Why Colon Cancer Scare Is Fake News
By Dr. Mercola
Colorectal cancer, which includes both cancers of the colon and rectum, is the second leading cause of cancer-related deaths in the United States.
An estimated 135,000 people are diagnosed with colorectal cancer each year (about 95,500 cases of colon cancer and 39,900 cases of rectal cancer1), and more than 50,000 die from it.
Historically, colon cancer has been confined to those over the age of 50, but that’s changing. According to a recent report2 by the American Cancer Society, prevalence among younger people is rising.3,4,5 As reported by STAT News:6
“Among adults between the ages of 20 and 39, colon cancer has increased by 1 percent to 2.4 percent a year since the mid-1980s. This rise has been so dramatic that those born in 1990 and afterward have rates of colon cancer not seen since 1890.”
The findings made headlines and, not surprisingly, younger people are now urged to consider colon cancer screening, which is typically done by colonoscopy.
What the study and many news sources fail to mention, however, is that if you’re in your 20s and 30s, your mortality risk from colonoscopy is FAR greater than your risk of colon cancer! This is a vitally important consideration that simply isn’t given the proper attention.
It’s a mistake to equate screening with prevention and, if anything, the findings are a wakeup call to Gen-Xers and Millennials that they really need to reassess their lifestyle choices, as the ramifications of poor diet and sedentary behavior are catching up to them at an increasingly younger age.
Colon and Rectal Cancer Rates on the Rise Among Young Adults
According to the featured report, while colon cancer incidence is on the decline overall, we’re seeing a rather rapid rise of incidence in 20- and 30-somethings. Rectal cancer is also on the rise. Some statistics revealed in the report include the following:7
- Since the mid-1980s, rates of colon cancer in adults between the ages of 20 and 39 increased by 1 percent, now affecting 2.4 percent of the population in this age-group annually
- Since the mid-1990s, colon cancer rates in adults between the ages of 40 and 54 have risen by 0.5 percent, now affecting 1.3 percent of this age group
- In adults aged 20 to 29, rectal cancer incidence rates increased 3.2 percent annually between 1974 and 2013
- In adults under the age of 55, rates of rectal cancer doubled, from 14.6 percent in 1990 to 29.2 percent in 2013
- An estimated 13,500 new cases of colon and rectal cancers will be diagnosed in adults under the age of 50 this year
According to the authors: “Consequently, compared with adults born circa 1950, those born circa 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer.”
Based on these findings, the American Cancer Society is reassessing its colon cancer screening guidelines, which currently recommend screening to begin at age 50.
Comparing Your Risk of Cancer With Risks of Screening
While all of that may sound frightening, let’s take a deeper look at your risk, and compare that to the risks of colonoscopy screening. The rate of colon cancer mortality among young adults has risen by about 1 death per 100,000 among young adults, to a 3-in-100,000 risk.
With some 15 million colonoscopies being done each year in the U.S.,10 that means as many as 15,000 Americans die as a result of this routine screening test, and numbers are likely to increase further if guidelines are changed to encourage people under 50 to get tested.
Again, an estimated 13,500 new cases of colon and rectal cancers will be diagnosed in adults under the age of 50 this year, and if you extrapolate the potential number of deaths at 37 percent (the average death rate for all age groups), then less than 5,000 individuals under the age of 50 will die from colorectal cancer.
This means you may be three times more likely to die from the screening procedure than the disease itself. Serious complications for colonoscopy also occur at a rate of about 1 per 20011 to 35012 procedures, again depending on the source of the data.
According to the report “Complications of Colonoscopy in an Integrated Health Care Delivery System,” the combined injury and kill-rate of colonoscopy-related complications is 0.5 percent, or about 70,000 per year.13
Recall, for comparison, 50,000 die each year from colon cancer and rectal cancer combined, so in the final analysis, if you’re still young, your risk of serious harm and/or death from colonoscopy is FAR greater than your risk of colorectal cancer.14
Other large studies have found that 1.5 to 3 colon cancer deaths are prevented for every 1,000 people screened once every 10 years, while 2.5 per 1,000 people screened are severely harmed or killed.15
That seems like a toss-up in terms of risk, but at least if you’re older and are in a higher risk category, screening becomes a more reasonable risk.
Also beware that X-ray exposure from virtual colonoscopy raises your lifetime risk of all forms of cancer by 20 percent. As noted by GutSense.org,16 “Virtual colonoscopies are now recommended every five years.
By age 70 one’s risk of developing any other form of cancer grows to 100 percent. Killing you with another form of cancer before the colon gets affected is one hell of [a] way to ‘prevent’ colon cancer.”
Other Side Effects of Colonoscopies
•Perforation of the colon, which occurs at a rate of 1 in 80019 (people at higher risk include those with diverticulitis, diseases of the colon and adhesions from pelvic surgery). Research20 shows the risk of death subsequent to perforation is nearly 52 per 1,000 colonoscopic perforations and 64.5 per 1000 sigmoidoscopic perforations
•Dysbiosis and other gut imbalances, caused by the process of flushing out your intestinal tract before the procedure with harsh laxatives21
•Complications from the anesthesia. Many experts agree you should opt for the lightest level of sedation possible, or none at all, as full anesthesia increases risks
•Infections caused by poorly disinfected scopes
•False positives. According to the Prostate Cancer Foundation,22 an estimated 30 to 40 percent of men treated for prostate cancer have harmless tumors that would never have caused problems in their lifetime. As noted by to Jessica Herzstein, a preventive-medicine consultant and member of the U.S. Preventive Services Task Force, “you’re going to die with them, not of them.”
False positives lead to unnecessary treatments that are nearly always harmful, in addition to the anxiety a cancer diagnosis brings. For example, incontinence and erectile dysfunction are two common side effects of radiation therapy, and hormone therapy has been linked to osteoporosis and depression.
Sigmoidoscopies Are Far Safer but Not Used as Often
Sigmoidoscopies tend to have 10 times fewer complications, yet most doctors still recommend colonoscopy 95 percent of the time. Moreover, while there are three acceptable methods to screen for colon cancer,23 colonoscopy — which is the riskiest of the three — is still most commonly recommended by doctors and chosen by patients.
Aside from getting a colonoscopy every 10 years, colorectal cancer can also be diagnosed using fecal occult blood testing (FOBT) on an annual basis (to check for signs of blood in your stool), or a flexible sigmoidoscopy every five years. Researchers have found that in most instances, doctors fail to review all of these options — and the benefits and drawbacks of each — with their patients.
Interestingly, other developed countries favor the FOBT stool test. Part of the reason for this is that in other countries doctors do not get paid for procedure referrals. In the U.S., however, doctors typically do get financial kickbacks when referring patients for various procedures, and as noted by Greger, “it’s estimated that doctors make nearly a million more referrals every year than they would have if they there were not personally profiting.”