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Do You Think Screening Should Begin At 40!

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Subject: Do you think screening should begin at 40!
Date: 03/20/2008
I'm writing in response to an article from this site, plus numerous articles I've read recently about improving screening for colorectal cancer.  That's good, but I'm frustrated that they haven't lowered the recommended screening age down from the current age 50.  I was diagnosed w/ stage 4 rectal cancer at age 40 & since I've been in treatment, I've heard of numerous patients that are in the 40's and even their 30's with colon or rectal cancer.  Certainly waiting until 50 wouldn't help us!  *Is there a way to influence moving the recommended screening age down from 50 to at least 40?  It's just like breast cancer screening- insurance starts paying for mammograms at 40, yet I know of firsthand at least 5 people around me who were diagnosed with breast cancer in their 30's (2 of them died from it).  Screening for cancer must be at younger ages than the current recommendations! 
Subject: RE: Do you think screening should begin at 40!
Date: 03/20/2008

I understand the frustration about the screening, however, the most recent statistics (from 2005) show that only 12% of all colorectal cancer occurs in people younger than 50.  While we meet these people all the time or see them on the boards, we have to recognize that there is no way for 12% of the population that the standards are likely to be lowered.  Then you have to think-ok, of that 12% how many are between 45-50, between 40-45 and so on.

 What I would like to see happen is that our general practictioners, internists, Family doctors, whomever, start taking people under 50 SERIOUSLY when someone talks about the bowel/digestion problems that they are having.  I also wish that docs wouldn't be so quick to dismiss women's issues as simply attributable to hemorrhoids-mainly because they have given childbirth.  I realize that childbirth can cause hemorrhoid problems, but really, some docs just take that excuse too far. While the medical community will never be able to catch all colorectal cancers early (obviously because of the no symptoms part of this disease)  Stories abound of patients telling their doctor for years about slight rectal bleeding and having hemorrhoids labeled as the cause without further examination.  In my case, I had hemorrhoids AND a rectal tumor!  It was only because I went to have the hemorrhoid banded that the surgeon saw the tumor.

We also have to remember that colonoscopies are not without risk.  While the risk of perforation is small, it does happen and then you have to weigh the risk of complications against the potential benefit of lowering the screening age.  Furthermore, even with the screening standards as they are now at 50, less than half the eliglble people in fact get screened.  What needs to be done is to raise awareness and get people to get their scopes.  Let's face it, the colonoscopy has a bad name-totally because of the prep.  People have heard how nasty the prep is and that totally turns them off to the whole idea.  Until we can get our society comfortable talking about our colons, BMs, etc. we aren't going to make a whole lot of headway here.  I do remember when breast cancer was a hush hush affair.  The women who spearheaded the whole breast cancer awareness movement really did a great service.  It really took off, however, when Betty Ford had no qualms and got up and spoke about her breast cancer journey to the whole world.  We hear of celebrities who have colorectal cancer, but how many of them do you ever hear talk about it?  I personally believe that if a celebrity (any one of us would do if someone like Oprah or Ellen would put us on their show) would go on a talk show and open up about their personal experience, it just might enlighten the average person. 

On another board, a poster wrote how absolutely terrified he is about his upcoming colonoscopy.  He is certain he has cancer and is certain he is going to die and in the same sentence adds, he can't bear the thought of a colostomy.  I do believe that one of the problems that colorectal cancer has is that the surgeries are drastic, that they do have long term side effects.  We all have to eat to survive and when we eat, the food goes through the digestive system.  When we mess with that digestive system, we change our lives.  Too many people have preconceived notions about what those changes are-they imagine the absolute possible worst case secanario and until someone can dispel those myths, those ideas, colorectal cancer is going to be one of those diseases that no one wants to talk or think about.  That's particularly sad since it is soooo preventable.

That's just my take on this.  Sorry this post is so long.

Jaynee

Subject: RE: Do you think screening should begin at 40!
Date: 05/08/2008

 

On 3/20/2008 soccermom wrote:

I understand the frustration about the screening, however, the most recent statistics (from 2005) show that only 12% of all colorectal cancer occurs in people younger than 50.  While we meet these people all the time or see them on the boards, we have to recognize that there is no way for 12% of the population that the standards are likely to be lowered.  Then you have to think-ok, of that 12% how many are between 45-50, between 40-45 and so on.

 What I would like to see happen is that our general practictioners, internists, Family doctors, whomever, start taking people under 50 SERIOUSLY when someone talks about the bowel/digestion problems that they are having.  I also wish that docs wouldn't be so quick to dismiss women's issues as simply attributable to hemorrhoids-mainly because they have given childbirth.  I realize that childbirth can cause hemorrhoid problems, but really, some docs just take that excuse too far. While the medical community will never be able to catch all colorectal cancers early (obviously because of the no symptoms part of this disease)  Stories abound of patients telling their doctor for years about slight rectal bleeding and having hemorrhoids labeled as the cause without further examination.  In my case, I had hemorrhoids AND a rectal tumor!  It was only because I went to have the hemorrhoid banded that the surgeon saw the tumor.

We also have to remember that colonoscopies are not without risk.  While the risk of perforation is small, it does happen and then you have to weigh the risk of complications against the potential benefit of lowering the screening age.  Furthermore, even with the screening standards as they are now at 50, less than half the eliglble people in fact get screened.  What needs to be done is to raise awareness and get people to get their scopes.  Let's face it, the colonoscopy has a bad name-totally because of the prep.  People have heard how nasty the prep is and that totally turns them off to the whole idea.  Until we can get our society comfortable talking about our colons, BMs, etc. we aren't going to make a whole lot of headway here.  I do remember when breast cancer was a hush hush affair.  The women who spearheaded the whole breast cancer awareness movement really did a great service.  It really took off, however, when Betty Ford had no qualms and got up and spoke about her breast cancer journey to the whole world.  We hear of celebrities who have colorectal cancer, but how many of them do you ever hear talk about it?  I personally believe that if a celebrity (any one of us would do if someone like Oprah or Ellen would put us on their show) would go on a talk show and open up about their personal experience, it just might enlighten the average person. 

On another board, a poster wrote how absolutely terrified he is about his upcoming colonoscopy.  He is certain he has cancer and is certain he is going to die and in the same sentence adds, he can't bear the thought of a colostomy.  I do believe that one of the problems that colorectal cancer has is that the surgeries are drastic, that they do have long term side effects.  We all have to eat to survive and when we eat, the food goes through the digestive system.  When we mess with that digestive system, we change our lives.  Too many people have preconceived notions about what those changes are-they imagine the absolute possible worst case secanario and until someone can dispel those myths, those ideas, colorectal cancer is going to be one of those diseases that no one wants to talk or think about.  That's particularly sad since it is soooo preventable.

That's just my take on this.  Sorry this post is so long.

Jaynee


 

I absolutely agree with you. For a fraction of what the cost is for the treatment of rectal cancer, a colonoscopy can be performed. At least we should get a CEA marker blood test done at 40 and use it at a base line marker. Breast cancer is a terrible disease - but the life changing effects of rectal cancer is far beyond what a breast cancer patient goes thru.
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