When you hear "colorectal cancer screening," you've probably heard only worst-scenarios: gross colon-cleansing drinks, doctors putting tubes where the sun don't shine.
As uncomfortable as all that might sound, here's the other scenario: What if you join the 1 of 20 people who are diagnosed with colon cancer at some point? In the United States, colorectal cancer is the second leading cause of cancer deaths for both women and men.
But here's the good news: It doesn't have to be that way.
Colorectal cancer screenings can find cancer early when it's easiest to treat. With screening, 60% of colorectal cancer deaths could be prevented.
Colorectal cancer screening saves lives, yet 1 in 3 people aren't up-to-date on their screenings. This may be because there are many myths floating around that can scare people away.
Here is the truth behind some of the most common colorectal cancer screening myths.
Myth: All colorectal cancer screening tests are created equal.
There are two main ways to screen for colorectal cancer: tests that allow providers to see your colon -- generally colonoscopies -- or stool tests that analyze your stool for signs of cancer.
The stool sample tests can be a little more appealing, since many can be done with an in-home kit, meaning you don't have to leave the house.
However, Maureen Hewitt, MD, assistant medical director of Penn Hematology Oncology at Chester County Hospital, warns that stool tests aren't quite as effective as colonoscopies. "There is a greater risk of a false test result compared to screenings that allow care providers to directly visualize the colon," Dr. Hewitt says.
"With a colonoscopy, a physician is able to visualize the lumen of the bowel, and any abnormalities, such as polyps. Polyps are removed before they have a chance to transform into a cancerous lesion," she explains. "It becomes a direct means to prevent colon cancer."
Stool tests have a greater likelihood of false positives -- they test positive for cancer, even though there isn't actually any cancer. If you receive a false positive, you may opt for further tests, such as biopsies, which are invasive and come with risks. A false positive can also cause unnecessary distress, anxiety, and sadness.
"And, a positive stool test obligates moving forward with a colonoscopy," Dr. Hewitt adds.
Additionally, most people can do colonoscopies every 10 years. But stool tests need to be repeated more frequently.
If you're still not sure you want a colonoscopy, talk to your provider to see if a stool test is an option.
Myth: Colonoscopies hurt.
During a colonoscopy, you will have a scope inserted into your rectum. Thinking about that might make you squirm, but you're probably more uncomfortable thinking about it now than you ever will be during or after the procedure.
Before the colonoscopy, you will be given a sedative to put you in a "twilight" haze. It technically won't make you fall asleep, as general anesthesia would, but the effect is very similar. You will essentially be knocked out for the procedure, meaning you won't feel anything while it's happening (or remember it after).
Also, you might see a touch of blood in your stool for the next day or so, but you shouldn't feel any pain.
Myth: Getting a colonoscopy is embarrassing.
You are getting tested in a usually private area of the human body, so it's natural to get a little sheepish. But keep in mind:
- The providers performing the test are medical professionals. They do it every day and they've seen it all.
- Again, you'll be sedated, so you won't notice or remember anyone looking. Plus, when you are awake, you'll be wearing a medical gown.
- Learning that you're in good health -- or finding something early enough to treat -- is a pretty good trade-off.
And seriously. They have seen it all.
Myth: The prep for a colonoscopy is awful.
Well...this one is probably the most factual of the myths. For a colonoscopy to work, you need to clear out your bowels. This generally involves taking a laxative, often in the form of a liquid you drink the night before.
These laxatives are very strong -- after all, they're clearing out your entire colon -- so you can expect to spend some quality time with your toilet. And the drink doesn't always taste that great.
But -- it's not awful. You will be on the toilet for a while, but you should not have a painful stomach ache all night.
And the taste? Well, there's not much to do about that. However, some liquid laxatives can be washed down with tastier clear liquids, such as apple juice. Ask your physician or pharmacist ahead of time what you can drink to make it go down easier.
Just remember -- one night of being in the bathroom and drinking something that doesn't taste great is worth staying cancer free.
Myth: Everyone should start screening at age 50.
Not necessarily. For people with an average risk of colorectal cancer, it's a good idea to start regular screenings at age 50. But if you have a higher risk, your provider might want to get you started earlier.
You may be at high risk if you have:
- A personal or family history of colorectal cancer or certain types of polyps
- A personal history of inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis
- A personal history of radiation to your pelvic area or abdomen as a treatment for a prior cancer
- Certain hereditary colorectal cancer syndromes, such as Lynch syndrome
- Obesity
- Diabetes
Your provider might also want to get you started before you hit the big 5-0 if you have symptoms of colorectal cancer, such as unexplained blood in your stool or stomach pains that won't go away.
Myth: Once I start, I'll never stop -- I'll need to get screened for colorectal cancer every year.
The general recommendation is that you get regular colorectal cancer screenings through age 75. Depending on your personal preferences, overall health, and screening history, your provider may recommend continuing screenings for a few more years. However, it's not recommended that people over age 85 get screened.
Usually, providers recommend getting a colonoscopy every 10 years. If you are at high risk or have had irregular screenings in the past, your provider may want you to do certain tests more frequently.
Myth: I have no family history of colorectal cancer, and I'm not experiencing any symptoms, so I'm fine without a screening.
Anyone can get colorectal cancer, whether or not it runs in the family. And don't let the no symptoms thing fool you -- colorectal cancer can be quite sneaky. It often doesn't cause symptoms until it is in its later stages when it's more difficult to treat.
Myth: If a colorectal cancer screening shows polyps, that means cancer.
Polyps are clumps of cells that form in the lining of the colon. When they first develop, they're noncancerous. However, some can eventually grow into cancerous tumors.
If your provider tells you that they removed polyps, take a deep breath. The polyps will be analyzed in a lab for signs of cancer, but know that most polyps don't turn into cancer and that getting them removed is usually just a precaution. This is actually very common -- about 20% to 30% of American adults will have noncancerous polyps at some point.
And remember -- a colorectal cancer screening is just that: a screening. By definition, a screening simply looks for signs of potential cancer. It doesn't actually diagnose anything.
For more information on colorectal cancer screenings, call 610-738-2300 or use our online form to schedule a colonoscopy.
Related Information from Chester County Hospital: