September 22, 2025 • 30 mins
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Colon cancer screening saves lives by catching cancer early and even preventing it, yet only 69% of eligible adults are up to date with their screenings. We explore who needs screening, what tests are available, and how to choose the right one for you.
• Most adults should start colon cancer screening at age 45, even if healthy
• Family history may mean you need to start screening earlier
• Stool-based tests like FIT and Cologuard are convenient home options
• Colonoscopy remains the gold standard, allowing doctors to remove polyps
• One in 23 men and one in 25 women will develop colorectal cancer
• The best screening test is the one you'll actually complete
Please get screened! Check with your doctor about which test is right for you based on your risk factors and preferences.
References
1. Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians (Version 2). Qaseem A, Harrod CS, Crandall CJ, et al. Annals of Internal Medicine. 2023;176(8):1092-1100. doi:10.7326/M23-0779.
2. AGA Clinical Practice Update on Risk Stratification for Colorectal Cancer Screening and Post-Polypectomy Surveillance: Expert Review. Issaka RB, Chan AT, Gupta S. Gastroenterology. 2023;165(5):1280-1291. doi:10.1053/j.gastro.2023.06.033.
3. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. Davidson KW, Barry MJ, Mangione CM, et al. JAMA. 2021;325(19):1965-1977. doi:10.1001/jama.2021.6238.
4. Colorectal Cancer Screening and Prevention. Sur DKC, Brown PC. American Family Physician. 2025;112(3):278-283.
5. Increasing Incidence of Early-Onset Colorectal Cancer. Sinicrope FA. The New England Journal of Medicine. 2022;386(16):1547-1558. doi:10.1056/NEJMra2200869.
6. From Guideline to Practice: New Shared Decision-Making Tools for Colorectal Cancer Screening From the American Cancer Society. Volk RJ, Leal VB, Jacobs LE, et al. CA: A Cancer Journal for Clinicians. 2018;68(4):246-249. doi:10.3322/caac.21459.
7. Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Lin JS, Perdue LA, Henrikson NB, Bean SI, Blasi PR. JAMA. 2021;325(19):1978-1998. doi:10.1001/jama.2021.4417.
8. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989.
9. How Would You Screen This Patient for Colorectal Cancer? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Burns RB, Mangione CM, Weinberg DS, Kanjee Z. Annals of Internal Medicine. 2022;175(10):1452-1461. doi:10.7326/M22-1961.
Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:12):
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Dolesky, a familymedicine doctor in the
Philadelphia area.
Speaker 2 (00:28):
And I'm Nicole Rufo.
I'm a nurse.
Speaker 1 (00:30):
And we are so excited you were able to join us here
again today.
So your shtick this week iswith new home builds and the
shrinkflation that goes on withthem.
Speaker 2 (00:44):
You were really passionate about this A little
little.
Yeah, It'll actually send meinto a rage.
Let's talk about it.
Pull the rip cord.
Speaker 1 (00:52):
Yeah, so what do you?
Speaker 2 (00:53):
what do you?
See, you know, like we'redaydreaming, we're yeah, we're
like peripherally looking forhouses, very, very peripheral.
Yeah, very, very peripheral.
Yeah, just kind of like seeingwhat's out there.
Speaker 1 (01:08):
Seeing what we like.
Speaker 2 (01:09):
Seeing what we like, where that will be Turns out.
The things that we like arereally expensive, but whatever
Anyway.
So what they're doing thesedays with these new builds Not
that we necessarily like, want anew build in particular, but
just like and look, cause I mean, as we look.
Speaker 1 (01:31):
you know I made a friend, our friend, recently
like had a new build, so part ofthe conversation.
Speaker 2 (01:36):
Yeah.
So you're looking at them andthey're, you know, beautiful on
the outside and all the picturesare beautiful and everything's
new.
Granted, probably not the bestquality stuff, but it looks nice
.
But then you get to the kitchenand, like the angle of the
(01:56):
angle of the picture, at firstlooks like this big, great, like
bright, open, wide, hugekitchen.
But then when you actually lookat it, the cabinets and the
counters are so narrow like youcan't.
You.
You couldn't fit.
Like an appliance on thatcounter or have any sort of like
(02:18):
cooking or prep room can't fit.
Where are you putting, likeyour bowls?
You can't fit them in thosenarrow cabinets no, something
totally taken for granted.
It's insane, but like theysomehow made it happen that,
like you're gonna have itactually pisses me off, like
(02:38):
this one house in particular waslike eight hundred thousand
dollars and for like six inchesof counter space.
Like what are you doing?
Speaker 1 (02:46):
That was crazy.
Speaker 2 (02:47):
And, like peep, someone's going to buy that
house and probably spend overthat much money.
Speaker 1 (02:55):
No, it's like you can't put anything there and
like now that I'm doing morecooking, I realized, like, how
important counter space is.
Speaker 2 (03:03):
Yeah, and we really don't have a lot of counter
space in in this house but likethis is I mean you need.
Speaker 1 (03:12):
You need places, like it's stuff you take for granted
.
You're like, yeah, I'm gonnahave like plenty of places to
put bowls and like coffee cups,which this is a good point.
Like I don't know why oneperson needs like 15 different
coffee mugs because, like Idon't know, we use the same two.
If it's an occasion Like, maybewe'll reach for a special Rowan
mug, if you will, maybe aCooper mug if you will, but for
(03:37):
the med school, that is.
But that's a good point, why dopeople need like a billion
coffee mugs?
Some people are like into it, Ido having different ones.
I love a coffee.
I'm not I know you aren't, butlike I got that, like nice rowan
one I like every once in awhile but um, back on theme.
(04:00):
Everything is thinner andsmaller.
It is annoying it's so annoyingbut you know, if they do have a
layout that's like big openkitchen leading into an
entertaining area, that would begreat because, as it's
currently constructed, likesomething I notice is like if
one of us is in the kitchendoing something, the other
(04:20):
person's on the couch and thenthere's like no way to have that
like communication.
Or if you're entertaining, itis like strictly like there is
kitchen where everyone always isat all times and you like never
get people on the couch, evenif it's the coziest place to be
yeah, well, one day we'll find ahouse yeah, one day it would be
(04:44):
cool.
Um, that would be fun.
Counter space and open, openkitchen concept.
Well, this like first time homebuyer podcast has been really
helpful.
Like you know, it's like very,very, very early preparation, so
that's cool, yeah, but that'sthanks for sharing your thoughts
on that.
Speaker 2 (05:02):
Oh, you're welcome.
Speaker 1 (05:03):
Yeah, you got really excited about that, I was like
we got to talk about this Pullthe ripcord so we've been.
What did we watch this week?
Speaker 2 (05:12):
What did we watch this week?
Speaker 1 (05:14):
We finished up the Summer.
Speaker 2 (05:15):
I Turned Pretty we finished the Summer, I Turned
Pretty, which now they're makinga movie.
