With the death of Chadwick Boseman from Colon Cancer, it brought more attention to a disease that is responsible for the third most cancer-related death in the US. As a large comic nerd, Chadwick’s passing was very upsetting to me. As a doctor, I saw his death as a way to save others by better educating and screening people for the disease that took him because in the end what makes one a superhero is their sacrifice to save others.
While Chadwick’s case historically is abnormal because he was younger than 50 years old when it was found, more research is showing that cases in this age group have been increasing recently. For the past decade, there has been more data showing that African-Americans have an increased risk at a younger age which is why some medical organizations recommend colon screenings starting at 45 years old. In 2018, The American Cancer Society moved its recommendations to everyone getting a screening to 45 unless they had risk factors to be screened even sooner.
For the average person, there will be no signs of colon cancer which is why screenings are so important. There are three main ways to be screened for colon cancer each with pros and cons. The first is iFOBT which is looking for blood in a small sample of stool. This is the cheapest and fastest which is their pros however, it is also the least accurate and must be repeated yearly. Next is Cologuard which is looking for abnormal DNA in a stool sample. This is more accurate then iFOBT testing, a negative test means nothing else has to be done for three years, no prep has to be done, and in this day and age of Covid it can be from your home. The biggest con about Cologuard is if the test is abnormal one must get a colonoscopy. Which brings up the last way to screen for colon cancer, a colonoscopy. A colonoscopy gives a direct visualization of the colon. The biggest pro is if there are any abnormalities found they can be fully worked up and, in some instances, dealt with while performing the scope. If everything is normal then nothing else is required for ten years for the average risk person, which is another great pro. Now the con that is talked about the most is the time needed, as there is the day of prep as well as the day the colonoscopy is done in either a hospital or outpatient center.
As in life, one size does not fit all, so to come up with your best screening plan, set up an appointment to talk to your provider to decide what action should be taken for you. With individualized plans and each person screened, we can help show heroes are not forgotten.