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posted: 5/6/2013 6:06 AM

More baby boomers embracing colonoscopies

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By Bill Ward
Minneapolis Star Tribune

After starving herself for two days, Lori Linder savored cream of mushroom soup. James Koci went for extra-crispy KFC. Robbe Christensen walked across the street for a Butter Burger and fries.

One of the most satisfying meals of their lives was a just reward after enduring a procedure that's as daunting as it is effective: a colonoscopy.

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The baby boomer generation -- 8,000 of whom turn 50 every day -- is embracing this dreaded procedure. The mere talk of a colonoscopy used to be taboo. For some boomers, it feels like an unwelcomed rite of passage that means they've reached old age.

But health experts have ramped up the conversation, using new tactics to persuade patients that it's worth the discomfort. While there's still pushback, the chatter -- combined with an aging populace -- has put the procedure in the spotlight like never before.

The message: These things work. Sixty percent of colorectal cancer deaths could have been prevented with proper screening.

"Colonoscopies are probably the best tool we have for finding and treating a cancer," said Dr. Anne Pereira, an internist at Hennepin County, Minn., Medical Center. "Among prostate, breast and colon screening, colon is the one we do the best job with ... because it's so easy to treat. People shouldn't die from colon cancer."

Even so, it's still difficult to get some people to care. Pereira said only about two-thirds of her patients follow through on colonoscopy recommendations. Even among those who seem fully committed, Minnesota Gastroenterology has about 1,000 "no shows" every year.

But 60,000 do show up.

For some, it starts with overcoming a common mental roadblock: the combination of turning 50 and being told they need to have this done. Pereira tries to address the anti-aging brigade's concerns by telling them, "You're old enough to need it, but that doesn't mean you're old."

Men are a particularly tough sell.

"Women, in general, buy into the concept that 'Even though it's unpleasant, it's good for me,' whereas men are less convinced of that argument," Pereira said.

Her compatriot, Dr. Aaron Brosam, who performs colonoscopies at HCMC's Gastroenterology Clinics, agreed.

"A colonoscopy for a man is usually the most invasive thing that happens to him," he said. "Women have had a lot (of pap smears, mammograms, etc.). And giving birth, you lose a lot of modesty in that process."

Pereira cited three "primary barriers" that people confront when committing to a colonoscopy: the preparation, the exam and the sedation.

Anne Carlson, executive director of the Colon Cancer Coalition, listed three slightly different barriers. "People are scared of the prep. They're scared of the cost. And honestly, they're scared of having cancer."

Being scared of the disease, of course, is a good reason to get a colonoscopy. Colon cancer is the second-leading cause of cancer death in the United States, and these screenings can reduce colon cancer by two-thirds, Brosam said. The five-year survival rate is 67 percent to 74 percent for stage I, IIA and IIIA, according to the American Cancer Society.

Still, less than 40 percent of Americans with health insurance are getting screened, Carlson said.

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