Why You Should Get Your First Colonoscopy at Age 45, Experts Say

Record numbers of young people are being diagnosed with colon or rectal cancer. Over the past few decades, more than ten percent of all colorectal cancers occurred in people under age 50, which is up more than five percent in that age group over previous years. Doctors say the increase is likely due to lifestyle factors such as an unhealthy diet, which is described as one lacking enough fiber-rich foods like fruits and vegetables, an unhealthy diet also consists of one that is high in processed foods, particularly processed meats, and high in animal fat, especially red meat. Other risk factors for colorectal cancer include being overweight or obese, heavy alcohol consumption, lack of physical exercise, and tobacco use. 

The increase in younger cancer diagnoses prompted the U.S. Preventive Services Task Force an independent, volunteer panel of national experts in disease prevention and evidence-based medicine, as well as the American Cancer Society to recommend people at average risk for the disease to begin getting their colonoscopy screenings at age 45 instead of age 50, which was the previous recommendation.  

While colorectal cancer affects all groups, African Americans are as much as forty percent more likely to die from the disease than others. However, that could be changing. 

A Pastor’s Testimony

For example, at Trinity Baptist Church, a predominantly black congregation in Columbus, Ohio, parishoners learn how to prevent early death from colon cancer so they can serve the Lord on this side of eternity as long as possible. Assistant Pastor Janet Sheppard’s family has worshipped at this church for five generations, which can be common.  

“This is our home, and has been our home for a long time,” she said. 

What may be considerably less common at her church is a person’s decision to get a colonoscopy, a screening procedure that can detect actual cancer or precancerous polyps. Reverend Sheppard followed her doctor’s advice to get one, and is now telling others at church she’s glad she did it. She says sometimes people tell her why they prefer to avoid a colonoscopy, and how she responds to them. 

“Some people say, ‘If I don’t know about it, I don’t have to deal with it,'” she explains, adding, “But you will eventually have to deal with it.”

Pastor Sheppard’s colonoscopy revealed three pre-cancerous polyps, which were removed during the same colonoscopy. Without that screening and discovery, the polyps could likely have grown into cancer, possibly taking her life. 

“Had I missed that opportunity, who knows what would’ve happened,” she said, “Those polyps would’ve remained. We don’t know if they would’ve turned to cancerous, they’re pre-cancerous, but they would’ve remained in my body and had the potential.”

During worship, Pastor Sheppard passes out blue colorectal cancer awareness ribbons and she shares her testimony, hoping others will get a colonoscopy as a result of hearing her success story. 

“When you talk about it from the pulpit, when you talk about it in your circles around church and that type of thing, people listen,” she said, “And it’s like, ‘Wow, if that happened to Reverend Janet, if that happened to whoever, maybe I need to listen to what my doctor’s saying.” 

Church Encourages Spiritual Health and Physical Health

Senior Pastor Victor Davis believes it’s totally appropriate for spiritual leaders to give medical advice at church. 

“It is not just a place where you come in fellowship and worship,” he said, “But it’s also a place where you receive resources, that you might be able to go back and serve the community better.”

He Pastor Davis adds that leaders of African American churches in particular, carry a responsibility to protect their congregation’s health. 

“The African American population in many cities, oftentimes is the population that does not have access to the information that is needed,” he said, “So that they might get the health care that they need.” 

Unfortunately, convincing people of their need for a colonoscopy isn’t enough to motivate them to get one in some cases.  For many, particularly those in the African American community, there can be other roadblocks, such as the procedure cost, especially if the patients does not have insurance, no transportation to the doctor’s office where the colonoscopy is performed,  not having someone to accompany them to the colonoscopy which is usually required because of the sedation involved, and an inability or unwillingness to take time off work. 

Do I Really Need a Colonoscopy?

As a potential solution, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Center for Cancer Health Equity started a program using home test kits, known as FIT kits not to take the place of a colonoscopy, but to cheaply and easily identify those who should make it a priority to get a colonoscopy, and those who can wait. 

The home test is being mailed to members of Trinity Baptist Church and other African American populations in the Columbus area. The home test kit involves collecting a small stool sample in the privacy of the patient’s home bathroom and sending the same to a lab, which tests the sample for microscopic traces of blood, too small to see with the naked eye, but a red flag for colorectal cancer. If the home test comes back positive, a colonoscopy is strongly recommended. If negative, a colonoscopy is likely unnecessary for now. 

Pastor Davis says the home test is a great tool for people who are hesitant to get a colonoscopy.

“This is an opportunity to receive and be tested in a private, noninvasive way,” he said, “If it comes back positive, you can take the next step.  This is a preliminary opportunity for you to get control of your health and know what’s going on in your body.”

Early Detection Saves Lives

Subhankar Chakraborty, M.D., PhD., a gastroenterologist at OSUCCC-James, and a developer of the outreach program, told CBN News a primary goal of the program is to motivate those in the earliest stages of colorectal cancer to get a colonoscopy, pointing out that these same people might wait to get one until they begin experiencing symptoms of colorectal cancer.  Some of the most common symptoms of colorectal cancer include: rectal bleeding or blood in the stool, diarrhea or constipation, change in the consistency of the stool, abdominal cramps or pain, gas, a feeling that the bowel doesn’t empty completely, weakness or fatigue, and unexplained weight loss. 

“Once they’re diagnosed with a later stage, the risk of death is high.  For example, if you got diagnosed with stage four colorectal cancer, there is a 90-percent chance that you will not survive for five years,” said Dr. Chakraborty, “But imagine if you get a colonoscopy, and you get precancerous polyps removed, you suddenly increase your chances to 100-percent survival.” 

Dr. Chakraborty said people who are not involved in the program can order home tests online, but recommends talking to your doctor about it first, adding that people at high risk of colon cancer should skip the home test and go straight to a colonoscopy.  High risk individuals include: people who have a family member diagnosed with colorectal cancer, especially a first degree relative (parent or sibling), people with multiple secondary relatives, such as grandparents or uncles, diagnosed with the disease, people with a family history or precancerous polyps, those with inflammatory bowel disease, Crohns disease, ulcerative colitis, and patients who have ever received radiation to the pelvic area such treatment for cervical cancer or endometrial cancer.  

Dr. Chakraborty recognizes colonoscopies can be unpleasant, but says certain aspects of the screening have improved in recent years.

“Many patients I’ve spoken to say the prep is the worst part,” he said, adding that people who dread the colonoscopy preparation the day before the screening should know there is good news.

“There are several, what I call, “low volume preps,” so you don’t have to drink as much as you used to before,” he said.

Dr. Chakraborty says patients also sometimes needlessly worry about the procedure causing pain. 

“There are sedation techniques where you can be completely asleep, be comfortable, and when you wake up you’re all done,” he said. 

While colonoscopies are still not anyone’s idea of a good time, doctors say the screening is definitely worth the effort, because it could save your life, or the life of someone you love. 

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