Colorectal cancer is one of the most preventable cancers, yet it remains the second leading cause of cancer-related deaths in this country.
American Cancer Society guidelines call for men and women at average risk to begin colorectal screening at age 50, while those with a family history should be screened earlier. More than half of colorectal cancer–related deaths could be avoided with regular screenings, yet 23 million Americans between age 50 and 75 do not get screened for CRC as recommended.
Many challenges – socioeconomic, perception, ease of use, confidence the test will work and provide accurate results, and cost – are associated with screening for colon cancer in women. Often, women, especially single mothers and sole breadwinners, need to make difficult choices concerning health care, sometimes between paying for food or care. Too often, women are not screened simply because of the expenses related to colonoscopies. If cost weren’t a factor, would screening compliance increase? However, if patients don’t get screened, they will pay more for a lifesaving/essential treatment if they want to survive cancer.
As ob.gyns., we are on the front lines in educating patients on the need for CRC screening. We need to instill in them the importance of the disease versus their perceptions of being screened, including the discomfort of some screening tests and cost implications.
Most importantly, we need to inform them they have options for screening and better understand our patients and their unique challenges so we can discuss which option(s) are best for them – a colonoscopy, fecal immunochemical test, or stool-based DNA test. It has been shown in studies that when screening options are provided, compliance rates increase (Arch. Intern. Med. 2012; 172:575-82).
Our profession carries a great responsibility when it comes to screening and the overall health of our patients. It is our duty to take a whole-body approach with patients and ensure they are educated and have the resources needed to get screened for overall wellness, not just gynecologic health.
Dr. Gewirtz is an ob.gyn. in East Islip, N.Y. Her practice is limited to gynecology, and she focuses on menopause and women’s care. She reported having no financial disclosures relevant to this commentary. E-mail her at email@example.com.