AS A GENERAL RULE, women are better than men when it comes to seeking health care and complying with medical screening tests. Most women learn to view mammograms, Pap tests, colonoscopies, and other screening protocols as just part of the fabric of routine healthcare. They may not be thrilled about undergoing these procedures, but most will follow through with them nonetheless.
Men, on the other hand, typically need a bit more coaxing (often from female partners) before they’ll undergo important health screenings. Take the colonoscopy, for example. The thought of this procedure evokes emotions in men ranging from mild trepidation to outright terror. Of course, once they’ve actually undergone a colonoscopy, most men wonder what all the fuss was about.
During a colonoscopy, the patient is sedated and a colonoscope—a long, thin, flexible tube equipped with a light and a tiny fiberoptic video camera—is inserted in the rectum and advanced along the entire length of the colon. As the colonoscope is maneuvered, it transmits a detailed view of the lining of the colon and rectum to a display monitor. If any polyps or other abnormalities are discovered during the procedure, they can be removed or biopsied immediately using instruments inserted through a port in the colonoscope.
One could argue that the worst part of a colonoscopy is actually the bowel prep on the preceding day, which can involve drinking a large volume of unpleasant-tasting liquid and then spending the rest of the day on the toilet while the colon is completely purged. However, nowadays colonoscopy patients may have the option of lower-volume, or even pill-form, bowel preparations that make this stage more palatable and less daunting.
Given what they’ve heard about the bowel prep and the somewhat invasive—and potentially embarrassing— nature of colonoscopy, it’s not surprising that people might be reluctant to have the procedure done despite its proven efficacy. But colonoscopy is the most powerful weapon doctors have for the early detection of colorectal cancer—and, as with any cancer, the earlier cancerous (or precancerous) colon polyps are detected and treated, the better the outcome for the patient.
In fact, though colorectal cancer is among the leading causes of cancer-related deaths in the U.S., it is almost always treatable if caught early. But therein lies the challenge for doctors. In its earliest stage, colorectal cancer often has no symptoms. Hence, screening via colonoscopy—even when nothing seems to be amiss—is your best line of defense against this disease.
As colorectal cancer progresses to more advanced stages, symptoms may begin to appear. See your doctor for an examination promptly if you experience blood in the stool; narrow stools; diarrhea, constipation, or other changes in bowel habits; pain and tenderness in the lower abdomen; unexplained anemia; or unexplained weight loss.
The American Cancer Society encourages people at average risk of developing colorectal cancer to begin regular screenings at age 45. Earlier or more frequent screenings may be necessary if an individual has risk factors such as:
• A personal history of colorectal cancer or certain types of polyps
• A family history of colorectal cancer
• A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
• A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
• A personal history of getting radiation to the abdomen or pelvic area to treat a prior cancer. At this point, many men might be wondering, “Why would I subject myself to an invasive colonoscopy when I have the option of doing a stool-based screening, such as Cologuard, right in the comfort of my own home?” While these do-it-yourself tests are better than getting no screening at all, they can’t compare to colonoscopy for several reasons: they aren’t nearly as effective at detecting precancerous polyps; they yield a not-insignificant percentage of false positives, which can cause unnecessary anxiety; and they don’t allow for the removal or biopsy of polyps. In other words, if the test produces a suspicious finding, you have to follow up with a colonoscopy anyway. You’re better off sticking with the gold standard of colorectal cancer screening—the colonoscopy—to begin with.
So, men, if you’ve reached or are soon to reach the age of 45, don’t wait for your wife or significant other to urge you into getting that first colonoscopy. Schedule it now. And if you’re younger and have any risk factors that increase your likelihood of developing colorectal cancer, discuss with your doctor whether it would be appropriate to start getting screened earlier. Your health and peace of mind are well worth the minor inconvenience.
✲
