Less may be more when it comes to colonoscopies.
While it’s a highly effective screening tool, the invasive colonoscopy is uncomfortable to prepare for. That may be why so many take a pass on it.
Rush University Medical Center gastroenterologist Dr. Joshua Melson said more than two-thirds of colorectal cancers are prevented by colonoscopies, making it a “very powerful preventative tool.
Current guidelines recommend colonoscopy at age 45, but for those with symptoms or a family history, screening should be done earlier. However, Melson said only about 60 percent of people who are eligible actually get a colonoscopy.
That’s not enough to make a dent in the mortality rate, and colon cancer remains the second deadliest cancer in the United States.
“We’re still seeing a stubborn rate of colorectal cancer incidence and death that we’ve had challenges in reducing. Obviously, we want no people to get colorectal cancer,” Melson said.
Without any screening, Melson said about one in 20 people could have their life cut short from colorectal cancer.
Now doctors say they have a new plan to help curb cancer rates. Melson is among a national group of gastroenterologists advocating for a change in the way patients are screened and tracked.
“When we look at health systems that have been able to get to higher rates of screening and therefore lower rates of the development and the death of colorectal cancer, they have used a multi-pronged approach,” Melson said.
At the top of the list is better at-home screening methods like stool testing, which has been found to reduce colorectal cancer deaths as well. But Melson said the non-invasive test is not for everyone.
“When we’re talking about stool testing, we have to select our patients carefully. That stool test may not be sensitive enough to pick up something that in five years or in three years may then develop colorectal cancer,” Melson said.
Doctors hope to partner with manufacturers to improve sensitivity, developing more effective biomarkers and better tracking methods to detect a problem early.
Melson said it’s also important to put a tracking system in place, so if a non-invasive test identifies someone as high risk they can receive immediate care.