Speaker 1 (05:20):
Same characters.
Speaker 2 (05:22):
Yeah, I think, because in the books.
I don't think the whole paristhing was in the books, but
there was a wedding with bellyand conrad oh, in the books I
think.
So I think the movie's gonna belike that, I'm assuming wow,
okay cool this girl is, she'sgot problems oh my god, she's so
(05:44):
hateable.
She has to be like a phenomenalactress because people just
collectively don't like her no,I think she is.
Speaker 1 (05:52):
No, she's doing a great job.
Speaker 2 (05:54):
Lola, lola, tongue, right, you know she's naturally
a redhead really, and like thatlast scene, um, where they like
went back to the summer houseand it was like a year later or
whatever, and her hair was kindof like.
Her hair like wasn't as dark,it was pulled back so you
couldn't really tell, but thatwas her like natural hair that
was the natural hair.
Oh interesting, no, I didn'tdidn't pick up on that.
Speaker 1 (06:16):
No, I came on this journey much later, and now it's
over, so and then we watchedthe girlfriend we did watch the
girlfriend, um, but that, thatwoman from game of thrones, um,
oh god, what's her name?
Olivia.
Speaker 2 (06:37):
Let's see what was your take on the girlfriend um,
I liked it, you didn't, it was alittle bit.
I think that was also a bookactually, you know I, you know.
No, I don't think I.
I liked it, you didn't, it wasa little bit I think that was
also a book actually.
Speaker 1 (06:46):
You know I, you know, no, I don't think I.
I liked it as much.
I was entertained, I said it'slike twisty books I read yeah, I
didn't love it as much as I washoping, but it happened and we
watched it.
Um, it was a quick, a quickditty.
It was only it's like sixepisodes, six episodes, but each
each was like a healthy hourcompared to like probably like
what?
Eight 40 minute episodes theycould have done, but you know it
(07:09):
happened.
We watched it, obviously backon football season, which is fun
.
Have not been able to sit downfor a long continuous period of
time and watch football threeweeks in, but you know, such is
life.
Such is life A lot going on,got things to do and what else.
(07:29):
Now the banter sections havebeen light Because I've been
working too much.
Have I made you food this week?
Or there was a little food Imade.
Speaker 2 (07:40):
Oh yeah, you made crab cavatelli the other day.
That was delicious.
That was a special request.
Speaker 1 (07:47):
Oh my God, this fantasy draft is a live call
that they update manually.
Yeah, it's like not through thedraft.
Shut the hell up.
So I'm in a fantasy dynastybasketball league, which is fun.
I appreciate the invitation forthe camaraderie and it's all
new, but it's in depth and, likeKarthik used to be in this,
(08:10):
mike is in it.
For all of you listeners outthere who know Mike.
They're doing it manually.
It's a manual call at 7 pm.
It was at 6.
Speaker 2 (08:19):
Is?
Is this gonna be like threehours we have rotting to do
tonight?
I?
Speaker 1 (08:22):
think this might be.
This is I think they update theexcel sheet, though I would
double check.
Oh my gosh, this is it's anexcel sheet this is way more.
Is this like?
1972 involved than I thought itwas gonna be.
No, it's amazing like thecamaraderie that happens and
they're so into it and I'mhonored to to be in there.
Yeah, we went to a top golf touse their conference room and
(08:43):
not actually go to top golf thatis actually so funny, it was
hilarious.
I'm so happy it happened.
But um, oh man, I am wildlyunprepared for this.
But I've been a part of acouple big trades that have like
it's a live call, shook theleague.
Speaker 2 (08:58):
Are you guys gonna going to have a conference call
too?
Speaker 1 (09:01):
Yeah, it's a Google meet.
Oh my God, yeah, that that forsure is happening.
But I was kind of thought.
I kind of thought I could likeanonymously sit on the couch
while we're like rotting andmake that happen.
Speaker 2 (09:10):
Well, we're still rotting.
Yeah, I guess I'm going to havethe laptop in front of me and
my like little square in thething and like just headphones
headphones might be good.
Speaker 1 (09:23):
Yeah, I'm not listening to that.
No, thank you.
No, I don't blame you.
Um, wow, oh, this is.
This is news.
We're nine minutes in all,right, all right.
Well, I think that was enoughexcitement, with some live
update and um and take.
Well, let's dive in, shall we?
We shall?
What are we going to talk abouttoday, nick?
Speaker 2 (09:41):
Today we're talking about colon cancer screening.
Speaker 1 (09:44):
Yeah, turns out, this is something I talk about every
single day and is somethingwildly important, as most of our
episodes are for the majorityof adult health and some peds
health too.
But this one, like I, need anepisode to be able to refer to
because it's a, it's a bigconversation and it's like I
(10:07):
think it deserves a little bitmore than just a.
Hey, you're due for a coloncancer screening, so here we go.
So colon cancer is one of themost common cancers and
unfortunately, it's the secondleading cause of cancer death in
the United States.
And so I'll say this in plainEnglish screening saves lives by
catching the cancer early andhelps us even prevent it a
(10:28):
little bit.
And so today we're going totalk about who needs screening,
what tests are out there, whatto expect and how to choose the
right one.
But I really think we can't gofurther without this little
anecdote that I had from one ofmy third years of med school and
one of the biggest reasons thatI chose to go into primary care
.
And we were rounding and we getto this guy in the hospital and
(10:51):
he's grade three, maybe gradefour, colon cancer, and it was a
new diagnosis that was beingdelivered and all I can remember
is this grown man weeping,wishing that he had more time
with his family, not knowingwhat the treatment options were,
et cetera, et cetera, and all Icould help think this guy was
(11:11):
in his 60s.
I think all I could help thinkwas wow, maybe all of this could
have been prevented.
And that stuck with me and Icouldn't get off of that
throughout the rest of medschool.
And then I decided to go intoprimary care to have these exact
conversations day in and dayout, because they are so
incredibly important.
(11:33):
So, nick, let's get started.
We'll go through the outlinehere and when we dive in.
So, nick, let's get started.
We'll go through the outlinehere, and why don't we dive in?
Speaker 2 (11:41):
Who should get screened?
Most adults starting at age 45,even if you are healthy.
Speaker 1 (11:47):
Yeah, so that comes up a little bit.
If you have a family history,if there are certain genetics
that impact you, they may putyou at higher risk and so you
may start earlier.
So you should talk to your owndoctor if you have a family
history, because that may changethe date that you should get
screened.
There are certain, like thereare certain genetic syndromes
that make people have to getcolon cancer screening early.
But, like you said, the vastmajority of people need to start
(12:10):
at age 45, which is up from age50, where it used to be.
So I do happen to see a lot of45 year olds or even 44 who are
like oh wait, really I'm due forthis now, and they're a little
surprised.
But 45 is the age.
So this continues until age 75,most usually, and it's not like
(12:34):
a hard stop at 75.
After that it's a conversation.
