Colonoscopy at 50, or not?

Do you have blood in your stool? Do you feel that something is not quite right in your gut? Do you have a lineage of cancer in your family? Then you should have a colonoscopy, either starting at 50 or whatever age you need. But what if you feel fine? What if there is no family history of colon cancer, or even cancer? (Note – a family member diagnosed with cancer past the age of 80 is not considered a genetic marker.) Do you need a colonoscopy? The answer is now questionable.

Sometime within the last 40 years, our society transitioned from seeing the doctor when we weren’t feeling well to going as a means of survival. Preventive medicine has come a long way in the last generation, but has our quest to live longer led us to become a nation addicted to medical testing? Testing that, as it turns out, may not extend our lives and could even cut it short.

The American Cancer Society recommends having a colonoscopy starting at age 50 and continuing them every 5-10 years until age 75 as our best chance to beat colon cancer (the number 2 silent cancer killer in the US). But is it? Colonoscopies supposedly prevent colon cancer by removing polyps (which may or may not be cancerous) and detect any early colon cancer. However, data is emerging that this claim may not be supported by fact. In turns out that most polyps do not even become cancerous (there is also a danger that cutting the polyp with precancerous cells releases otherwise dormant cells into the blood stream), many colon cancers are actually lesions that would not be detected or removed during a colonoscopy,  and for some unanswerable reason the colonoscopy is only highly effective in the left colon, not the right. Not to mention that colonoscopies have a .2% risk of serious injury, the highest of any standardized medical test. While undergoing a colonoscopy, it is also possible to bleed out when one of the polyps are cut or to perforate the colon (which could lead to loss of the colon) and death. 1% of the population (note – some studies place the risk at 6% depending on the age group – the higher the age, the higher the risk) will likely get colon cancer throughout their lifetime; however, colon cancer doesn’t tend to arise until the age of 60 or 70 (not 50) and is very slow-growing, around 10 years before the cancer becomes symptomatic.

If you are concerned about colon cancer, there is another test which involves sending in a stool sample once a year that is very effective at detecting colon cancer (if cancer is detected, then a colonoscopy would be required). There is also the virtual colonoscopy, but it is not recommend due to the high level of radiation it emits.

The reality is that a balanced dietmoderate exercise, minimal tobacco, limited alcohol and sufficient Vitamin D are proven to be the best things we can do to increase our healthy longevity and protect against all cancers. Could we do all of this and still get cancer? Yes. Should you get tested if you feel like something is wrong? Yes. Should we blindly test ourselves to death? The choice is yours.



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