Kristen Bell had an elective colonoscopy at 41 — here's when experts say you should consider getting screened
Kristen Bell recently shared some interesting health news with fans: She had a colonoscopy at 41.
"I got my first elective colonoscopy," the actress revealed on Jimmy Kimmel Live on Jan. 25, referring to the exam that checks for abnormalities or disease in the colon and rectum. "I am 41. I was like. 'Get in there. Let's see what we got.'"
Kimmel pointed out that the recommended screening age for colorectal cancer is 45, and Bell responded that she's "looking out for number one" by getting screened early. An elective colonoscopy like Bell's is not to be confused with "optional"; rather, it's defined as a procedure that may be "necessary" but does "not need to be performed immediately" and can be scheduled in advance.
More recently, the actress brought up her colonoscopy on her husband Dax Shepard's Feb. 7 Armchair Expert podcast, revealing that she has a family history of colon cancer, which led to her being tested early. “I had an elective colonoscopy. You’re supposed to start getting colonoscopies at, I think, [age] 45 and 40 if you have a family history [of colon cancer], and I do,” she said.
Colon cancer is one of the most preventable cancers but only if you get screened. An estimated 40 percent of those who are considered at-risk for the disease have never been screened.
Bell's experience raises a lot of questions about elective colonoscopies and when you should get one. Here's what you need to know.
What are the current colon cancer screening guidelines?
Currently, the American Cancer Society (ACS) recommends that people with an average risk of colorectal cancer start regular screenings at age 45. That can involve either a stool-based test that looks for signs of cancer in your stool or a visual exam that looks at your colon and rectum.
"Average risk" means that you don't have:
A personal history of colorectal cancer or certain types of polyps
A family history of colorectal cancer
A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
A personal history of getting radiation to the abdomen or pelvic area to treat a prior cancer
People who are in good health and have a life expectancy of more than 10 years are advised by the ACS to continue with regular colorectal cancer screenings through age 75 (the exact amount of time varies by test). People ages 76 to 85 should get screenings based on their own preferences, life expectancy, overall health and prior screenings. Although there's no upper age limit, most U.S. medical organizations don't typically recommend that people over 85 get screened for colorectal cancer.
People who are considered higher risk for colon cancer, such as those with a family history of colon cancer, may need to start screenings earlier than age 45 — and get them more often.
Screening options include:
Stool-based tests: options include a highly sensitive fecal immunochemical test (FIT) every year, highly sensitive guaiac-based fecal occult blood test (gFOBT) every year or multi-targeted stool DNA test (mt-sDNA) every three years
Visual exams of the colon and rectum: options include a colonoscopy every 10 years (unless otherwise indicated by your doctor), CT colonography (aka virtual colonoscopy) every five years or flexible sigmoidoscopy (FSIG) every five years
What exactly is a colonoscopy?
A colonoscopy is a procedure in which a doctor uses an instrument called a colonoscope to look inside your rectum and colon, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains. The procedure can show irritation, swollen tissue, ulcers, polyps and cancer.
A colonoscopy requires you to change your diet for a few days and clean out your bowel in advance of the procedure, according to the NIDDK. You'll be given a sedative, anesthesia or pain medication for your procedure, and your doctor will insert the scope to see inside your colon and rectum. If polyps are spotted, the doctor will likely remove them and send them to a lab for testing.
Colonoscopy is generally considered the best type of colon cancer screening, Dr. Anton Bilchik, a surgical oncologist, professor of surgery, chief of medicine and director of the gastrointestinal research program at Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif., tells Yahoo Life. And, if someone happens to have an abnormal test result with a different test, it's recommended they follow that up by having a colonoscopy.
What is a fecal occult blood test?
A fecal occult blood test looks at a sample of your stool to check for blood, according to Medline Plus. "Occult blood" means it can't be seen with the naked eye. Blood in the stool could be a sign of a range of conditions, including polyps, hemorrhoids, diverticulosis, ulcers, colitis or colorectal cancer, according to Medline Plus.
So should you consider a colonoscopy before the recommended age, even if you don't have a family history of cancer?
Not necessarily. "There are specific guidelines in place as to when to start your elective colonoscopies — what we call colon cancer screening guidelines," Dr. Mark Friedman, a gastroenterologist in Moffitt Cancer Center's Gastrointestinal Oncology Department, tells Yahoo Life, noting that getting screened for colon cancer during the recommended timeframe is "absolutely something that everyone should consider and follow through with."
But there's really no need to get a colonoscopy or other colorectal cancer screening procedure done before the recommended age unless you have risk factors for the disease, Bilchik notes. If you have a family member who has had colon cancer, especially one who had it before age 50, "the recommendation is to get screened 10 years before your immediate family member was diagnosed," he says.
So if you have a first-degree family member — namely, a parent or sibling — who was diagnosed at age 40, it's a good idea to get a colonoscopy at age 30.
As for what type of test to get, colonoscopies are considered the gold standard for colon cancer screening, Friedman says. "In addition to identifying cancers, a colonoscopy can detect precancerous lesions that may grow into cancer in the future," he says. "It is also the preferred test for anyone who has gastrointestinal symptoms or is considered at an increased risk for colon cancer."
But, Friedman says, the medical community knows that not everyone is OK with getting a colonoscopy. Some may be considered high risk for the sedation required with the procedure, while others may not be able to afford it. "In these scenarios, we might suggest a cheaper or less invasive exam such as fecal-based screening exams," Friedman says.
Whatever you do, doctors say it's important to follow the colon cancer screening guidelines. "Please get screened," Dr. David S. Weinberg, chair of the department of medicine at Fox Chase Cancer Center, tells Yahoo Life. "Discussing with your [gastrointestinal] provider about risk and benefit is reasonable, but follow guidelines in average risk patients."
Bilchik agrees. "Colon cancer is mostly preventable," he says. "Everyone should be very aware that there is this sudden surge of young people being diagnosed with this cancer. Screening allows for the identification of polyps that, if removed, can prevent someone from developing colon cancer."
He also points this out: "If someone pays attention to diet, exercise and screening, they have an up to 80 percent reduction in the probability of developing colon cancer — that's huge."
If you have questions about colon cancer screening or your individual risk, talk to your doctor, who should be able to provide personalized guidance.
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