03/24/2014 12:23 EDT | Updated 05/23/2014 05:59 EDT

No Butts About It: Don't Fear the Colonoscopy

Bottoms up, push for your tush, get your butt seen, and get behind your behind: Colon cancer organizations have tried every cheeky trick in the book with their campaigns aimed at convincing Canadians to submit to colonoscopy screening -- considered the gold standard for the detection of colon cancer. There were 23,900 new cases of this cancer in Canada in 2013, and as March is colon cancer awareness month, Dr. Sapna Makhija of the GI Health Centre in Burlington, Ontario, has a special message for women: Just do it.

"Until recently women have been hesitant to seek medical attention. Historically, women had to be clean and proper. We don't like to discuss our bowels or look at our stools to see if there is anything different," says Dr. Makhija, a gastroenterologist who with two other female GI specialists has launched a clinic specializing in GI disorders. "But colon cancer is the third most common cancer for women; over a lifetime, one in 15 women will be diagnosed with it and one in 31 will die."

"It's not a procedure that people look forward to," Dr. Makhija says, referring to the universally dreaded colonoscopy. And though the procedure is pretty common today, myths continue to plague it. For example, some people still think they don't need to be checked until they're over 50. "But for patients with a family history of colon cancer, polyps, uterine or ovarian cancer, colonoscopies should be started earlier," she stresses. "Say your mother was diagnosed with colon cancer at the age of 46, then her daughter or son would need to be checked at age 36. Yet most 36 year-olds would not think of getting screened for colon cancer." On the other hand, only ten to 20 percent of people who have this cancer have a family history, so don't be complacent.

There's still a lot of misinformation around symptoms, she says, and some people dismiss the idea of screening because they say they have no symptoms. But colon cancer can have few symptoms until advanced; you want to catch it soonest. Rectal bleeding, dark stools, or a change in bowel habits lasting more than a few days are some worrisome signs. If you're over the age of 50, have a family history of cancer, or have any of these symptoms, make an appointment with your family doctor now. There are several tests that could be considered, including a fecal occult blood test, fecal imuno-chemical test (FIT), a flexible sigmoidoscopy, a double-contrast barium enema or a colonoscopy.

Fear and anxiety stops some people from making that colonoscopy appointment. And the fact that in Canada colonoscopy wait times, especially for outpatient hospital procedures, can be several months doesn't help; public not-for-profit clinics which are on the increase have less wait times -- sometimes just a few weeks.

Dr. Makhija adds that pain should not be a worry or a colonoscopy deal breaker because comfortable sedation is widely available. Anyone who has had a colonoscopy will tell you that the preparation, the day before it spent taking laxatives and running to the bathroom, is worse than the actual procedure. (To learn what to expect from this procedure, check out "There's still a social stigma to having a colonoscopy," she says. "It's still considered a taboo subject."

Taboo it may be, but one recent U.S. report attributes the decrease in the incidence of colon cancer in older adults by 30 percent in the past decade to the tripling of the colonoscopy rate. "Much of the credit for the lower incidence of colorectal cancer goes to improved uptake of colonoscopy among people ages 50 to 75," reported Charles Bankhead. The results came from data analyzed from the National Cancer Institute Surveillance, Epidemiology, and End Results program, the North American Association of Central Cancer Registries, and the National Center for Heatlh Statistics.

Despite this, and the knowledge that colonoscopies can detect and successfully treat polyps which are precursors to bowel cancer -- in effect curing the potential cancer during the screening process -- millions of North Americans are still bottom shy and have avoided screening.

That may change, however. A recent report in www.medical noted that American colorectal cancer organizations have pledged to have 80 percent of Americans over the age of 50 screened by 2018. A worthy goal for Canada, too!


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