A study published last week in CA: A Cancer Journal for Clinicians reported results that caused a lot of jaws to drop: Rates of colon cancer fell by nearly one-third in the last decade, and the reason, it said, was because more people were getting colonoscopies.
You’d expect the organization responsible for conducting the study – the American Cancer Society (ACS) – to spread such positive results far and wide, and, indeed, the news was widely covered and widely welcomed.
And it is good news … for some people – those older than 50. As explained on USAToday.com, the biggest declines were among people older than 65. They qualify for Medicare, which provides free colon cancer screenings. Younger people with insurance coverage that conforms with the Affordable Care Act (ACA, or “Obamacare”) also qualify for free colon cancer screenings, because they’re considered a preventive service.
That still leaves some people out of subsidized luck. Some can’t afford to pay for the screenings themselves, and some who can just don’t get one.
Most doctors recommend that people at average risk for colon cancer get their first screening when they’re 50. But some doctors aren’t convinced. See our blog from a couple years ago, “Testing for Colon Cancer Offers Mixed Messages,” which said that the best colon-health practice appeared to be colonoscopy screening for everyone who’s 60. Those results would indicate their risk, so high-risk people would be advised to get regular colon follow-ups, and everybody else could stop worrying.
According to the USA Today story, colorectal cancer is the third leading cause of cancer death in the U.S. The ACS estimates that 136,830 Americans will be diagnosed with the disease this year, and that 50,310 will die from it.
There are two primary colon cancer screens – sigmoidoscopy, in which a fiber-optic tube is inserted into the rectum to examine the lower portion of the large intestine. Usually, people don’t require sedation for the procedure. Colonoscopy uses a longer tube to examine the entire colon. It’s more invasive, requires sedation and presents more risk. But, obviously, it’s more thorough than sigmoidoscopy.
Both procedures enable doctors to detect and remove polyps before they become cancerous.
Between 2000 and 2010, colonoscopy screening rates for people between 50 and 64 nearly tripled, from 19 in 100 people to 55 in 100. Colonoscopies also were more common among people older than 64, growing from 55 in 100 to 64 in 100.
Deaths from colon cancer dropped by about 3% a year during the same decade, but noticeably accelerated toward the end of the decade – 7.2% a year from 2008 to 2010.
But it’s worrisome that the decline is limited to older people; rates of the disease are rising slightly among younger people. The ACS report says that’s probably because of obesity and poor diet. Colon cancer rates rose by slightly more than 1 in 100 per year among people younger than 50.
And not everybody in each age group is affected equally: Although colon cancer incidence declined among all racial groups, the drop was more significant among whites than minorities, and death rates were half again as high among blacks than whites.
For more guidance about getting a colonoscopy, see our newsletter, “Colon Cancer: How to Save Your Life by Finding the Right Doctor to Do Your Screening Exam.”