may need to start screening far earlier. It’s also highly recommended that you stick to the gold-standard screening of colonoscopy, rather than rely on other types of CRC screenings.
History of IBD
If you have IBD, you should have your first colonoscopy no later than eight years after you were diagnosed with Crohn’s disease or ulcerative colitis. Screening is repeated every 1-3 years.
High-risk genetic syndromes
Certain genetic syndromes, such as familial adenomatous polyposis (FAP) and Lynch syndrome, are associated with a high risk for CRC. You may need to start screening as early as your teen years and may also need more frequent follow-ups to stay cancer-free.
You have your whole life ahead of you, so why wait? Book your colonoscopy by calling us at 860-242-8591 today. Or schedule your appointment online at our Bloomfield, South Windsor, or Plainville, Connecticut, clinics.