This week, Dr. Howard Freilich, a board certified gastroenterologist at Coastal Carolina Hospital, discusses colonoscopies — not just for men anymore.
Question: Are colonoscopies something only men should be concerned about? What about women? At what age should women be screened for colon cancer or consider having a colonoscopy?
Answer: Women should certainly undergo colonoscopy for colon cancer screening in the same manner as men. Let’s take a moment to review the facts about colon cancer.
In the U.S., colon cancer is a significant health problem for both men and women. Cancer of the colon and rectum is the third most frequently diagnosed cancer and the third leading cause of cancer related death in men and women combined.
Aside from skin cancer, in women only breast cancer and lung cancer are more frequently diagnosed than colon cancer. The average lifetime risk of developing colon cancer in women is just slightly less than in males.
Although the age of onset in females on average may lag behind males by several years, the incidence is about the same at older ages. Some studies suggest women may have a higher risk of complications from the disease that could portend a worse outcome. Overall, up to 50 percent of adults diagnosed with this disease may die from it.
It has been well established that colon cancer is a preventable disease by simply detecting and removing precursors of the disease such as colon polyps before they become cancer. The American Cancer Society and a number of leading medical organizations have put into place guidelines for colon cancer prevention as well as early detection.
These guidelines do not discriminate between men and women and apply to both sexes. These include initiating screening with colonoscopy or other approved procedures in an average risk individual, male or female, at no later than age 50, and at subsequent intervals of no greater than 10 years, depending on an individual’s risk factors and results of their personal evaluation.
Patients with a family history of colon cancer, for instance, may receive a recommendation to begin the program at an earlier age and with more frequent surveillance going forward. With our screening programs in effect, we are beginning to witness a decline in the incidence and mortality of colon cancer over the past several years.
However, despite these facts, compliance in women having appropriate screening with colonoscopy has been less than ideal. Although the compliance with breast cancer and cervical cancer screening has been more widely accepted, studies suggest only 52 percent of women over age 50 have had some form of colon cancer screening and these rates are considered inadequate.
The goal of the ACS is a 75 percent screening rate, which as of 2015 has not been met. With better education and motivation we hope to see the number of both women and men having colon screenings improve.