Peter Attia on Colorectal Cancer Screening

September 27, 2020 • #

Peter Attia is speaking my language here:

In my practice, we typically encourage average-risk individuals to get a colonoscopy by age 40, but even sooner if anything suggests they may be at higher risk. This includes a family or personal history of colorectal cancer, a personal history of inflammatory bowel disease, and hereditary syndromes such as Lynch syndrome and familial adenomatous polyposis.

I was diagnosed in 2017 during a colonoscopy (age 35 at the time). It was stage IV by the time it was seen, in my case the disease was in the sigmoid colon. Even with the earliest recommended screening strategies, like what Attia’s practice recommends, I wouldn’t have made it in in time, my disease was too strange. I do have it in family history, but not with early onset.

Since the smoke cleared on my surgeries and all the treatment, I’ve advocated to everyone I know in my age group that colonoscopies are the most effective form of diagnostic tool for any type of cancer. Attia makes the same point:

Of the top 5 deadliest cancers, CRC is the only one we can look directly at, since it grows outside of the body (remember, your entire GI tract, from mouth to anus, is actually outside of your body, which is why a colonoscope or endoscope looks directly at the lining of the esophagus, stomach, and colon in the same way a dermatologist can look directly at your skin). Furthermore, as discussed above, the progression from normal tissue to polyp to cancer is almost universal, while we don’t have such an analog for breast, liver, pancreatic, or lung tissue.

The risks are real with colonoscopy or endoscopy procedures, to be sure. But perhaps with enough training, better preparation methods for patients, and higher volumes of procedures (to reduce costs), we can put a further dent in CRC through more common early detection. The best arsenal against cancer is to never let it form in the first place.