Fredericksburg Parent

www.FredericksburgParent.NET 13 Q: What if my insurance still won't cover a colonoscopy before age 50? Dr. Baldwin Young: Unfortunately, there is often a lag between recommenda- tions from national medical societies and putting things into policies, and that is what we were seeing with insurance companies covering screening colonoscopies before 50. More insurers are figuring out that numbers are going up among young people, and have made the decision to cover it. I tell patients to at least go for a consult with the gastroenterologist or surgeon who will perform your colonos- copy, and see what your options are. They are usually the ones who can either help argue for that insurance approval, or may be able to talk about other types of screening. People can also call their insurance provider to inquire about any out- of-pocket cost they should expect to have with a screening colonoscopy. It's important to know that if you have any symptoms at all of colon or rec- tal cancer, your colonoscopy is not a screening test, it's a diagnostic test, and should be covered by insurance. It is important not to ignore these symptoms, and to talk about them with your doctor: • Changes in bowel habits, such as constipation or diarrhea. • Bloating in the abdominal area. • Nausea or vomiting, especially if there is no other cause for these symptoms. • A change in the look of the stool, such as narrow stool. • Sudden weight loss with no change in diet or exercise. Q: Is a colonoscopy the only way to screen for colorectal cancer? Dr. Baldwin Young: Colonoscopies are the best way to identify and remove pol- yps—the masses that eventually cause these cancers. If you are of average risk for developing colon and rectal cancer, then there are other tests you can take starting at age 45 as surveillance for these cancers, such as tests that analyze stool samples. But if any of these tests are abnormal, then you must get a colo- noscopy in order to diagnose the problem. It's also impor- tant to remember that these surveillance tests need to be done far more often than a colonoscopy, because of the risk of false negative results. What is helpful about colonoscopy as a screening method is that you are not only screening for cancer, but you can get treated at the same time—if there is a polyp, it can be removed during the same procedure. Factors that would put an individual at higher than aver- age risk include a family history of colon or rectal cancer, or precancerous polyps. (this may indicate a need for screen- ing before age 45, so be sure to discuss family history with your doctor), inflammatory bowel disease such as Crohn's disease or ulcerative colitis, a history of radiation to the abdomen, or a personal history of polyps or cancer. To ensure cases are caught while still treatable, regular screening should start at age 45. Introducing Dr. Ayana Chase Greaves, MD, FACS, FASCRS. Dr. Greaves is a new colon and rec- tal surgeon with Mary Washington Healthcare. She will be practicing at Mary Washington General Surgery, 4548 Empire Court, Fredericksburg, VA 22408. Call 540.373.2244 to make an appointment. Q: Can lifestyle factors influence risk for colorectal cancers? Dr. Baldwin Young: Yes. People who are obese are at increased risk for developing many types of cancer, including colorectal cancers. Diets that are high in red meat and processed meats, and low in fiber, are asso- ciated with a higher risk of colorectal can- cer. So we recommend eating less red meat, less processed meats, and eating four to five servings of fruits and vegetables a day. Instead of eating white carbohydrates, try to eat more of the brown, whole-wheat carbo- hydrates. Exercise is also important. If you live a sedentary lifestyle, that increases your risk for a lot of cancers. Smoking increases your risk of almost any cancer, including colorectal cancers. A moderate to high level of alcohol consumption is also associated with an increased risk of colorectal cancers. If you drink try to stay under that moderate to high level. If you are 45 and have not scheduled your first colonoscopy, or if you have a family history or symptoms that might make earlier screenings necessary, consult your primary care physician or call Mary Washington Healthcare's HealthLink representatives at 540-741-1404. Visit cancer.mwhc.com for more information.

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