It depends on your health,depends on your preferences.
I mean, age is but a number.
So you can have a 75 year oldwho plans on living 30, 35 more
years, or you have someone who'snot so lucky.
So after 75, it's a, it's aconversation.
Speaker 2 (12:56):
What are the different types of screening
tests to do?
Speaker 1 (13:00):
Yeah, so this is where the money is.
There are two main categoriesof screening tests.
There are stool-based tests anddirect visualization tests.
So we'll go through bothcategories.
A stool-based test tend to be athome and non-invasive, but each
has their trade-off.
So the first one is the fittest, and this checks the stool
(13:24):
for hidden blood.
This one is done once a year.
One pro of it is that there'sno prep.
The prep is the thing that hasto be done to prepare for the
colonoscopy, and so the prep isthe solution that you drink to
prepare for the colonoscopy, andso the prep is the solution
that you drink to prepare forthe colonoscopy, and often makes
you go to the bathroom a lotbecause you have to clean out
(13:45):
your entire colon to make surethat they are able to see.
So in this case stool-basedtest oftentimes you don't have
to do the prep.
If the fit test is positive,you still have to do the
colonoscopy.
Then there's the GWIAC fecaloccult blood test or GFOBT,
which also checks for blood, butthis one has some diet and
(14:09):
medication restrictions and isless commonly used Also once a
year, but it's less sensitive.
And then comes the one that youprobably see advertisements for
all of the time, which is thestool DNA test, which is the
Cologuard.
This one looks for blood andfor DNA changes and can be done
from every one to three years.
This one's more sensitive, tothe tune of about 92%, but also
(14:34):
causes more false positives.
So there's a little bit to talkabout here.
In the law of big numbers 92out of 100, you're going to miss
eight out of 100 colon cancerswhen you screen in this way, and
this test, being more sensitivethan the FIT test, means it's
(14:56):
going to pick up more.
But it also might pick up more.
That isn't important, and that'sthe false positive.
So when you have a falsepositive with maybe a coligard,
you're going to get that result,and then you're going to have
to go do a colonoscopy to maybelearn that you're good or that
(15:20):
there's something there thatneeds to be addressed.
And so this is part of theconversation that I end up
having a lot of the time,because one 92 out of a hundred
pretty good, but not perfect iswhat it picks up.
And then there's the chance forfalse positives, which can be
anxiety provoking.
We've talked about like gettingtest results and having to
(15:42):
follow up those test results andimaging stuff before.
So this is all things that youhave to think about when you're
choosing which one you're goingto do, like, yeah, it's
convenient, but it's not perfect.
So what do you expect fromthese tests?
What you're going to do isyou're going to collect a sample
at home and then you mail it in.
(16:03):
That's it.
So it is pretty easy.
And for people who think, likeI am absolutely not going to do
the colonoscopy, I am absolutelynot going to do the prep, or if
you're lying to yourself sayingyeah, I'm going to do it, I'm
going to do it, and year onegoes by, year two goes by, 45,
46, 47.
All of a sudden you're 65, andyou haven't done colon cancer
(16:25):
screening.
Maybe it's time to think aboutone of the stool-based tests, if
it's reasonable for you andyou've talked to your doctor
about it.
So yeah, you collect the sampleat home, you mail it in,
there's no prep, and if it'spositive, you bet you still
bought yourself a colonoscopy.
Speaker 2 (16:42):
Okay, we did the stool-based test.
What are the directvisualization tests?
Speaker 1 (16:47):
Yeah, so far far most common one of the direct
visualization is the colonoscopy.
This is the gold standard, thisis the one you should go for,
this is the one you should get,but of course people don't
always do it.
So the colonoscopy is when asmall, very small camera looks
(17:07):
at the entire colon.
And, yes, they have to get tothe colon somehow.
So, yeah, they're going in frombehind, but it looks at the
entire colon and they can seethings.
But what's also important isthey can take care of stuff, so
they can remove polyps and takesamples of tissue if they see it
.
So that's the huge benefit.
(17:29):
It's the gold standard.
It's exceedingly rare to missanything and if they do see
anything, they can just takecare of it.
If you get the clean bill ofhealth and they call it normal,
you might not have to do thisagain for another 10 years.
If it get the clean bill ofhealth and they call it normal,
you might not have to do thisagain for another 10 years.
If it's anything a little lessthan normal, they may be more
conservative and call you backsooner.
But that's it.
It does require the bowel prep,which, to say it again, is
(17:53):
drinking a large amount ofsolution and that requires you
to go to the bathroom a lot.
And this is usually thesticking point for people.
They're like oh my God, theprep, I can't believe I have to
do the prep, the prep, the prep,the prep.
Speaker 2 (18:05):
Yeah, people do say that a lot.
But like what's worse gettingcolon cancer or like pooping a
lot for one night?
Speaker 1 (18:13):
It's true, we're a poop forward household.
We are.
So it might be fun.
We're not close to doing coloncancer screening, which is fun,
so skinny and young, but I don'tknow.
I would think that, like, yeah,you should do this, and if you?
Speaker 2 (18:31):
You can handle having diarrhea for one night.
Thank you.
Speaker 1 (18:33):
Right, it seems like mildly yeah it sucks, your
stomach probably hurts.
Speaker 2 (18:39):
Neither of us have ever had colonoscopy so I guess
we really can't speak to thatpart.
Sure, like, do you want to dealwith one night of being
uncomfortable and running to thebathroom, or how many weeks of
cancer treatment surgery, maybedying?
Yeah, you know so I've.
Speaker 1 (18:56):
I have met one guy who because there's always a
certain ambivalence when itcomes to the colonoscopy, and
then my style is to try to findout why, more of like why
haven't you gone to go get thecolonoscopy?
And there is one story that Iremember vividly of this guy who
(19:17):
, like you know, there's alwaysa good reason.
You can't go dunk on someoneand be like like why haven't you
gotten your colonoscopy?
like he had a great reason, likehis son had special needs, oh
yeah, that's good, remember thisone and like he had special
needs and his shtick, his thingwas like being close to the
bathroom the son and like heloved the bathroom and in their
house, with what they were ableto have, like they had one
(19:38):
bathroom.
And so the guy was like, well,I'm the sole caretaker of my son
, who's literally always in thebathroom and I can't get to the
bathroom overnight when I wouldneed to do this.
So, yeah, that's a great reasonand like we're being like a
(19:59):
little harsh.
I guess we're like, please getlike for the average person with
like the ability and thecapability to do it.
I just do it, yeah, but yeah,we also recognize that like it
doesn't work for everyone.
There are really good reasonsout there.
So that was just one that likeI really remember.
Speaker 2 (20:15):
So you can't go dunking on people but well,
sometimes you can, sometimes youcan, I think, a lot of cases
you can.
Speaker 1 (20:25):
So yeah, there's a little bit of shame.
Is not a bad thing, is?
Speaker 2 (20:29):
bring back shame, bring back a little bit of shame
.
