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People now urged to get first colonoscopy at age 45

CDC provides updated information on screenings after years of monitoring diagnoses.

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Dr. Kevin Ree
Special to the Globe
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WORTHINGTON, Minn. — Gretchen O’Donnell was 37 years old when her mom suffered severe stomach pains while on vacation and was ultimately diagnosed with colon cancer.

The Worthington, Minnesota, woman rushed to Washington state to see her mom, and when she returned back home, she scheduled a colonoscopy.

A colonoscopy is one of the best tests available to prevent colorectal cancer. O’Donnell’s mom had never gone in for the screening.

At the time, colonoscopies were recommended at age 50 for those at average risk, with follow-up screenings every 10 years if there weren’t any issues. Recently, Sanford Health lowered the recommended age for a first-time colorectal screening to 45, based on findings by the Centers for Disease Control and Prevention.

According to the CDC, while colorectal cancer rates have decreased for people over 50 years old, they have climbed 51% since 1994 for those under age 50. Lowering the recommended age for screening will help detect an issue early — before symptoms begin and when the cancer is most preventable, it noted.

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Those with a family history like O’Donnell, however, are urged to get screened sooner and more frequently.

O’Donnell has since had three colonoscopies — her doctor recommends she get checked every five years and all have been clear. Her older sister, however, had to have polyps — small groups of cells that form in the lining of the colon and can lead to cancer — removed. She now gets tested every three years.

“Mom survived, but it was pretty tough,” O’Donnell said. “Several weeks after the diagnosis and her surgery she had a stroke, which I guess is not uncommon after surgery. She’s 84 now, but she’s never been the same since the stroke.”

While O’Donnell doesn’t look forward to her next colonoscopy — she’s scheduled for one again next year — she knows it’s something she can do to prevent getting colorectal cancer.

“I’m not going to lie — it’s not pleasant; but it’s something that’s worth it,” O’Donnell said. “I feel like (the regimen) has gotten worse because I know what to expect. I think the liquid is vile — it’s horrible.”

And perhaps that’s why her mother never had the screening.

“If my mom had had the colonoscopy, they probably would have discovered years sooner that she should have been checked more often,” O’Donnell said.

Dr. Kevin Ree, Sanford Health Family Medicine Physician in Worthington, said anyone who has had a family member diagnosed with colorectal cancer in their 50s should begin screening a decade prior.

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“Because of those screenings, we’re seeing an increase (in younger people being diagnosed),” Ree said. “We are moving the screenings up five years in order to catch some of those premature colon cancers.”

Today, people have two options for colon cancer screenings — the colonoscopy or DNA testing. The DNA test is good for three years, while the colonoscopy — if no polyps are detected — is good for 10 years.

“By far, the colonoscopy is the gold standard,” Ree said. “You’re going to find it at an earlier stage. When it is found at an earlier age, there is a higher treatability rate.”

While people may complain about the liquid they need to drink in advance of the screening, the procedure itself takes only about 30 minutes.

Patients will be given medicine to relax, and most fall into a light sleep before the scope is inserted. If polyps are discovered, they are immediately removed. Once completed, the patient moves into post-op for an hour before they are released to go home.

While doctors were told a year or two ago to encourage patients to get a colonoscopy prior to age 50, insurance providers hadn’t followed suit.

“People need to talk with their insurance and make sure it is covered for them at age 45 and, if not, make sure it gets covered,” Ree said. “The American Cancer Society and other groups have been pushing for this.”

While O’Donnell’s mother suffered severe stomach pains that ultimately led to her colon cancer diagnosis, Ree said most times, patients will report seeing blood in their stool.

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“If it gets big enough, they think it’s constipation, but it’s actually a blockage and a pretty advanced tumor by that time,” Ree said.

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