The Colonoscopy: A Historical Timeline

As we approach the end of this year’s Colorectal Cancer Awareness Month, let’s take a closer look at something near and dear to our hearts: the colonoscopy. 

As the only screening test that detects and prevents cancer, the best test for finding precancerous polyps, and the only test recommended for people with risk factors such as personal history of polyps or cancer, the colonoscopy is truly a life-saving resource. Over 15 million colonoscopies are performed across the United States each year, reducing the widespread risk of colorectal cancer death by over 60%.

However, despite the colonoscopy’s widespread use and unequivocal standard of effectiveness, it is actually a fairly new methodology, one that took decades to be widely-known and well-established. While variations of the colonoscopy were first conceptualized throughout the 1960s, it wasn’t until the last few decades that the standards of quality which govern the colonoscopy as we know it came to be.

Follow along for a deep-dive into our favorite colorectal cancer screening test. 

1960s-70s: The Early Years

Up until the mid-1960s, the closest thing to a colonoscopy was an endoscopic procedure using a rigid sigmoidoscope. This device had very limited movement, reach, and was unable to actually remove polyps. 

In 1969, colleagues Dr. William Wolff and Dr. Hiromi Shinya of Beth Israel Medical Center in New York City invented the fiberoptic colonoscope, the first device to allow doctors to actually examine the entire length of the colon, thanks to its flexible, dynamic design.

Dr. Shinya also invented the polypectomy snare in 1969, a device which was able to physically remove colorectal polyps using a wire and electro-cauterizing mechanism. 

By 1973, the pair had performed over 5,000 colonoscopies, demonstrating the validity and safety of the procedure. 

1980s-90s: Increasing Awareness

In 1983, the Welch Allyn Corporation invented the first video endoscope, allowing doctors to see the procedure on-screen. Before, they were only able to observe the colon through a small eyepiece. 

Although the colonoscopy continued to develop, there was still a lack of general public accessibility and awareness towards the procedure. Many people opted for tests such as fecal occult blood testing and sigmoidoscopy. It wasn’t until 1985, when President Ronald Reagan underwent a life-saving colonoscopy, that the procedure began to garner national attention. 

In the mid-90s, the first screening recommendations were established in the United States. Adults over the age of 50 were suggested to receive regular colonoscopies. However, in a 1999 survey conducted by the CDC, only 40.3% of American adults over the age of 50 reported ever having a colonoscopy or sigmoidoscopy.  

2000-Now: New Developments

In 2000, the American Society for Gastrointestinal Endoscopy (ASGE) published the first colonoscopy guidelines. This seminal work allowed the quality of a colonoscopy to be measured with a numeric value, the Adenoma Detection Rate (ADR) as well as evaluate measures such as the quality of bowel preparation, patient assessments, rate of complications, cecal intubation rate, and withdrawal time. Doctors were finally able to be pragmatically evaluated for their ability to perform a colonoscopy. 

The early 21st century saw a significant increase in colonoscopies. Self-reported colonoscopies across the United States increased from 20% in 2000 to 47% in 2008. This can be contributed to many factors: a variety of educational campaigns and visibility measures pushed by doctors, government, and public organizations; Medicare coverage of colonoscopy, beginning in 2001; even celebrity stunts such as the Today Show’s Katie Couric’s publicized colonoscopy.

From 2000 to 2015, colon cancer rates rose considerably across increasingly younger populations. For adults aged 40-44, colorectal cancer incidence increased by 28%, for those aged 45-49, colorectal cancer increased by 15%, and while colonoscopy rates increased 17% in those aged 50–54. 

Rising colorectal cancer rates have led to efforts such as the U.S. Preventive Services Task Force’s 2020 recommendation that all adults aged 45-75 should be regularly screened. This was an update from the 2016 guidelines that suggested adults without risk factors should begin screening at the age of 50.

What is the future of the colonoscopy?

The colonoscope of the present remains largely unchanged from that first created by Dr. Wolff and Shinya in 1969. While it has developed in mechanical quality, such as flexibility and control, and now features a light source, suction device, lens cleaning, and a camera, it doesn’t really vary in its fundamental use: to observe and remove colorectal polyps, acting as both a diagnostic and therapeutic instrument. Why is this the case? Likely because it is highly effective at what it does! 

