You might be done with school, but you still need to take some testS

Working adults and retirees may be far removed from school and the stresses that come with high-stakes testing.

No matter our age, though, we’re not done taking tests. Unlike the pop quiz in English literature, algebra or world history, the tests we take as older adults are some of the most important exams in our lives.

Colorectal cancer is one of the most common cancers and the second-most common cause of cancer death in the U.S. and  worldwide. The American Cancer Society estimates that two-thirds of colorectal cancer deaths occur in patients over 65. However, if caught early, cancer of the colon is highly treatable and often curable.

In 2021, the U.S. Preventive Services Task Force lowered the recommended testing age for colorectal cancer from 50 to 45 due to an increase in its incidence among younger individuals.

Gen Xers, Baby Boomers and older generations who are up to date on their testing likely have already completed a colonoscopy, the gold standard of testing for this dangerous cancer. This screening test is highly important because colorectal cancer often doesn’t have symptoms in the initial stages.

The screening uses a scope to look for polyps, a small clump of cells that forms on the lining of the colon. Most colon polyps are harmless, but some can become cancerous. When cancer forms in a polyp, it grows into the wall of the colon and eventually can spread to distant parts of the body. During a colonoscopy, the doctor can remove colorectal polyps to help prevent cancer.

While the test itself is done under general anesthesia, the preparation for a colonoscopy is often what people dislike. To make sure doctors can see polyps, the colon must be clean and empty before the procedure. That means everything in your bowel must go, which is accomplished by drinking large volumes of water mixed with a laxative the day before, and sometimes the morning before, the procedure. The liquid results in diarrhea and considerable time in the bathroom as your colon is cleared. You will also be on a clear-liquid diet the day of the procedure.

The preparation can be unpleasant. Perhaps that is why four in 10 Americans aged 45 and older are not up to date on their colorectal cancer screenings, according to the American Cancer Society.

But there is good news. People who don’t have other risk factors generally only need to have a colonoscopy every 10 years. Also, a lot has changed in recent years. Today, the preparation liquid (often a gallon) does not need to be consumed in one sitting and may be taken the night before and the next morning, making it more tolerable. The solutions are also better-tasting than they once were.

Also, there are some alternatives, including lower-volume solutions and a pill prep involving 12 tablets taken twice with large amounts of water. In addition, the FDA has approved three types of stool tests to screen for colorectal cancer at home. They should be completed every one to three years. If a stool test is positive, which doesn’t always mean cancer is present, a follow up colonoscopy is necessary.   

There are things we can do to prepare for a colonoscopy to make the preparation less unpleasant:

·         The less you have in your stomach before colonoscopy preparation, the easier it will be. Start eating smaller portions and reducing fiber five to seven days in advance.

·         The week before a colonoscopy, avoid nuts and seeds, popcorn, red meat, raw vegetables, corn, peas, broccoli, cabbage, dried beans, whole grain bread and pasta, brown or wild rice, fruit with skins, fried foods and cereals like oatmeal, shredded wheat and granola.

·         Chill any liquid preparation, as it is often easier to drink when it’s cold.

·         Use a straw to bypass the tastebuds in your mouth as you drink the preparation.

·         Suck on lemon slices or sugar-free menthol candy while you drink or after each sip to help with the taste.

·         Mix in sugar-free water flavorings that are clear, not red, blue or purple.

·         If nausea was an issue during a previous preparation, ask your doctor for anti-nausea medicine in advance.

While age is a risk factor for developing colorectal cancer, increasing physical activity, maintaining a healthy weight, not smoking and limiting alcohol can reduce the risk of developing colorectal and other cancers. Even if you were inactive in your younger years, becoming active when you are older can lower your risk.

Your primary care doctor can help you keep track of preventive services, like screening tests and vaccines, as well as help make lifestyle recommendations such as diet and exercise to help reduce risk for illness.

About the Author

Jaimenee “Jaime” Khemraj is chief medical officer for Healthcare Network, which has practices throughout Collier County offering family care, dental care and pharmacy as well as behavioral health counseling. For more information, visit HealthcareSWFL.org, or to schedule an appointment, please call 239-658-3000.