My 30th birthday is less than two months away.
This means that I am almost twenty years younger than the currently recommended age to begin colonoscopy screenings.
It also means that I am ten years younger than my father was when he died of Stage IV colon cancer.
It was the summer of 1999. I was on vacation in Canada when I got the call. By the time of his diagnosis, my dad’s cancer had already spread from his colon to his stomach, kidneys, liver, and lungs. He died less than eleven months later.
This is why I had a colonoscopy earlier this spring.
My dad had felt sick for a while, but had brushed it off until it was too late. He didn’t go to a doctor; he didn’t have any tests done. Had he gone in sooner, he could still be alive today.
I wasn’t about to follow the same pattern.
I’ve been acutely aware of my colon cancer risks for years, which admittedly made me hyper-vigilant. I knew the symptoms inside and out. This is why, when my digestive patterns changed beginning about a year ago, I paid close attention. And when things didn’t go back to normal, I saw my doctor immediately. I explained what was going on and my family history, and she referred me to a gastroenterologist. He immediately scheduled me for a colonoscopy ten days later.
You see, there are two kinds of colon cancer: “genetic” and “bad luck” cancers.
Bad luck cancer is just that: bad luck. There are no other obvious mitigating factors other than luck-of-the-draw. Diet and lifestyle can play a role, but it’s basically just the universe pooping on your parade. My gastroenterologist told me that 60% of all cancers call into this category.
Genetic cancers are a smaller, but arguably more dangerous group. While the percentage of genetic cancers is lower, those with the genetic predisposition have a significantly higher cancer risk than the general public.
About 3-5% of colon cancers are genetically based. Lynch Syndrome is the most common genetic condition for colon cancer. Lynch Syndrome causes the cancer to occur at a younger-than-normal age, present more aggressively, and also results in a higher risk for ovarian and endometrial cancers in women.
Because of my dad’s unusually young age for Stage IV colon cancer, there is a chance I have Lynch Syndrome. However, genetic testing was highly uncommon in the ’90s, so there is no way to know if my dad’s cancer was genetically based. And because genetic testing for colon cancer is about ten years behind that of BRCA1, the breast cancer gene, the test is currently only available to those with a significant family history of cancer (I only have one person), or who already have polyps (luckily my colonoscopy was clear).
So for now I wait.
And repeat my colonoscopy in two years.
(I also will need to have a hysterectomy sometime between 35 and 40 years old, based on my potential elevated risk for aggressive ovarian and endometrial cancers.)
The current suggested age for someone with no familial history to begin regular screenings is 50. After that, it is every ten years, unless polyps are discovered. Someone with a familial history, such as myself, is recommended to get a colonoscopy ten years prior to the family members’ diagnosis, but you still have to prove necessity. Luckily, my gastroenterologist defined “necessity” as the daughter of someone who died at the unusually young age of 40.
The problem with the current guidelines is two-fold.
First, more and more colorectal cancer diagnoses are under the age of 50, making early screenings vital for detection. Second, polyp growth rates vary greatly from person to person, depending on a number of lifestyle and genetic factors. This means you could have a clean colonoscopy at 50, and have Stage 3 colon cancer at 52. A one-size-fits-all screening policy simply doesn’t work.
I miss my dad every day. He didn’t get to see me grow up, go to college, or get married. He didn’t get to meet his grandchildren. He missed so much. I don’t want my kids to experience that same pain.
Because of this, I will pursue regular colonoscopy screenings, and will continue to fight to make colonoscopies a part of the prevalent medical conversation. They shouldn’t be a luxury screening withheld from the general public until an insurance board deems it necessary. Early detection equals successful treatment.
Colonoscopies literally save lives.