With this in mind, the most important development concerning colonoscopies, arguably, is in the public sphere. While the mechanisms of the procedure itself will undoubtedly continue to evolve and innovate, it’s important to consider the future of public access and opinion towards the colonoscopy.

There is still a surprising amount of misconception surrounding the colonoscopy. A 2020 survey of several European countries found that only 45% of people understood that it can prevent colon cancer. In the United States (pre-pandemic), around 68.8% of adults were up-to-date with their colonoscopy. Many people remain uninformed, fearful, and resistant to receiving the  life-saving screening test. Other people are limited by financial means or geographic accessibility to the procedure. 

By working to increase public awareness around the value of the colonoscopy, we can continue to prevent and reduce colorectal cancer deaths around the world. By educating your friends and loved ones about the importance of colonoscopy, partaking in events such as #DressInBlueDay and National Colorectal Cancer Awareness Month, getting involved with organizations like the Colon Cancer Coalition, and getting screened, yourself, you can help promote widespread change. 

See new infographics created by the Digestive Health Physicians Association below. To read stories about people’s experiences with colonoscopies and colorectal cancer, click here. To see our favorite online resources for promoting awareness, click here. To learn more about what exactly colorectal cancer is, click here.

The colonoscopy a historical timelineColorectal screening tests

An Overview of Colorectal Cancer Screening Tests

March is National Colorectal Cancer Awareness Month, an important time to spread awareness and learn more about the risks associated with colorectal cancer.

Colorectal cancer is one of the most common forms of cancer and the second-leading cause of cancer deaths in the world. In the United States this year, an estimated 151,030 adults will be diagnosed with colorectal cancer and ​​an estimated 52,580 will die from the disease. 

Despite its significant rate of incidence, colorectal cancer is highly preventable through the use of screening tests. Gastroenterology Health Partners, in conjunction with the American Cancer Society and Digestive Health Partners Association, recommends that those with an average risk start screenings at age 45. 

Of the colorectal cancer screening tests that we offer, colonoscopy remains the gold-standard of effectiveness and is strongly suggested for anyone eligible. Observational studies have suggested that colonoscopy can reduce colorectal cancer occurrence by 40% and mortality rates by 60%. 

If you’re considering scheduling a screening test, talk to an experienced gastroenterologist. They can help you make the right decision for your needs. 

Keep reading to learn about six commonly-offered colorectal cancer screening tests.

6 Common Colorectal Cancer Screening Tests

1. Colonoscopy

As mentioned above, the colonoscopy is the best diagnostic tool available. This out-patient procedure involves the use of a thin, flexible tube with a camera to exam the lining of the colon (large intestine) for abnormalities such as polyps. Some polyps can be removed with a scope during the procedure. Your doctor may also take tissue samples for analysis as well.

While the colonoscopy does require prep and recovery time, it is a fast, virtually risk-free procedure. Afterwards, your doctor will discuss your results with you and recommend whether you should be screened in 1, 5, or 10 years. To learn more about the colonoscopy, how it works, how to prepare, and more, read here

2. Fecal immunochemical test (FIT)

Often considered the second choice after a colonoscopy, the fecal immunochemical test (FIT) offers a non-invasive method for identifying colorectal cancer. The test, often performed at home, tests for hidden (occult) blood in the stool. This unnoticeable blood is often an early-sign of colorectal cancer. 

If you test positive for hidden blood during a FIT test, your doctor will want to perform another test, most likely a colonoscopy. FIT, unlike colonoscopy, is unable to actually identify or remove polyps and abnormal tissue. Therefore, the FIT is not really a viable “preventative” test and has a much lower accuracy rate. 

3. CT Colonography

The CT Colonography is also known as a “virtual colonoscopy.” This test uses a CT scan (a form of x-ray technology) to exam the colon for polyps. A small scope is inserted slightly into the colon to inflate it with air. Then, pictures are taken of the entire colon. The CT Colonography is highly effective, and, unlike a colonoscopy, it doesn’t require sedation. However, unlike a colonoscopy, this exam doesn’t actually remove precancerous polyps, it only can identify them.

