Woodlands gastroenterologist explains new colonoscopy recommendations

By: Kim Kyle Morgan, Woodlands Online
| Published 06/07/2018

Dr. Apurv Varia, Gastroenterologist, Houston Methodist The Woodlands Hospital

THE WOODLANDS, Texas – The American Cancer Society recently changed its colonoscopy screening guidelines, reducing the recommended age for first screening from the age of 50 to 45.

Gastroenterologist Dr. Apurv Varia, a physician at Houston Methodist The Woodlands Hospital, said one of the reasons behind the change is an increase of colon and rectal cancer in a younger population.

Woodlands Online chatted with Varia for more information. Here's what he had to say.

WOL: How have the guidelines changed?

Dr. Varia: The American Cancer Society (ACS) has changed their position on colon cancer screening from 50 to 45 years of age for all patients. There are many organizations that provide recommendations for screening colonoscopy, but this is the first organization to make that particular recommendation. At this time, US Preventative Services Task Force as well as other organizations have not updated or change their guidelines.

WOL: Why have the guidelines changed?

Dr. Varia: The guidelines have changed due to the increase in colon and rectal cancer occurring in younger patients. In 2017, a study suggested an increase in incidence of colon and rectal cancer in individuals below age of 50. Previously, colon cancer rates were declining but now we are finding an increase in disease and to a lesser degree death in the younger population compared to previous generations. This was reviewed by ACS along with other data which supported the screening at younger age would save lives.

WOL: How does this impact most people's annual exams?

Dr. Varia: This will now lead to primary care providers to recommend screening at age 45 instead of 50. This only impacts the initial screening age. We have already been recommending African Americans to be screened at the age of 45 so this is no change for this demographic population.

WOL: People are still leery of colonoscopies - has the experience improved over the years?

Dr. Varia: Yes. We now give sedation via propofol to induce sleep which provides comfort through the procedure. In addition, the preparation solutions have improved in volume. In the past, patients were given Golytely to prep for the colonoscopy which was 4 liters but now we are able to prep with solutions that are two bottles of 5.4 oz. The lower volume solutions are more tolerable and provides a better patient experience.

WOL: Do you have anything else you would like to add?

Dr. Varia: Despite these recommendations, many insurances have not changed their approved or covered screening age. We recommend you contact your insurance company to determine if they have changed their age of coverage. If you ever have symptoms and are not of the age of 45 or greater, you may still warrant a colonoscopy for diagnostic purposes. In addition, if you have family history of colon cancer, you may be advised to start screening earlier than 45.

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