Speaker 1 (20:32):
So with that there's a little bit of sedation as well
in the procedure and there's aslight risk to that as well.
The the colonoscopy is notcompletely without risk.
If we're going to be fair andbalanced, you're going to be
startled when we tell you howoften people get colon cancer
later in the episode.
But the risks of a colonoscopyinclude a small chance of
(20:56):
bleeding, which is oftenreported about one in a thousand
.
Maybe a gastroenterologist isgoing to come after me, I don't
know and a small risk ofperforation about one in 3000.
So that's what we're dealingwith here.
And then a small possiblereactions to sedation which are
usually very commonly usedeasily accessible medications.
(21:17):
So the colonoscopy, colonoscopy, colonoscopy that is direct
visualization essentially.
There are other ones.
There's a sigmoidoscopy.
It's basically colonoscopy,light.
It looks at the lower parts ofthe colon.
It may be done every five to 10years.
They could be done in like alittle bit less intensive venues
and sometimes they're pairedwith fit tests.
(21:39):
They are a little less invasivebut can miss things higher up.
And then there's the CTcolonography.
There's a reason for everything.
There's a lid for every pot.
This happens to be a CT scan.
It can be done every five years.
It still needs the prep.
So you're not getting out ofthat with this one.
It doesn't require sedation,but leads to a radiation
(22:00):
exposure and the kicker.
If it's abnormal, you stillneed a colonoscopy.
So all roads lead to thecolonoscopy, so why not start
there if you can?
This is what I'm thinking.
So what do you expect out ofthese tests?
You need the prep to clean thecolon, the sedation for the
(22:21):
colonoscopy, and someoneprobably has to drive you home.
She's going to be a littleloopy, all right, so we talked
about those.
Nick, I guess I didn't realizehow passionate I feel about this
topic, so I'm talking a lot inthis one.
Can you take us to the benefitsof screening and why is this so
important?
(22:41):
What can people like?
What are we trying to do here?
What does it do?
Speaker 2 (22:46):
So screening cuts the risk of dying from colon cancer
by up to 26%.
Speaker 1 (22:52):
I mean, which is a lot?
Do you need more?
But tell us more.
Speaker 2 (22:57):
It can also just prevent cancer from removing any
polyps that are in there beforethey turn into something more
dangerous.
There you go and if we'redetecting cancer early, that's
kind of like the best time tostart treatment, because the
treatment will work best ifsomething is caught earlier
rather than later.
Speaker 1 (23:16):
Yeah, it's just like easier all around for it's a
smaller monster to deal with.
Like for the oncologist or thesurgeon to deal with like it's
like less dramatic if we justknow earlier and like it's less
like a part of your life.
So there are some really keynumbers that I want to share
because I really want to makethis real for people.
(23:37):
And so buckle up, because thisis about to get kind of scary.
Um, some of the best data thatwe have suggests that one in 23
men and one in 25 women will getcolorectal cancer in their
lifetime.
I guarantee anyone listeninghere knows 23 and 25 people, so
(24:00):
just let that settle in.
What's more problematic maybeis for things now that are
pretty accessible, with a lot ofoptions for different people.
I know we were ragging onpeople about the colonoscopy,
but there are a lot of differentoptions.
Screening rates are only around69% of eligible adults, so
(24:20):
that's 69% of adults are up todate on their colon cancer
screening.
So that is a lot, and part ofthis might be because of this
not so recent but like awarenessisn't so high moving of the age
from 50 to 45.
But this is because they foundthat starting at age 45 saves
(24:42):
more lives than waiting until 50that makes sense.
Speaker 2 (24:47):
I keep seeing online which this is simply from like
what I've been served on socialmedia and I have no like
legitimate backup to this.
I just keep seeing, like whenyou know, when you're doom
scrolling, all these like 30 ishyear olds that are like I kept
having diarrhea LOL, I actuallyhad colon cancer.
(25:12):
Is there any like actuallegitimate numbers of like
younger people who are gettingcolon cancer?
Yeah, you can also cut this ifI'm spreading misinformation.
Would hate to be doing that.
Speaker 1 (25:28):
Well, I mean part of the let's see.
So there is some evidence.
There was a review in JAMApublished in maybe 2025, and
they described that among thoseyounger than age 40 in the
United States, the annualincidence rate of colon cancer
(25:50):
was from 4.1 to 5.5 per 100,000people between the years 2013 to
2022.
And so that was an increase of3.4%.
And I think you bring up whenyou say this, you bring up an
important piece in thatscreening is in someone who has
(26:13):
no symptoms, has no concern fordisease and is going to get this
test anyway.
But you mentioned importantthings like when someone's on
TikTok and they're talking abouttheir experience, they had some
sort of symptom and so thatsymptom was addressed with like
a proper evaluation, I guess.
And a lot of times you end uplike if you were to look up any
(26:39):
gastrointestinal system likesymptom, like it silos down into
the colonoscopy or endoscopy islike the ultimate part of the
evaluation to wherever it soundslike you need a colonoscopy
based on your daily reports.
Speaker 2 (26:56):
Since we're a poop forward family, you know it
changes.
Speaker 1 (26:59):
Every day it changes um, so that's what I'm, that's,
that's my two cents on that.
Like, yeah, I think certainsalient stories online can be a
little bit sensationalizedbecause, like I mean, they're
personal, it's a big deal,you're young, you're not
expecting it and bang, you'relike slapped with the colon
cancer diagnosis.
I do still think it's rare.
(27:20):
There was a move to obviouslybring the age down from 50 to 45
, which was huge.
But you know you shouldn'tlinger in symptoms that you're
having that are likegastrointestinal related, at
home without an evaluation.
Like, if you need to getchecked out, you need to get
checked out, and if it requiresa colonoscopy for diagnostic
(27:44):
purposes rather than screening,and so be it.
I mean, it's your health we'retalking about for all the doom
scrollers out there.
For all the doom scrollers sothe next part is how to choose
the right test, and this goesalong with my shtick of like the
best test is the one you'llactually complete.
(28:06):
So I really have no problemcalling someone out and being
like, hey, this colonoscopy wasordered four years ago, are you
actually going to get it?
And then the dude's like,because it's always a guy, it's
like nah.
So let me talk aboutalternatives, of which we
discussed today.
You should talk to your doctorabout the risk and certain
(28:28):
preferences, if you have them.
Family history counts here, guys, so you should ask your family.
That's something that comes upa lot.
I ask about different familyhistories a lot, ones that
impact people and would impacttheir own screening, and
sometimes they don't know andthey don't talk about it.
So ask your family and really,this is the most important part
(28:49):
Please, for the love of God,just go get screened.
That's really all we reallywant, and that's it.
That's the episode for today.
So thank you for coming back toanother episode of your Checkup
.
Hopefully you learned somethingfor yourself, a loved one or a
neighbor who needs a colonoscopy.
(29:11):
Check out our website.