4. Cologuard

Cologuard is another non-invasive, at-home colon screening test. Much like the FIT test, it looks at stool DNA samples. While Cologuard is generally more effective than FIT, it still doesn’t compare to the effectiveness of the colonoscopy–while colonoscopy is known to identify over 70% of precancerous polyps, Cologuard only identifies around 42%.

5. Flexible Sigmoidoscopy

A flexible sigmoidoscopy is a comparable procedure to the colonoscopy. It is an exam of the lower part of the colon using a small, flexible, lighted tube. The tube, called a flexible sigmoidoscope, has a camera which allows the doctor to view the inside of the rectum and the sigmoid colon—about the last two feet of the large intestine. Unlike a colonoscopy, this procedure does not allow the doctor to see the entire colon; any cancers or polyps far in the colon cannot be detected. 

6. Capsule Endoscopy

A capsule endoscopy is a procedure that examines the lining of the middle part of the small intestine, the duodenum, jejunum and ileum. This procedure is necessary because a standard endoscope or colonoscope cannot reach this part of the bowel. Capsule endoscopy is often used to search for causes of bleeding as well as detect polyps, tumors, ulcers, and IBD.

During this procedure, the patient will swallow a tiny pill containing a video camera, light source, and battery. The camera will take 2-3 pictures per second for up to 12 hours, traveling through the GI tract. The photos are saved automatically to a recording device and strung into a video. 

While capsule endoscopy is effective for detecting and documenting significant lesions attributed to conditions such as IBD, tumors, and ulcers, it is significantly less effective as a colon screening test compared to colonoscopy. 

 When it comes to colon cancer screenings, the experienced medical team at Gastroenterology Health Partners is here to serve you. To learn more about our services or to schedule an appointment at one of our offices in Southern Indiana or Kentucky, contact a Gastroenterology Health Partners location near you.

What is Adenoma Detection Rate (ADR)?

For decades, the screening colonoscopy has been recognized as the most effective modality to prevent and detect colorectal cancer. By identifying and  removing precancerous polyps (adenomas), colonoscopies save thousands of  lives each year. Regularly-scheduled screening colonoscopies are crucial for  adults aged 45 and older.  

However, it’s important to note that the effectiveness and quality of each colonoscopy varies from doctor to doctor. Different levels of education,  experience, and methodologies have been found to influence the “success” of a medical practitioner at performing screening colonoscopies. These case-by-case disparities ultimately led to a need for a standard of quality, a numerical  framework. In 2002, a Multi-Society Task Force was assembled to create just that: the adenoma detection rate, or ADR. ADR gives a percentage value to  each doctor’s levels of safety, quality, and thoroughness when performing a  colonoscopy.  

How does ADR work? ADR measures the average rate of precancerous polyps that a doctor identifies and removes in each colonoscopy. In the U.S., it has been  established that at least 30% of men and 20% of women aged 50+ should have  one or more adenoma found in a colonoscopy. It has been found that doctors  that meet or exceed these national quality benchmarks are generally more likely to prevent colorectal cancer, including advanced-stage or fatal cancer. In fact, even a marginally higher ADR can indicate a significant improvement in outcome. Likewise, doctors with lower-than-average ADRs have been connected with the  failure to identify cases of colorectal cancer.  

While the ADR is considered the “gold-standard” of evaluating endoscopic quality, it is not the only measure of a doctor’s ability to identify polyps. Other well-regarded quality metrics include practices such as: the quality of bowel  preparation; patient assessments; compliance rates with general screening  guidelines; rate of complications; cecal intubation rate; withdrawal time (the  amount of time a doctor should spend withdrawing the colonoscope at the end of  the procedure, which should be at least 6 minutes); and documentation of  informed consent. 

