Hopefully by now you know that the Plums are only willing to be silly about stuff that’s really serious, so we trust you'll forgive the love-toilet graphic. If you’re 45 or older, it is time to talk to your provider about colon screenings. While a colonoscopy might not be everyone's (anyone’s?) idea of a good time, it's your best tool for early colon cancer detection and treatment.
Fortunately, there’s another option for some. If you have:
no personal history of colorectal cancer or adenomas
no positive result from another colorectal cancer screening method within the last six months
and no diagnosis of a condition associated with high risk for colorectal cancer (e.g. IBD),
there are simple FDA-approved at-home tests you can do. We’re walking you through the Cologuard System because it’s what we have experience with, but there are others. Cologuard takes cells from your stool and checks for cancer markers in the DNA of your colon cells. No need for sedation or a scope, just a simple collection in the comfort of your own bathroom, and off it goes to the lab for analysis. It's not as comprehensive as a colonoscopy, but it's a solid option for those without the risk factors we mentioned up top. Other at-home Fecal Immunochemical Tests, or FITs, look for the presence of blood in your stool. This is just one piece of colon health, but not a complete picture; lots of things can cause GI bleeding - including colon cancer. Be sure to check with your health care provider before shelling out for an at-home test to make sure it’s the right one for you.
At-home tests are the more convenient, less invasive cousin of the colonoscopy. Lauri Lopp, MD, Director of Medical Informatics and Assistant Director of SIU Family Medicine Residency Program – Springfield, says that she likes the every-three-years schedule for Cologuard compared to the yearly FIT schedule. And, while Cologuard is handy, it's not for everyone. It's best suited for folks at average risk. If Cologuard flags anything suspicious, guess where you're headed? Yep, you guessed it – straight to the colonoscopy zone for a closer look.
According to the latest research from the US Preventive Services Task Force (USPSTF), colorectal cancer screening is recommended at age 45 if you're cruising along at average risk. If that first run-through doesn't spot any trouble, congrats, you get a 10-year breather. But if life throws a few curveballs your way, like a family history of colon cancer or other health hiccups, your colonoscopy calendar might need to be a bit more packed.
Dr. Lopp agrees with the USPSTF. Folks at higher risk need colonoscopies more frequently than every decade. If you have a family history of colon cancer, your first colonoscopy might need to happen earlier, with follow-ups every five years. And if polyps make an unwelcome appearance during your screening, you might find yourself back in the doc's office sooner than expected. If you've battled colon cancer before, the post-op plan includes a colonoscopy at year 1, followed by check-ins every three years to keep things on track. And folks with Lynch syndrome or pancolitis are on the one to two-year colonoscopy circuit.
If you have no family history or preexisting conditions and your results come back clean or show benign bumps, you're golden for another decade. But if anything sketchy pops up, like polyps with potential, you might be penciling in your next appointment much sooner.
Let's not overlook the prep work. It's not the most glamorous part of the colonoscopy process, but it's crucial. Lots of clear liquids and several large doses of a hypertonic drink draw water into the colon. That large volume of water flushes fecal matter, giving your physician a clear few of your colonic wall - which is the whole point. If the consistency of these drinks is not for you, to speak to your health care provider about a capsule form of colonic prep.
According to Dr. Lopp, the biggest pushback she hears from her patients is that the whole process is… gross. She gets a lot of wrinkled up noses during conversations about colonoscopies and/or the handling of our own poop.
"You know what else is gross?" asks Dr. Lopp, answering her own question with a dead-serious wink and a smile, "Colon cancer. Colon cancer is gross."
The… ahem… bottom line here? Cologuard and colonoscopies are critical to your overall health, not just to making it through perimenopause and menopause.
So stay on top of your screenings, and raise a glass to having options aplenty:
Cheers to your colon health!
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