You can send us an emailyourcheckuppod at gmailcom.
You can send us fan mail, butthat's like a one directional
thing which we would love tohear but we can't answer back.
Find us on Instagram or threadswhich we're like kind of active
on, but I'm a busy boy now soI'm not online all day.
Speaker 2 (29:30):
Someone goes to work now.
Speaker 1 (29:31):
Let's go to work now, um, but check out our old
episodes or just come back andvisit us next week.
So until then, stay healthy, myfriends.
Until next time.
I'm at the Lusky.
I'm Nicole Rufo.
Thank you, until next time.
I'm Ed Dolesky.
I'm Nicole Rufo.
Thank you and goodbye.
Speaker 2 (29:45):
Bye.
Speaker 1 (29:48):
This information may provide a brief overview of
diagnosis, treatment andmedications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments or
medications for a specificperson.
This is not medical advice oran attempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
(30:09):
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorseany treatments or medications
for a specific patient.
Always talk to your healthcareprovider for complete
information tailored to you.
In short, I'm not your doctor,I am not your nurse, and make
sure you go get your own short.
I'm not your doctor, I am notyour nurse, and make sure you go
get your own checkup with yourown personal doctor.
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Dolesky, a familymedicine doctor in the
Philadelphia area.
Speaker 2 (00:28):
And I'm Nicole Rufo.
I'm a nurse.
Speaker 1 (00:30):
And we are so excited you were able to join us here
again today.
So your shtick this week iswith new home builds and the
shrinkflation that goes on withthem.
Speaker 2 (00:44):
You were really passionate about this A little
little.
Yeah, It'll actually send meinto a rage.
Let's talk about it.
Pull the rip cord.
Speaker 1 (00:52):
Yeah, so what do you?
Speaker 2 (00:53):
what do you?
See, you know, like we'redaydreaming, we're yeah, we're
like peripherally looking forhouses, very, very peripheral.
Yeah, very, very peripheral.
Yeah, just kind of like seeingwhat's out there.
Speaker 1 (01:08):
Seeing what we like.
Speaker 2 (01:09):
Seeing what we like, where that will be Turns out.
The things that we like arereally expensive, but whatever
Anyway.
So what they're doing thesedays with these new builds Not
that we necessarily like, want anew build in particular, but
just like and look, cause I mean, as we look.
Speaker 1 (01:31):
you know I made a friend, our friend, recently
like had a new build, so part ofthe conversation.
Speaker 2 (01:36):
Yeah.
So you're looking at them andthey're, you know, beautiful on
the outside and all the picturesare beautiful and everything's
new.
Granted, probably not the bestquality stuff, but it looks nice
.
But then you get to the kitchenand, like the angle of the
(01:56):
angle of the picture, at firstlooks like this big, great, like
bright, open, wide, hugekitchen.
But then when you actually lookat it, the cabinets and the
counters are so narrow like youcan't.
You.
You couldn't fit.
Like an appliance on thatcounter or have any sort of like
(02:18):
cooking or prep room can't fit.
Where are you putting, likeyour bowls?
You can't fit them in thosenarrow cabinets no, something
totally taken for granted.
It's insane, but like theysomehow made it happen that,
like you're gonna have itactually pisses me off, like
(02:38):
this one house in particular waslike eight hundred thousand
dollars and for like six inchesof counter space.
Like what are you doing?
Speaker 1 (02:46):
That was crazy.
Speaker 2 (02:47):
And, like peep, someone's going to buy that
house and probably spend overthat much money.
Speaker 1 (02:55):
No, it's like you can't put anything there and
like now that I'm doing morecooking, I realized, like, how
important counter space is.
Speaker 2 (03:03):
Yeah, and we really don't have a lot of counter
space in in this house but likethis is I mean you need.
Speaker 1 (03:12):
You need places, like it's stuff you take for granted
.
You're like, yeah, I'm gonnahave like plenty of places to
put bowls and like coffee cups,which this is a good point.
Like I don't know why oneperson needs like 15 different
coffee mugs because, like Idon't know, we use the same two.
If it's an occasion Like, maybewe'll reach for a special Rowan
mug, if you will, maybe aCooper mug if you will, but for
(03:37):
the med school, that is.
But that's a good point, why dopeople need like a billion
coffee mugs?
Some people are like into it, Ido having different ones.
I love a coffee.
I'm not I know you aren't, butlike I got that, like nice rowan
one I like every once in awhile but um, back on theme.
(04:00):
Everything is thinner andsmaller.
It is annoying it's so annoyingbut you know, if they do have a
layout that's like big openkitchen leading into an
entertaining area, that would begreat because, as it's
currently constructed, likesomething I notice is like if
one of us is in the kitchendoing something, the other
(04:20):
person's on the couch and thenthere's like no way to have that
like communication.
Or if you're entertaining, itis like strictly like there is
kitchen where everyone always isat all times and you like never
get people on the couch, evenif it's the coziest place to be
yeah, well, one day we'll find ahouse yeah, one day it would be
(04:44):
cool.
Um, that would be fun.
Counter space and open, openkitchen concept.
Well, this like first time homebuyer podcast has been really
helpful.
Like you know, it's like very,very, very early preparation, so
that's cool, yeah, but that'sthanks for sharing your thoughts
on that.
Speaker 2 (05:02):
Oh, you're welcome.
Speaker 1 (05:03):
Yeah, you got really excited about that, I was like
we got to talk about this Pullthe ripcord so we've been.
What did we watch this week?
Speaker 2 (05:12):
What did we watch this week?
Speaker 1 (05:14):
We finished up the Summer.
Speaker 2 (05:15):
I Turned Pretty we finished the Summer, I Turned
Pretty, which now they're makinga movie.
Speaker 1 (05:20):
Same characters.
Speaker 2 (05:22):
Yeah, I think, because in the books.
I don't think the whole paristhing was in the books, but
there was a wedding with bellyand conrad oh, in the books I
think.
So I think the movie's gonna belike that, I'm assuming wow,
okay cool this girl is, she'sgot problems oh my god, she's so
(05:44):
hateable.
She has to be like a phenomenalactress because people just
collectively don't like her no,I think she is.
Speaker 1 (05:52):
No, she's doing a great job.
Speaker 2 (05:54):
Lola, lola, tongue, right, you know she's naturally
a redhead really, and like thatlast scene, um, where they like
went back to the summer houseand it was like a year later or
whatever, and her hair was kindof like.
Her hair like wasn't as dark,it was pulled back so you
couldn't really tell, but thatwas her like natural hair that
was the natural hair.
Oh interesting, no, I didn'tdidn't pick up on that.
Speaker 1 (06:16):
No, I came on this journey much later, and now it's
over, so and then we watchedthe girlfriend we did watch the
girlfriend, um, but that, thatwoman from game of thrones, um,
oh god, what's her name?
Olivia.