By meeting and exceeding these standards of safety and thoroughness, your doctor directly improves your chance of identifying or preventing colorectal  cancer. Therefore, it’s not rude or uncommon to ask about your doctor’s ADR,  withdrawal time, or other procedures that ensure a quality colonoscopy. These  are serious, relevant questions that can aid in your decision to choose a gastroenterologist.  

Our board-certified team of gastroenterologists has addressed many common concerns related to colonoscopies on our website. Click on any of the questions below to see complete answers: 

  1. When should I get a colonoscopy? Isn’t 45 too young?
  2. What should I expect from my colonoscopy? How should I prepare for it? What happens during and after?
  3. Where can I read about someone else’s experience with colon cancer? 
  4. I tend to be constipated. How should I prepare for my colonoscopy?
  5. Why should I get a colonoscopy instead of other screening tests? What makes it more effective? (Video)
  6. What’s the difference between a screening colonoscopy, Cologuard, and other screening tests? (Video)

The experienced team of medical professionals at Gastroenterology Health Partners is committed to making every patient’s experience with a colonoscopy as easy and effective as possible. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you.

Getting Ready For A Colonoscopy Prep When You Tend To Be Constipated

Preparing for your colonoscopy is important because it enables your physician to visibly access all areas of your colon to provide the best screening possible. A successful prep – one where your colon is thoroughly cleansed in advanced – makes it easier for your gastroenterologist to do their job thoroughly and accurately. When patients do not have a successful colonoscopy preparation, and stool is still visible in the colon, it makes it much harder for your doctor to do a thorough evaluation.

If you’re a person that tends to struggle regularly with constipation, the colonoscopy prep may be a bigger concern. You may wonder if the prep will actually work and feel an added worry about how this relates to the actual procedure. Fortunately, there are some additional things you can do a week or so in advance to make the entire process easier and more successful.

People who are often constipated frequently have a longer, tortuous colon which may be more challenging to completely empty out. In these cases, your doctor may provide some additional guidance regarding your prep.  Follow along for some helpful suggestions for preparing for your colonoscopy if you tend to be constipated.

8 Things To Know If You Are Preparing For A Colonoscopy And Are Often Constipated

1. You should tell your doctor in advance that you struggle with constipation. People who tend to be constipated may have to think about their colonoscopy prep further in advance than those who are not. Make sure to let your doctor know in advance if constipation is something that you struggle with frequently. Depending on your symptoms and medical history, your doctor may advise additional things like Dulcolax to help make sure your colonoscopy prep is a success.

2. Ask your doctor about medications, vitamins and supplements you normally take. You may be advised to adjust your normal routine in some way depending on your situation.

3. Cut out high fiber foods several days before your procedure. This includes things like raw fruits and vegetables, canned and fresh corn, whole grains like oatmeal, brown rice, quinoa, popcorn, and wheat bread, all kinds of nuts, and seeds (including sunflower, sesame, and poppy). Focus instead of non-fibrous foods like soups (without vegetables), eggs, yogurt, white bread and puddings.

4. Your doctor may advise you to begin the clear liquid diet for your prep a day early (two days in advance). This involves avoiding solid foods and consuming clear liquids that are NOT red, blue, or purple in color. This includes things like gelatin, clear broth, sports drinks with electrolytes, black coffee, fruit juice like apple or white grape, and popsicles.

5. It can be helpful to drink lots of extra water the week leading up to your procedure to make sure you are very well hydrated. Not only is hydration a key part of addressing constipation, but it also may help to make your overall prep experience easier. Keep in mind that if you tend to drink caffeinated beverages like coffee and tea, these tend to have a dehydrating effect on your body, and you may need to compensate with additional water.

6. Make the time to deal with your worry and stress. Sometimes constipation is exacerbated by stress. It is important that you recognize and deal with this if possible. Find ways to help yourself relax. Consider trying mindfulness, meditation and/or breathing exercises, listen to relaxing music, and engage in other healthy practices that help you feel calmer and more relaxed.

7. Prioritize a healthy routine including getting enough sleep leading up to the procedure. While it is always important to focus on a healthy routine, including getting enough sleep each night, it may become even more important the week leading up to your colonoscopy. This can help you feel your best for the procedure, enabling you to follow the prep with greater ease, also reducing your level of stress and worry.

