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Colon Cancer Screenings

March comes in like a lion and out like a lamb. But let’s not let the transformation occur without recognizing it’s finer attributes. Caesar was bludgeoned during the Ides of March. There is the madness of college basketball finales. We spring forward to a normal time zone when there is still daylight when you get home from work. And we get to think about our colons! It’s Colon Cancer Awareness Month, y’all!! Holla!

Colon cancer is common and it’s preventable. Colon cancer is the second leading cause of cancer deaths in the United States (after lung cancer). Roughly 150,000 people are diagnosed with colon cancer each year and roughly 50,000 people die from it. Six percent of American deaths each year is due to colon cancer, that is one in 17. Colon cancer starts as a polyp. It’ s a growth in the lining of the colon that causes no symptoms. Most polyps never turn in to cancer but nearly all cancers start out as polyps. So if you can find and remove these polyps then one need not die of colon cancer. The biggest risk for having polyps is age. A first degree (mother, father, brother, sister, son, or daughter) family member with either polyps or colon cancer is the second biggest risk.

For years, the recommendation was to start colon cancer prevention at age 50 as over 93% of people that died of colon cancer were above that age. Over the last decade we’ve seen a change in that trend. We are increasingly seeing people between the ages fo 20 to 50 that are getting diagnosed with colon cancer. The risk continues to be age related. Now, roughly 88% of people who die of colon cancer of above age 50. A drop of 5%. (I so wish I could draw a curved graph depicting colon cancer mortality on the y axis and age on the x axis, then show how the shape of the curve hasn’t changed. Only that there has been a shift in the percentages to the left, leaning towards younger ages).

So in an effort to extend the protective efforts of colon cancer prevention to younger people who are at risk, the American Cancer Society took the first step. Two years ago, they recommended that we start preventative efforts at age 45. Their “qualified recommendation” was based on computer models of the number of colonoscopies required per life saved and at what age you implement the initial colonoscopy. Then 75% of people in the room had to agree that the trade off was worth it. They then issued their recommendation.

In October 2020, the US Preventative Task Force, which is more of a driving force of clinical practice, issued a “preliminary recommendation” agreeing that age 45 was an appropriate time to start preventative strategies. That recommendation was finalized in January 2021.

As a member in good standing for 25 years of the American College of Gastroenterology, who just received his lapel pin and certificate, I was going to wait for my own peeps to weigh in. The news came that we, too, of the ACG, are going to recommend starting to prevent colon cancer at age 45. Now that means something to me.

However, just because the ACS, the USPTF, and the ACG recommend that you ought not die of colon cancer, doesn’t mean that your insurance company agrees. We can recommend till the cows come home, but someone has to pay for it. There is a bill at the Texas House of Representatives right now HB 2250 sponsored by Represetative Julie Johnson D-Farmer’s Branch that would guarantee that insurance companies would have to cover colon cancer prevention at age 45 for those people that wanted it. It is being heard in then House Insurance Committee.

So if you between the ages of 45 and 50, would like to not to die of colon cancer, and believe that people who evaluate evidence are to be trusted, perhaps you ought to contact your Legislator and let them know your feelings.

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ABOUT DR. KUMAR

Dr. Kumar’s mission is to educate the public about their health. To that end, he had a call in radio show, The Dr. Kumar Show on TALK Radio 1370 from 2003 to 2009. It received the Anson Jones MD Award for Physician Excellence in Reporting from the Texas Medical Association. Dr. Kumar has also been doing a segment on FOX 7 Austin on Wednesday mornings since 2005. That, too, won an Anson Jones MD Award. He is dedicated to the proposition that people can understand science if it is explained without scientific jargon.

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Dr. Pradeep Kumar shares his valuable medical insights through his Blog and Health & Wellness in Austin podcast. 

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