Question:

I’m 55 years old with a family history of colon cancer. I know I’m supposed to be getting a colonoscopy every 5 years, but I don’t have health insurance, and I feel okay. What are some of the signs or symptoms I should look for that would make it really worth the money to get the test?

Answer:

Signs or symptoms that can be concerning for colon cancer include blood in the stool, weight loss, abdominal pain, fatigue, or a change in bowel habits. However, no symptoms are present in many patients with colon cancer if it is in the early stages of disease. That is why we generally begin screening individuals for colon cancer around age 50 — the whole idea is to try to catch colon cancer, or its precursor, polyps called adenomas, early on before symptoms develop.

Actually, the interval between colonoscopies depends upon several factors including how strong your family history is: whether first degree or second degree relatives were affected, and at what age they developed colon cancer. Assuming you have previously had colonoscopies, the interval also depends on whether you have a personal history of adenomatous polyps and whether the colon was relatively free of stool such that the examiner was able to get a good look at the colon lining. Among individuals with a family history of colorectal cancer or adenomas who undergo a colonoscopy in which the colon is relatively free of stool and no polyps are found, the interval until the next colonoscopy (5 years versus 10 years) is dependent upon how strong the family history is. I would recommend discussing this with your primary care provider if you have one.

You should consider fully exploring your options regarding the cost of a colonoscopy to determine what your expense would be. Some hospitals offer reduced charges for individuals without health insurance, depending upon income level. In addition, March 25, 2011 was National Colorectal Cancer Awareness and Screening Day, on which programs in 20 states provided free screening colonoscopies for the uninsured. This program was offered at one of the hospitals at which I work for uninsured patients who met specific income guidelines. The American Gastroenterological Association, one of the national gastroenterology societies, is preparing for a screening program in 25 states for March 2012 in conjunction with National Colorectal Cancer Awareness Month.

For more information:

Go to the Colon Cancer health topic.