8. Don’t be embarrassed, constipation is something many people experience. According to the U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney diseases, constipation is common among people of every age and population in the U.S. Approximately 16% of adults experience symptoms of constipation on a regular basis, with this number increasing with age, to a third of adults 60 years and older.

Data reported by the Centers for Disease Control and Prevention (CDC) suggests that upwards of one in three adults ages 45 to 75 has not had a colonoscopy, the recommended screening for colorectal cancer. While there are many reasons why people may opt to avoid this recommended procedure, concerns about what is required to prepare for the exam certainly play a role for some.

The experienced team of medical professionals at Gastroenterology Health Partners is committed to making every patient’s experience with a colonoscopy as low stress and easy as possible. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you.

Importance of Colon Screening in Younger Adults – Dr. Sohi Interviewed

Dr. Sunana Sohi of Gastroenterology Health Partners was recently featured in a WHAS-11 article and video about the increasing rates of colon cancer in younger adults.

The story featured Amanda Blackburn, a 37 year-old mother of two who was diagnosed with stage 3 colon cancer in 2017. She received a diagnosis after coming to Dr. Sohi with her symptoms of rectal bleeding and a change in bowel habits.

Blackburn had no family history of colon cancer and knew very little about the disease, like many younger adults. “It wasn’t on my radar. The ‘C’ word wasn’t a thing for me,” she said.

Dr. Sohi was able to help Blackburn receive diagnosis and treatment.

“If you have symptoms, don’t wait. There are a lot of tests that can be done, including stool tests, but the number one, the gold standard is colonoscopy. That’s because it’s not only diagnostic but preventative, where we can find and remove small polyps before they become cancer,” Dr. Sohi said.

Read the rest of the Dr. Sohi’s write-up here.

Colon Cancer is not a disease of the elderly anymore; article

 

 

 

 

 

 

 

 

 

 

 

 

 

The article also discussed the upcoming Kicking Butt 5K Run/Walk, scheduled for Saturday September 25th at the Louisville Waterfront Park. This event, sponsored by the Colon Cancer Prevention Project, was started in 2003 as a way to bring together cancer survivors and advocates, spread awareness, and encourage screenings. It’s not too late to sign up for the 5K, 1 mile, or virtual event, and support this worthy cause.

If you or a loved one are experiencing symptoms of colon cancer or another GI condition, don’t hesitate to contact Dr. Sohi or one of the many experienced physicians at Gastroenterology Health Partners.

As the largest independent gastroenterology practice in the region, GHP is considered the only one of its kind providing results-orientated treatment for a full spectrum of digestive system disorders. Call to set up an appointment at one of our locations in Southern Indiana, Northeast & Central Louisville, and Lexington.

Why You Shouldn’t Wait To Get A Colorectal Cancer Screening

Are you on the fence about getting screened for colorectal cancer? Perhaps you think you’re too young to get cancer, or you don’t have a family history of it, or you’re anxious about the procedure. You push off the appointment, allowing yourself to think, “I’ll do it sometime soon…”

When it comes to colorectal cancer screenings, you shouldn’t ever wait. Regular screenings are recommended for those 45 years and older, and even younger if you have certain risk factors. For example, people with certain inherited conditions are at a higher risk for colon cancer, including those with Lynch syndrome and those with adenomatous polyopsis. You are also at higher risk if you suffer from certain inflammatory bowel diseases like Crohn’s colitis, or ulcerative colitis.

Early detection is the key to effectively dealing with colorectal cancer. When detected early, colorectal cancer has a 95% survival rate. However, that rate drops to 25% if the cancer is not detected and spreads to other organs. 

Screening tests aren’t just used to identify existing cancer. Through screening, your doctor may find and eliminate precancerous polyps (abnormal tissue growths) in the rectum or colon, removing them before they even have the chance of becoming cancerous. Between 25-40% of adults in the United States are estimated to have colorectal polyps.