Speaker 2 (06:37):
Let's see what was your take on the girlfriend um,
I liked it, you didn't, it was alittle bit.
I think that was also a bookactually, you know I, you know.
No, I don't think I.
I liked it, you didn't, it wasa little bit I think that was
also a book actually.
Speaker 1 (06:46):
You know I, you know, no, I don't think I.
I liked it as much.
I was entertained, I said it'slike twisty books I read yeah, I
didn't love it as much as I washoping, but it happened and we
watched it.
Um, it was a quick, a quickditty.
It was only it's like sixepisodes, six episodes, but each
each was like a healthy hourcompared to like probably like
what?
Eight 40 minute episodes theycould have done, but you know it
(07:09):
happened.
We watched it, obviously backon football season, which is fun
.
Have not been able to sit downfor a long continuous period of
time and watch football threeweeks in, but you know, such is
life.
Such is life A lot going on,got things to do and what else.
(07:29):
Now the banter sections havebeen light Because I've been
working too much.
Have I made you food this week?
Or there was a little food Imade.
Speaker 2 (07:40):
Oh yeah, you made crab cavatelli the other day.
That was delicious.
That was a special request.
Speaker 1 (07:47):
Oh my God, this fantasy draft is a live call
that they update manually.
Yeah, it's like not through thedraft.
Shut the hell up.
So I'm in a fantasy dynastybasketball league, which is fun.
I appreciate the invitation forthe camaraderie and it's all
new, but it's in depth and, likeKarthik used to be in this,
(08:10):
mike is in it.
For all of you listeners outthere who know Mike.
They're doing it manually.
It's a manual call at 7 pm.
It was at 6.
Speaker 2 (08:19):
Is?
Is this gonna be like threehours we have rotting to do
tonight?
I?
Speaker 1 (08:22):
think this might be.
This is I think they update theexcel sheet, though I would
double check.
Oh my gosh, this is it's anexcel sheet this is way more.
Is this like?
1972 involved than I thought itwas gonna be.
No, it's amazing like thecamaraderie that happens and
they're so into it and I'mhonored to to be in there.
Yeah, we went to a top golf touse their conference room and
(08:43):
not actually go to top golf thatis actually so funny, it was
hilarious.
I'm so happy it happened.
But um, oh man, I am wildlyunprepared for this.
But I've been a part of acouple big trades that have like
it's a live call, shook theleague.
Speaker 2 (08:58):
Are you guys gonna going to have a conference call
too?
Speaker 1 (09:01):
Yeah, it's a Google meet.
Oh my God, yeah, that that forsure is happening.
But I was kind of thought.
I kind of thought I could likeanonymously sit on the couch
while we're like rotting andmake that happen.
Speaker 2 (09:10):
Well, we're still rotting.
Yeah, I guess I'm going to havethe laptop in front of me and
my like little square in thething and like just headphones
headphones might be good.
Speaker 1 (09:23):
Yeah, I'm not listening to that.
No, thank you.
No, I don't blame you.
Um, wow, oh, this is.
This is news.
We're nine minutes in all,right, all right.
Well, I think that was enoughexcitement, with some live
update and um and take.
Well, let's dive in, shall we?
We shall?
What are we going to talk abouttoday, nick?
Speaker 2 (09:41):
Today we're talking about colon cancer screening.
Speaker 1 (09:44):
Yeah, turns out, this is something I talk about every
single day and is somethingwildly important, as most of our
episodes are for the majorityof adult health and some peds
health too.
But this one, like I, need anepisode to be able to refer to
because it's a, it's a bigconversation and it's like I
(10:07):
think it deserves a little bitmore than just a.
Hey, you're due for a coloncancer screening, so here we go.
So colon cancer is one of themost common cancers and
unfortunately, it's the secondleading cause of cancer death in
the United States.
And so I'll say this in plainEnglish screening saves lives by
catching the cancer early andhelps us even prevent it a
(10:28):
little bit.
And so today we're going totalk about who needs screening,
what tests are out there, whatto expect and how to choose the
right one.
But I really think we can't gofurther without this little
anecdote that I had from one ofmy third years of med school and
one of the biggest reasons thatI chose to go into primary care
.
And we were rounding and we getto this guy in the hospital and
(10:51):
he's grade three, maybe gradefour, colon cancer, and it was a
new diagnosis that was beingdelivered and all I can remember
is this grown man weeping,wishing that he had more time
with his family, not knowingwhat the treatment options were,
et cetera, et cetera, and all Icould help think this guy was
(11:11):
in his 60s.
I think all I could help thinkwas wow, maybe all of this could
have been prevented.
And that stuck with me and Icouldn't get off of that
throughout the rest of medschool.
And then I decided to go intoprimary care to have these exact
conversations day in and dayout, because they are so
incredibly important.
(11:33):
So, nick, let's get started.
We'll go through the outlinehere and when we dive in.
So, nick, let's get started.
We'll go through the outlinehere, and why don't we dive in?
Speaker 2 (11:41):
Who should get screened?
Most adults starting at age 45,even if you are healthy.
Speaker 1 (11:47):
Yeah, so that comes up a little bit.
If you have a family history,if there are certain genetics
that impact you, they may putyou at higher risk and so you
may start earlier.
So you should talk to your owndoctor if you have a family
history, because that may changethe date that you should get
screened.
There are certain, like thereare certain genetic syndromes
that make people have to getcolon cancer screening early.
But, like you said, the vastmajority of people need to start
(12:10):
at age 45, which is up from age50, where it used to be.
So I do happen to see a lot of45 year olds or even 44 who are
like oh wait, really I'm due forthis now, and they're a little
surprised.
But 45 is the age.
So this continues until age 75,most usually, and it's not like
(12:34):
a hard stop at 75.
After that it's a conversation.
It depends on your health,depends on your preferences.
I mean, age is but a number.
So you can have a 75 year oldwho plans on living 30, 35 more
years, or you have someone who'snot so lucky.
So after 75, it's a, it's aconversation.
Speaker 2 (12:56):
What are the different types of screening
tests to do?
Speaker 1 (13:00):
Yeah, so this is where the money is.
There are two main categoriesof screening tests.
There are stool-based tests anddirect visualization tests.
So we'll go through bothcategories.
A stool-based test tend to be athome and non-invasive, but each
has their trade-off.
So the first one is the fittest, and this checks the stool
(13:24):
for hidden blood.
This one is done once a year.
One pro of it is that there'sno prep.
The prep is the thing that hasto be done to prepare for the
colonoscopy, and so the prep isthe solution that you drink to
prepare for the colonoscopy, andso the prep is the solution
that you drink to prepare forthe colonoscopy, and often makes
you go to the bathroom a lotbecause you have to clean out
(13:45):
your entire colon to make surethat they are able to see.
So in this case stool-basedtest oftentimes you don't have
to do the prep.
If the fit test is positive,you still have to do the
colonoscopy.
