By Dr. Trpko Dimovski
With age comes wisdom, experience and, often, a long list of doctor’s appointments. For seniors, the number of recommended cancer screenings can be extensive, but keeping up-to-date on these tests can be life-saving. Unfortunately millions of Americans ignore their doctor’s recommendations.
One important example of the impact of screening avoidance is colon cancer. Widely considered one of the most preventable cancers, colon cancer grows slowly in the body, first developing into a polyp—or non-cancerous growth—that can take several years to become cancer. If these polyps are identified early through routine screening and removed, doctors can effectively prevent cancer from ever forming. For people whose colon cancer is caught early, their five-year survival rate can be greater than 90 percent.
The problem is that despite the American Cancer Society’s screening guidelines that call for men and women at average risk to begin colon cancer screening at age 50, new data from the Centers for Disease Control and Prevention reveals that two out of five adults are not up-to-date. As a result, more than 60 percent of colon cancer cases are detected in the late stages when treatment is difficult and survival rates as low as 12 percent, making colon cancer the second-leading cause of cancer-related death in the U.S.
The reasons why people skip colon cancer screening are personal and can vary from fear to inconvenience to embarrassment. Colonoscopy remains the standard for detecting and removing cancerous and precancerous polyps; however, many are unable or unwilling to undergo the procedure because it’s invasive, requires bowel preparation (including a clear liquid diet and laxatives) and sedation, as well as time off of work and transportation to and from the procedure.
The good news is there are now more colon cancer screening options than ever before.
For example, fecal occult blood tests (FOBT) and fecal immunochemical tests (FIT) were developed to meet the need for less invasive screening options. Both tests were designed to detect blood in a patient’s stool sample that can’t be seen with the naked eye. However, there are unrelated conditions that can cause blood in the stool, not all polyps bleed regularly, and some don’t bleed at all, so these tests may not be reliable on their own for the detection of cancer or precancer.
Last year, the U.S. Food and Drug Administration (FDA) approved another option called Cologuard®. Unlike other noninvasive colon cancer screening tests, Cologuard analyzes a stool sample and looks for both blood and DNA known to be associated with cancer and precancers. The concept is simple: every day, cells are shed from the colon wall during the digestion process. As part of this process, normal cells, along with abnormal cells from precancers or cancers, are shed into stool as it passes through the colon – it is these abnormal cells that Cologuard uniquely is designed to find.
The process of taking Cologuard is simple. First, a physician orders the test and a collection kit is sent to the patient’s home. The patient collects a stool sample in the comfort of home and at his/her convenience—no medication, dietary restrictions, bowel preparation, sedation, time off of work or transportation required. Once a patient completes the Cologuard stool collection process, he/she ships it directly to the lab via a prepaid mailer.
The patient receives the test results from the prescribing healthcare provider in about two weeks. If test results are positive, the doctor will refer the patient for a diagnostic colonoscopy. If the test is negative, the patient should continue to participate in a screening program at an interval and with a method appropriate for the individual patient.
A study published in the New England Journal of Medicine found Cologuard to be highly accurate, detecting 92 percent of colon cancers in average risk patients and 69 percent of the most advanced precancerous polyps with a specificity of 87 percent.
Being proactive about your health is important at every age, but for seniors it’s especially critical to stay current with recommended screenings. Whether you’re talking about colon cancer or any number of other diseases, early detection is crucial to long-term survival, so the most important test is the one that gets done. The good news is that today’s seniors have many noninvasive screening options available to them, so don’t wait, talk to your physician today about the tests you should complete and which screening options are right for you.
Dr. Dimovski is a Family Practice doctor with St. John Hospital and Medical Center in Detroit, Michigan.