Intermountain Healthcare

Prevention, Not Procrastination Key to Colon Cancer Care


Salt Lake City, UT -- (ReleaseWire) -- 04/01/2021 --If people knew they could prevent certain types of cancer with minimal risk and minimal financial burden, it seems logical that they would be interested.

Colorectal cancer screening does just that, but there are some who are still hesitant to schedule an appointment.

"This is a highly preventable cancer that really lends itself to early detection," says Dr. Christoph Woerlein, gastroenterologist with Intermountain St. George Red Rock Digestive Health. "The gold standard in detection is the fiber optic colonoscopy."

With more than 150,000 people developing large bowel cancer nationwide each year, Woerlein says it is surprising more people aren't willing to take advantage of early detection screenings that can prevent the vast majority of those cases.

"It's always been a problem," Woerlein says. "It's just not something people are in a hurry to do."

Among the typical human nature hurdles such as procrastination and a tendency to put self-care lower on the priority list, one of the biggest hurdles, it seems, is the preparation required for the procedure; a preparation which consists of following a clear liquid diet for a short time and ingesting a doctor recommended laxative treatment to clean out the colon.

"Yes, life sucks for a day or two, but once you have colon cancer life sucks a lot more than that," Woerlein says.

While some still wrinkle their nose at a procedure that requires such preparation, Woerlein says the industry has come a long way in terms of the preparation materials available.

"Most of the world has moved collectively to a split prep, where the patient drinks part of the prep in one sitting, and the other part later on," Woerlein says. "The lower volume is really helpful for people who had trouble stomaching four liters at a time."

Not only is the prep less difficult than in the past, the ability to detect problems has increased.

During the procedure the doctor is looking for anything abnormal, including signs of inflammatory bowel disease, microscopic colitis, pre-cancerous polyps and other abnormalities. Often problems can be detected even in patients who are not experiencing symptoms. This allows patients to be diagnosed and treated before the problem gets worse.

While fiber optic colonoscopy remains the gold standards of care, there are other non-invasive tests available however there are downsides to these options, not the least of which is the high rate of false positives.

"It almost defeats the purpose of these alternative methods (such as stool samples)," Woerlein says. "If you have a lot of people who have false positive outcomes, they end up needing a colonoscopy anyway."

People with no family history of colon cancer and no previous polyps are generally recommended to have their first colonoscopy at age 50. However, there is some movement by the American Cancer Society to lower that age to 45, as there has been an increase in the incidence of left-sided colon cancer in younger people.

"There needs to be more momentum to lower the age," Woerlein says. "Recommendations are one thing, but insurers heeding those and covering for an earlier age is a whole other thing."

If you have a family history of cancer, talk to your doctor about when to have your first colonoscopy. Many gastroenterologists are available without a referral.

About Intermountain Healthcare
Intermountain Healthcare is a not-for-profit system of 24 hospitals, 215 clinics, a Medical Group with 2,500 employed physicians and advanced practice clinicians, a health insurance company called SelectHealth, and other health services in Idaho, Utah, and Nevada. Intermountain is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes and sustainable costs.