Then there's the GWIAC fecaloccult blood test or GFOBT,
which also checks for blood, butthis one has some diet and
(14:09):
medication restrictions and isless commonly used Also once a
year, but it's less sensitive.
And then comes the one that youprobably see advertisements for
all of the time, which is thestool DNA test, which is the
Cologuard.
This one looks for blood andfor DNA changes and can be done
from every one to three years.
This one's more sensitive, tothe tune of about 92%, but also
(14:34):
causes more false positives.
So there's a little bit to talkabout here.
In the law of big numbers 92out of 100, you're going to miss
eight out of 100 colon cancerswhen you screen in this way, and
this test, being more sensitivethan the FIT test, means it's
(14:56):
going to pick up more.
But it also might pick up more.
That isn't important, and that'sthe false positive.
So when you have a falsepositive with maybe a coligard,
you're going to get that result,and then you're going to have
to go do a colonoscopy to maybelearn that you're good or that
(15:20):
there's something there thatneeds to be addressed.
And so this is part of theconversation that I end up
having a lot of the time,because one 92 out of a hundred
pretty good, but not perfect iswhat it picks up.
And then there's the chance forfalse positives, which can be
anxiety provoking.
We've talked about like gettingtest results and having to
(15:42):
follow up those test results andimaging stuff before.
So this is all things that youhave to think about when you're
choosing which one you're goingto do, like, yeah, it's
convenient, but it's not perfect.
So what do you expect fromthese tests?
What you're going to do isyou're going to collect a sample
at home and then you mail it in.
(16:03):
That's it.
So it is pretty easy.
And for people who think, likeI am absolutely not going to do
the colonoscopy, I am absolutelynot going to do the prep, or if
you're lying to yourself sayingyeah, I'm going to do it, I'm
going to do it, and year onegoes by, year two goes by, 45,
46, 47.
All of a sudden you're 65, andyou haven't done colon cancer
(16:25):
screening.
Maybe it's time to think aboutone of the stool-based tests, if
it's reasonable for you andyou've talked to your doctor
about it.
So yeah, you collect the sampleat home, you mail it in,
there's no prep, and if it'spositive, you bet you still
bought yourself a colonoscopy.
Speaker 2 (16:42):
Okay, we did the stool-based test.
What are the directvisualization tests?
Speaker 1 (16:47):
Yeah, so far far most common one of the direct
visualization is the colonoscopy.
This is the gold standard, thisis the one you should go for,
this is the one you should get,but of course people don't
always do it.
So the colonoscopy is when asmall, very small camera looks
(17:07):
at the entire colon.
And, yes, they have to get tothe colon somehow.
So, yeah, they're going in frombehind, but it looks at the
entire colon and they can seethings.
But what's also important isthey can take care of stuff, so
they can remove polyps and takesamples of tissue if they see it
.
So that's the huge benefit.
(17:29):
It's the gold standard.
It's exceedingly rare to missanything and if they do see
anything, they can just takecare of it.
If you get the clean bill ofhealth and they call it normal,
you might not have to do thisagain for another 10 years.
If it get the clean bill ofhealth and they call it normal,
you might not have to do thisagain for another 10 years.
If it's anything a little lessthan normal, they may be more
conservative and call you backsooner.
But that's it.
It does require the bowel prep,which, to say it again, is
(17:53):
drinking a large amount ofsolution and that requires you
to go to the bathroom a lot.
And this is usually thesticking point for people.
They're like oh my God, theprep, I can't believe I have to
do the prep, the prep, the prep,the prep.
Speaker 2 (18:05):
Yeah, people do say that a lot.
But like what's worse gettingcolon cancer or like pooping a
lot for one night?
Speaker 1 (18:13):
It's true, we're a poop forward household.
We are.
So it might be fun.
We're not close to doing coloncancer screening, which is fun,
so skinny and young, but I don'tknow.
I would think that, like, yeah,you should do this, and if you?
Speaker 2 (18:31):
You can handle having diarrhea for one night.
Thank you.
Speaker 1 (18:33):
Right, it seems like mildly yeah it sucks, your
stomach probably hurts.
Speaker 2 (18:39):
Neither of us have ever had colonoscopy so I guess
we really can't speak to thatpart.
Sure, like, do you want to dealwith one night of being
uncomfortable and running to thebathroom, or how many weeks of
cancer treatment surgery, maybedying?
Yeah, you know so I've.
Speaker 1 (18:56):
I have met one guy who because there's always a
certain ambivalence when itcomes to the colonoscopy, and
then my style is to try to findout why, more of like why
haven't you gone to go get thecolonoscopy?
And there is one story that Iremember vividly of this guy who
(19:17):
, like you know, there's alwaysa good reason.
You can't go dunk on someoneand be like like why haven't you
gotten your colonoscopy?
like he had a great reason, likehis son had special needs, oh
yeah, that's good, remember thisone and like he had special
needs and his shtick, his thingwas like being close to the
bathroom the son and like heloved the bathroom and in their
house, with what they were ableto have, like they had one
(19:38):
bathroom.
And so the guy was like, well,I'm the sole caretaker of my son
, who's literally always in thebathroom and I can't get to the
bathroom overnight when I wouldneed to do this.
So, yeah, that's a great reasonand like we're being like a
(19:59):
little harsh.
I guess we're like, please getlike for the average person with
like the ability and thecapability to do it.
I just do it, yeah, but yeah,we also recognize that like it
doesn't work for everyone.
There are really good reasonsout there.
So that was just one that likeI really remember.
Speaker 2 (20:15):
So you can't go dunking on people but well,
sometimes you can, sometimes youcan, I think, a lot of cases
you can.
Speaker 1 (20:25):
So yeah, there's a little bit of shame.
Is not a bad thing, is?
Speaker 2 (20:29):
bring back shame, bring back a little bit of shame
.
Speaker 1 (20:32):
So with that there's a little bit of sedation as well
in the procedure and there's aslight risk to that as well.
The the colonoscopy is notcompletely without risk.
If we're going to be fair andbalanced, you're going to be
startled when we tell you howoften people get colon cancer
later in the episode.
But the risks of a colonoscopyinclude a small chance of
(20:56):
bleeding, which is oftenreported about one in a thousand
.
Maybe a gastroenterologist isgoing to come after me, I don't
know and a small risk ofperforation about one in 3000.
So that's what we're dealingwith here.
And then a small possiblereactions to sedation which are
usually very commonly usedeasily accessible medications.
(21:17):
So the colonoscopy, colonoscopy, colonoscopy that is direct
visualization essentially.
There are other ones.
There's a sigmoidoscopy.
It's basically colonoscopy,light.
It looks at the lower parts ofthe colon.
It may be done every five to 10years.
They could be done in like alittle bit less intensive venues
and sometimes they're pairedwith fit tests.
(21:39):
They are a little less invasivebut can miss things higher up.
And then there's the CTcolonography.
There's a reason for everything.
There's a lid for every pot.
This happens to be a CT scan.