Colorectal Cancer Increases in Younger Populations 

While the overall occurrence of colorectal cancer has dropped in recent years (largely due to a rise in screenings), its rate among younger populations has actually increased. In fact, according to the American College of Gastroenterology, a millennial now has 2 times the risk of getting colon cancer and 4 times the risk of getting rectal cancer than someone from the baby boom generation. Research shows that rates in adults younger than 50 are continually increasing by 2%, every year. Mortality rates are also increasing.

What is causing this alarming change? Researchers attribute higher colorectal cancer rates in younger adults to a number of factors, including higher rates of obesity, more sedentary lifestyles, poor diet, and other environmental factors. A study released this May found a link between the consumption of sugar-sweetened drinks and colorectal cancer in women under 50. According to the study, women who drank two or more servings of sugary beverages had twice the risk of developing early-onset colorectal than those who consumed less. Furthermore, adolescents ages 13-18 who consumed sugary sodas had a 32% risk of eventually developing early-onset colorectal cancer. Research is only beginning to unlock certain lifestyle and dietary factors that play a role in developing colorectal cancer.

Colorectal Cancer and Covid-19

During the beginning of the Covid-19 pandemic, lockdowns and closings forced many people to cancel or put off every type of screening test. Colorectal screening tests in particular decreased by over 90%. In the following months, the numbers of tests only increased to 50% of what they were before the pandemic began. This drastic decline in testing is associated with troubling data about cancer outcomes. In June 2020, the National Cancer Institute predicted an excess of 10,000 colorectal cancer or breast cancer related deaths in the U.S. over the next 10 years, just because of pandemic-induced delays in testing, diagnoses, and treatments. Remaining up-to-date on testing is more important now than ever. 

If you’re due for a colorectal screening test or appointment, but are concerned about Covid-19 safety, don’t hesitate to book an appointment at Gastroenterology Health Partners. We uphold a number of safety procedures in-office, including mask requirements, cleaning and sanitization practices, disinfecting common spaces, and upholding social distancing when possible. Maintaining your safety is of the highest importance to us, just as is providing you with colorectal screening tests such as colonoscopies, flexible sigmoidoscopies, and more. Give us a call today to schedule your appointment.

ValueOfColonoscopy.org: ASGE’s Useful Awareness and Screening Tool

There are a lot of great resources if you are interested in learning more about colon cancer and screenings. One of our favorites comes from the American Society of Gastrointestinal Endoscoy (ASGE). The ASGE has a plethora of resources including videos, a screening tool, and statistics at ValueOfColonoscopy.org. Today on the blog, we’ll take you through some of the useful resources on the website.

Screening Tool: Determining Which Test You Should Get

One question many people have about screenings is which test to get. There are numerous options available. It can be confusing when figuring out which is the best fit. Fortunately, the ASGE created a tool that helps you identify the screening method that’s right for you. In a simple yet informative document, they take you through your options based on your risk level (no personal or family history of colon polyps or cancer, family history, or personal history). This tool shows you how these factors impact when you should be screened, how often, and with which screening method. For example, if you have a family history of colon cancer or polyps, it shows that you should have a screening as early as age 40. It also shows that a colonoscopy is best screening given your family history. It recommends talking with your doctor to establish a plan.

Colonoscopies during the Pandemic

During the pandemic, many people have had valid concerns about the safety of activities like doctor’s visits. This has actually impacted how many colonoscopies doctors have performed, and as a result an increase in the number of missed colorectal cancer diagnoses (read our blog post here to learn more). In a video, the ASGE shows how many steps medical professionals are taking to ensure your safety during screenings. They talk about pre-arrival screenings, in-office distancing and barriers, masking, PPE, testing, staff vaccinations, and more. We highly recommend watching this video to get a clear picture of how safe your screening will be. Plus, read our blog post here about what we have been doing at GHP to keep you safe.

