Colorectal cancer is one of the top causes of cancer deaths.
More than 2,000 people died from colorectal cancer in Ohio in 2022.
March is colorectal cancer awareness month. WYSO’s Mike Frazier speaks with Dr. Bradley Jackson, chief medical officer and plan performance medical director for Anthem Blue Cross and Blue Shield, who shared why it’s so important to get screened for colorectal cancer.
This transcript has been lightly edited for clarity.
Dr. Bradley Jackson: It is one of the most preventable cancers, yet it remains one of the leading causes of cancer deaths. In Ohio, only 55% of adults aged 45 to 54 are actually up to date on their screening. So that means there's another half that are not getting screened.
Mike Frazier: So what if someone says, "Cancer doesn't run in my family, so I'm not a high risk, so I don't want to bother getting screened." What would you say to them?
Jackson: Family history is a very important matter, and certain individuals need to be screened earlier, but we do have standard screening periods, particularly the earlier age groups, ages 45 to 54, which is where a great number of incidents are occurring.
But what we believe is that early screening, particularly beginning at age 45 is where, despite family history, we do pick up early indications of potential cancer risk, particularly individuals that may have polyps. And interesting is that polyps that are small little finger-like projections in the intestinal lining can take up to 10 to 15 years to turn cancerous.
So it's better to identify those earlier pre-cancer stages in individuals where you can actually have some interventions, whether it's removing those polyps so that you're not at risk long-term for cancer.
Frazier: For people who have not gotten a colon cancer screening, can you describe the process?
Jackson: Most people are probably familiar with the colonoscopy and we do those screenings as early as 45 to 50 years of age. In most cases, you'll probably see them getting their first colonoscopy screening at 50. And then every 10 years after that, assuming there is a normal colonoscopy.
"It is one of the most preventable cancers, yet it remains one of the leading causes of cancer deaths."
But there are other non-invasive procedures that can also be done too. And one of the more common ones is the home stool-based test, such as Cologuard. You probably see many commercials about that. Non-invasive, done in the privacy of your own home, which is a very great opportunity to look at some of the early screening based on stool content.
Frazier: I know nothing is 100% accurate, but how accurate are the home testing kits? The Cologard and the other testing, home testing kits you refer to.
Jackson: They are very accurate. I think they give you a much better opportunity to look at early screening opportunities. What it does is it looks at various byproducts of cancer that can occur as an excretion from your stool. And so they see these contents here. But it's not always, and when I say what is the likelihood that that is positive that you have cancer, is a very high likelihood. But, that is not the final testing. Those who do have a positive stool screening test, they will need to have a colonoscopy to actually go through and look at every part of that colon to see where that cancer may exist as well as maybe some other additional testing that might occur.
Frazier: So a colonoscopy, that's not an annual thing you have to have done, unless you have a high cancer risk.
Jackson: If you have a high cancer risk, the incidence may be greater. The standard test is usually every 10 years. So for instance, if you get your first screening at 50, the next screening would be at 60. Now with that being said, if for instance you had an abnormal colonoscopy, depending on what they see - for instance if there was a polyp that was seen there - the frequency might be greater depending on the recommendation of your gastroenterologist. Typically, those might be probably every two years, depending on what was detected.
Frazier: What would you say to someone who just really doesn't want to go through the routine and the lack of dignity of getting a colonoscopy? How would you convince them to change their mind and just get tested?
Jackson: What I would share with individuals is the why not. And when you ask the "why not," many times it's because of some anecdotal experience. The fear of knowing, and because usually there's something in their past that prompted them to say something differently, or many times it's misinformation. But I'd say the importance of knowing is better than not knowing and you have fewer options.
Now, I'm a cancer survivor myself, of prostate cancer, and I had a strong family history. I have an uncle that died from prostate cancer and I have three cousins, all within a span of five years who had a stage of cancer that prompted intervention. And so when I got that news, I had been working with urologists for a number of years that said this is the time to get a biopsy, and then making the decision, but I had many options to choose from. And me having more options is better than me saying there are not many options that are going to change your fate. And so I always say it's better to have options than not.