It can be done every five years.
It still needs the prep.
So you're not getting out ofthat with this one.
It doesn't require sedation,but leads to a radiation
(22:00):
exposure and the kicker.
If it's abnormal, you stillneed a colonoscopy.
So all roads lead to thecolonoscopy, so why not start
there if you can?
This is what I'm thinking.
So what do you expect out ofthese tests?
You need the prep to clean thecolon, the sedation for the
(22:21):
colonoscopy, and someoneprobably has to drive you home.
She's going to be a littleloopy, all right, so we talked
about those.
Nick, I guess I didn't realizehow passionate I feel about this
topic, so I'm talking a lot inthis one.
Can you take us to the benefitsof screening and why is this so
important?
(22:41):
What can people like?
What are we trying to do here?
What does it do?
Speaker 2 (22:46):
So screening cuts the risk of dying from colon cancer
by up to 26%.
Speaker 1 (22:52):
I mean, which is a lot?
Do you need more?
But tell us more.
Speaker 2 (22:57):
It can also just prevent cancer from removing any
polyps that are in there beforethey turn into something more
dangerous.
There you go and if we'redetecting cancer early, that's
kind of like the best time tostart treatment, because the
treatment will work best ifsomething is caught earlier
rather than later.
Speaker 1 (23:16):
Yeah, it's just like easier all around for it's a
smaller monster to deal with.
Like for the oncologist or thesurgeon to deal with like it's
like less dramatic if we justknow earlier and like it's less
like a part of your life.
So there are some really keynumbers that I want to share
because I really want to makethis real for people.
(23:37):
And so buckle up, because thisis about to get kind of scary.
Um, some of the best data thatwe have suggests that one in 23
men and one in 25 women will getcolorectal cancer in their
lifetime.
I guarantee anyone listeninghere knows 23 and 25 people, so
(24:00):
just let that settle in.
What's more problematic maybeis for things now that are
pretty accessible, with a lot ofoptions for different people.
I know we were ragging onpeople about the colonoscopy,
but there are a lot of differentoptions.
Screening rates are only around69% of eligible adults, so
(24:20):
that's 69% of adults are up todate on their colon cancer
screening.
So that is a lot, and part ofthis might be because of this
not so recent but like awarenessisn't so high moving of the age
from 50 to 45.
But this is because they foundthat starting at age 45 saves
(24:42):
more lives than waiting until 50that makes sense.
Speaker 2 (24:47):
I keep seeing online which this is simply from like
what I've been served on socialmedia and I have no like
legitimate backup to this.
I just keep seeing, like whenyou know, when you're doom
scrolling, all these like 30 ishyear olds that are like I kept
having diarrhea LOL, I actuallyhad colon cancer.
(25:12):
Is there any like actuallegitimate numbers of like
younger people who are gettingcolon cancer?
Yeah, you can also cut this ifI'm spreading misinformation.
Would hate to be doing that.
Speaker 1 (25:28):
Well, I mean part of the let's see.
So there is some evidence.
There was a review in JAMApublished in maybe 2025, and
they described that among thoseyounger than age 40 in the
United States, the annualincidence rate of colon cancer
(25:50):
was from 4.1 to 5.5 per 100,000people between the years 2013 to
2022.
And so that was an increase of3.4%.
And I think you bring up whenyou say this, you bring up an
important piece in thatscreening is in someone who has
(26:13):
no symptoms, has no concern fordisease and is going to get this
test anyway.
But you mentioned importantthings like when someone's on
TikTok and they're talking abouttheir experience, they had some
sort of symptom and so thatsymptom was addressed with like
a proper evaluation, I guess.
And a lot of times you end uplike if you were to look up any
(26:39):
gastrointestinal system likesymptom, like it silos down into
the colonoscopy or endoscopy islike the ultimate part of the
evaluation to wherever it soundslike you need a colonoscopy
based on your daily reports.
Speaker 2 (26:56):
Since we're a poop forward family, you know it
changes.
Speaker 1 (26:59):
Every day it changes um, so that's what I'm, that's,
that's my two cents on that.
Like, yeah, I think certainsalient stories online can be a
little bit sensationalizedbecause, like I mean, they're
personal, it's a big deal,you're young, you're not
expecting it and bang, you'relike slapped with the colon
cancer diagnosis.
I do still think it's rare.
(27:20):
There was a move to obviouslybring the age down from 50 to 45
, which was huge.
But you know you shouldn'tlinger in symptoms that you're
having that are likegastrointestinal related, at
home without an evaluation.
Like, if you need to getchecked out, you need to get
checked out, and if it requiresa colonoscopy for diagnostic
(27:44):
purposes rather than screening,and so be it.
I mean, it's your health we'retalking about for all the doom
scrollers out there.
For all the doom scrollers sothe next part is how to choose
the right test, and this goesalong with my shtick of like the
best test is the one you'llactually complete.
(28:06):
So I really have no problemcalling someone out and being
like, hey, this colonoscopy wasordered four years ago, are you
actually going to get it?
And then the dude's like,because it's always a guy, it's
like nah.
So let me talk aboutalternatives, of which we
discussed today.
You should talk to your doctorabout the risk and certain
(28:28):
preferences, if you have them.
Family history counts here, guys, so you should ask your family.
That's something that comes upa lot.
I ask about different familyhistories a lot, ones that
impact people and would impacttheir own screening, and
sometimes they don't know andthey don't talk about it.
So ask your family and really,this is the most important part
(28:49):
Please, for the love of God,just go get screened.
That's really all we reallywant, and that's it.
That's the episode for today.
So thank you for coming back toanother episode of your Checkup
.
Hopefully you learned somethingfor yourself, a loved one or a
neighbor who needs a colonoscopy.
(29:11):
Check out our website.
You can send us an emailyourcheckuppod at gmailcom.
You can send us fan mail, butthat's like a one directional
thing which we would love tohear but we can't answer back.
Find us on Instagram or threadswhich we're like kind of active
on, but I'm a busy boy now soI'm not online all day.
Speaker 2 (29:30):
Someone goes to work now.
Speaker 1 (29:31):
Let's go to work now, um, but check out our old
episodes or just come back andvisit us next week.
So until then, stay healthy, myfriends.
Until next time.
I'm at the Lusky.
I'm Nicole Rufo.
Thank you, until next time.
I'm Ed Dolesky.
I'm Nicole Rufo.
Thank you and goodbye.
Speaker 2 (29:45):
Bye.
Speaker 1 (29:48):
This information may provide a brief overview of
diagnosis, treatment andmedications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments or
medications for a specificperson.
This is not medical advice oran attempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
(30:09):
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorseany treatments or medications
for a specific patient.
Always talk to your healthcareprovider for complete
information tailored to you.
In short, I'm not your doctor,I am not your nurse, and make
sure you go get your own short.
I'm not your doctor, I am notyour nurse, and make sure you go
get your own checkup with yourown personal doctor.
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