Tips as you Prepare for a Colonoscopy

Another important thing this website covers is common patient FAQs leading up to a colonoscopy. The ASGE has a number of helpful guides and tips for you as you prepare for a screening. For example, they have a webpage dedicated to understanding bowel prep, an aspect of screening that many patients dread. They discuss the importance of bowel prep, what type of prep you may need to pursue, and other helpful tips. They even discuss common side effects, specific steps in prepping, and what to do if you forget to take prep medication. This is a great resource to help you make sure your screening is as effective as possible. The ASGE also has content and FAQs that help you understand colon polyps and colonoscopies.

Our experienced team at GHP has years of experience screening for colorectal cancer. We can help establish the best plan of care for your situation. Read more about how we perform screenings here. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

How has the Pandemic Affected Colonoscopies?

The coronavirus pandemic has impacted our lives in countless ways. From finances to health and other aspects of life, it has changed how we live each day. In particular, many common medical check-ups, screenings, and elective procedures have been put on hold or delayed. One of these, the colonoscopy, has seen significantly decreased rates during the pandemic. This is a serious issue, as we know colonoscopies are a key screening strategy to prevent colorectal cancer. On today’s blog, we’ll take a look at how the pandemic has affected colonoscopies.

Colonoscopies During the Pandemic

Early on in the pandemic in 2020, medical practices put many elective and non-essential medical visits and procedures on hold. As a result, screenings for cancer like colonoscopies dropped significantly. One study examining screening rates in the San Francisco area found that colonoscopies decreased about 90% from February to May 2020. This coincided with an 85% decrease in fecal immunochemical testing (FIT), another screening method in the same time frame. There was also a 70% decrease in all in-person appointments, and a 60% increase in telehealth visits. Another report estimated that if that trend continued through early June 2020, there could be around 19,000 missed colorectal cancer diagnoses and over 4,000 additional colorectal cancer deaths across the United States.

These are significant impacts, and compound existing inequities in health outcomes. Many groups that have an increased risk of colorectal cancer have also experienced a higher risk of death from the coronavirus. These groups include Black, Native American, and Hispanic people.

Clearly, the pandemic has caused cascading public health problems. Fortunately, as we have learned more about the coronavirus, medical practices have been able to respond to transmission threats to practice safely. Masking, social distancing, sanitizing, and now vaccinations for medical staff have helped to create safe spaces for patients to receive medical care.

Importance of Screening for Colorectal Cancer

Screening for colorectal cancer is extremely important. When properly done, it has a high success rate at cancer prevention. With a colonoscopy, doctors can identify and remove precancerous polyps that could otherwise develop into cancer over time. The colonoscopy is the gold standard for screenings. When patients get colonoscopies on a proper schedule, the incidence of colorectal cancer falls by around 90%.

Gastro Health Partners, in line with various other organizations, is now endorsing regular screenings starting at age 45. Previously, 50 was the standard for beginning screenings. By changing this to 45, we can prevent more potential cases of cancer and save lives. If you are close to 45 or older, talk with your doctor about getting screened. They will take your situation into account and may recommend earlier or more frequent screenings depending on factors like family history and personal history of polyps.

Our experienced team at GHP has years of experience screening for colorectal cancer. We can help establish the best plan of care for your situation. Read more about how we perform screenings here. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Colorectal Cancer and Age, Race, and Ethnicity

Colorectal cancer is not experienced equally by everyone. In the past several years, younger people have experienced increased colorectal cancer rates and deaths. Additionally, Black people and American Indians experience more cases of this cancer and related deaths. Here’s what you need to know about how this disease affects different people.

Colorectal Cancer in Younger Adults

Rates of colorectal cancer have been on the rise for younger and younger adults over the last several years. According to the American Cancer Society, while rates for adults 50 and older have fallen due to increased screenings, the opposite trend has occurred for younger adults. Recently, people 65 and older have experienced a decrease of around 3% per year from 2011 to 2016. In contrast, people ages 50 to 64 have seen rates rise by 1% per year in the same time frame. People under 50 have actually seen rates rise by 2.2% per year in the same window. Clearly, younger adults are seeing steeper increases in cases. Death rates have followed similar patterns. Death rates for colorectal cancer also vary by age group. Between 2008 and 2017, death rates fell by 3% per year in people 65 and older and dropped by 0.6% in people 50 to 64. However, they rose by 1.3% in people younger than 50.

