It’s not exactly a topic that’s typical family dinner-time discussion. But colon cancer shouldn’t be taboo, especially among immediate family.
Knowing if your sister recently had a pre-cancerous polyp removed from her colon, or your father began getting colonoscopies at age 40 because of Crohn’s disease, could have serious implications on your health and timing for when you begin regular colon cancer screening.
First-degree relatives – parents, siblings and children – of patients with colorectal cancer or polyps have a two- to three-fold increased risk of developing polyps and colon or rectal cancer, says Craig Reickert, M.D., who leads the colon and rectal surgery team at Henry Ford Hospital in Detroit.
“Those with a family history of colon polyps or colon cancer, often need to start colon cancer screening before the recommended age of 50, and/or be screened more frequently than those patients at average risk,” Dr. Reickert says.
Having the Colon Cancer ‘Talk’ with Family
Colon cancer is the third leading cause of cancer death among men and women in the U.S. According to the National Cancer Institute, the lifetime risk of developing colorectal cancer is about 1 in 20. The risk is similar for men and women.
It’s estimated 5 to 10 percent of colon cancer cases occur with some inherited genetic component.
While hereditary risk of developing colon cancer is comparatively small, knowing your family health history could mean the difference between catching colon cancer early, when it’s highly treatable and has a high survival rate, or at a more advanced stage that requires surgery, chemotherapy and possibly radiation therapy.
To start the conversation at your next family gathering, Dr. Reickert recommends asking these questions:
- Has anyone in the family been diagnosed with colon cancer?
- Have any family members had a pre-cancerous or cancerous colon polyps removed? If so, how many polyps were removed?
- At what age was this family member diagnosed with a colon polyp or colon cancer?
- Does anyone have chronic conditions like Crohn’s disease or/and ulcerative colitis, placing them at higher risk for colon cancer?
- For family members in their 50s and 60s: Are you up-to-date on your colon cancer screenings? What were the results?
Once you have your answers, follow up with your physician to discuss next steps and timing to begin screening colonoscopy – and encourage other family members to do the same.
The Colonoscopy Conversation
Colonoscopy is the best option for colon cancer screening if you have a family or personal risk for colon cancer or colon polyps, and should also be a part of any family discussion, Dr. Reickert says.
Standard guidelines recommend that colon cancer screening begin at age 50 for average risk individuals. But if you have family members that have previously been diagnosed with polyps or colon cancer, you may need to start screening colonoscopies earlier.
In most cases, screening should begin 10 years before the age your first-degree relative was diagnosed.
And, Dr. Reickert understands that some patients may be wary of colonoscopy because of the preparation the day before, or concerns about being uncomfortable during the procedure.
What’s important to keep in mind, he says: “Colonoscopy provides us with a more definitive view of a patient’s risk, where we can see polyps and remove them before they become cancerous. And it’s all for a day of prepping and a 30 minute procedure.”
Still getting resistance from family members?
Dr. Reickert suggests explaining it like this: You change the oil in your car so you don’t have to replace the entire motor. Colonoscopy is just like that oil change; it’s preventative maintenance to extend your life and avoid invasive treatments down the line, including surgery, chemotherapy and radiation therapy.
When colon cancer is caught early, at stage 1, there’s a 90 to 95 percent five-year survival rate.
When it has advanced to stage 4 with cancer spreading to other organs, however, colon cancer is only controllable, not curable, says Dr. Reickert. Five-year survival for stage 4 colon cancer is 20 to 25 percent.
“It’s really important to know your inherited risk and discuss with your family members that colonoscopy is a minor inconvenience with a prolonged benefit,” says Dr. Reickert. “Colon cancer is preventable and curable when diagnosed early.”