Fortunately, colorectal cancer can be very treatable if it’s caught early. Younger adults should be aware of warning signs. These include changes in bowel movements (particularly over two weeks or more), rectal bleeding, unusual stools, and tiredness or low energy. If they have any of these symptoms, they should see their doctor.

Disparities Based on Race and Ethnicity

Along with age, looking at colorectal cancer rates and death rates based on race and ethnicity shows significant variation. The American Cancer Society’s data from 2012-2016 showed that rates were dramatically different based on race. Rates for Asian people and Pacific Islanders were the lowest at 30 per 100,000. Non-Hispanic white people had a rate of 39 per 100,000, and Black people had a rate of 46 per 100,000. Alaska Natives and American Indians had the highest rate, at 89 per 100,000. Death rates vary significantly as well- colorectal cancer rates are around 20% higher for Black people than non-Hispanic white people, but death rates are nearly 40% higher in Black people. Additionally, for Alaska Natives and American Indians, death rates are about double the rate for Black people.

Early Screenings Save Lives

While many of these statistics are troubling, we do know that screening early is an effective way to catch more cases of colorectal cancer. More and more organizations, including Gastro Health Partners, are pushing for earlier screenings and research on the disparities around this disease. Early screenings save lives.

Our experienced team at GHP has years of experience screening for and treating colorectal cancer. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Lynch Syndrome: An Overview

Lynch syndrome is an inherited genetic condition that increases risk for colorectal and other cancers. It is the single most common cause of hereditary colorectal cancer. Here’s what you need to know about the condition.

What causes Lynch Syndrome?

Lynch syndrome, sometimes called hereditary nonpolyposis colorectal cancer, is inherited by children from their parents. It is inherited in an autosomal dominant pattern, meaning that only a single copy of the altered gene needs to be present. So, if someone inherits a mutation in a gene related to the syndrome, they will still have a normal copy. However, cancer occurs when a second mutation affects the normal copy of the gene.

The specific genes involved in the syndrome are all involved in repairing errors that occur during DNA replication. If any of the genes (MLH1, MSH2, MSH6, and PMS2) have a mutation, errors occurring in replication accumulate, which can end up leading to uncontrolled cell growth and cancer.

Complications from Lynch Syndrome

If you have Lynch syndrome, you have a higher risk of developing colorectal cancer, and developing it at a younger age. People with the syndrome also have a higher risk of developing kidney, stomach, brain, liver, uterine, and some skin cancers. There are several other inherited conditions that can increase your risk of colon cancer, but this syndrome is the single most common. A rough estimate is that around 3% of all colorectal and endometrial cancers are caused by the syndrome. Around 1 in 279 people in the United States have Lynch syndrome.

In addition, having Lynch syndrome has impacts on the rest of your family. First, a positive diagnosis means that your blood relatives may have a chance of having the syndrome. In addition, any children you may have are at a higher risk of having it. If one parent has a genetic mutation related to the syndrome, a child has a 50% chance of inheriting it. This is because the syndrome is autosomal dominant, as discussed previously. You may want to meet with a genetic counselor to talk through these implications if you have a Lynch syndrome diagnosis.

The Importance of Family History

Since you inherit Lynch syndrome, knowing your family history related to colorectal cancers is crucial. If your family has a history of colorectal or endometrial cancer, you should talk with your doctor to evaluate your risk. In particular, you are more likely to have the syndrome if your family has a history of colorectal cancer at a young age, endometrial cancer, or other related cancers.

Your doctor may recommend a genetic evaluation of your family history and risk. Genetic counselors can help you understand Lynch syndrome and whether genetic testing is a good option for you. Usually, family members with the syndrome share the same specific genetic mutation. If any of your family members have a known a syndrome mutation, you may be tested for the same mutation if you are pursuing genetic testing.

The good news is that we can prevent a lot of the cancers caused by Lynch syndrome with early screenings. Screening early and often can help catch cancer early and lead to better outcomes.

Our experienced team at GHP has years of experience screening for and treating cancers caused by Lynch syndrome. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.