A recent study by the New England Journal of Medicine (NEJM) on colon cancer, the third leading cause of cancer deaths, falsely gave Americans an easy out to skip a colonoscopy. The media falsely gave people the impression that colonoscopies did not reduce cancer rates or dates. Within days of media reports on the study, advocates and doctors countered the advice saying the study had major flaws. America’s biggest proponent of colon screenings, Katie Couric, said don’t cancel your next colonoscopy appointment. Despite the misleading interpretation of the results, colonoscopies significantly reduce cancer risk and death.
We all cringe at even the idea of getting a colonoscopy. Naturopathic doctor Tina Kaczor, FABNO, editor-in-chief of Natural Medicine Journal (NMJ) and the creator of Round Table Cancer Care, says there are a lot of important details in the study that must be considered before you believe the news reports. Dr. Kaczor, board certified in naturopathic oncology, reviews the study details in a recent NMJ podcast (see below for the link).
Without flooding you with too many numbers, Dr. Kaczor says the media reported that the NEJM study said the risk of colon cancer within ten years was less than 1% (0.98%) with a colonoscopy and 1.2% with no colonoscopy. Before you stop reading, this is not what the study revealed.
Why you should not skip a colonoscopy
As anyone can see, these numbers are very close. However, as Dr. Kaczor explains, the two groups in the NEJM study either received an invitation to get a colonoscopy or did not. The media did not report that 40% (12,000) of the people invited to get a colonoscopy followed through. The remaining 60% opted out of the invitation. For the group that got the test, the risk reduction of death from colon cancer was as high as 50%. These results align with other studies showing that colonoscopies are associated with a 67% reduction in the risk of death from colorectal cancer.
Dr. Kaczor calls the media reporting a spin on the results. She is surprised that the NEJM editors accepted this study, given the confusing data collection. Here are details and nuances of the study that might be easily misinterpreted without a thorough evaluation:
- Among the study participants invited to undergo a single colonoscopy and who got the test—there was a 31% reduction in risk for colon cancer and a 50% reduction in dying from colon cancer.
- The study duration was ten years, which isn’t enough time to see a rise in mortality.
- The study was performed between 2009 and 2014 in Poland, Norway, Sweden, and the Netherlands. At the time of the study, these countries did not have a history of any standardized colon screening. Standardized colon screenings were not encouraged and did not start until 2015 for the countries used in the study, hence the low compliance in the invited group.
- The data came from an all-white population group. According to Centers for Disease Control data, ethnicity and race are major risk factors for colon cancer.
- The study did not collect information on other relevant patient demographics, such as smoking, aspirin use, and prior screening history.
Above all, no one wants to get a colonoscopy, but this study should not give you permission to stop getting the test.
Reduce your risk of colon cancer
Naturopathic medicine is highly focused on reducing the risk of cancers of all types. As much as 89% of colon cancer risk death can be reduced by modifiable lifestyle factors, including getting screened for colon cancer. Consider the following suggestions to reduce risk:
- The United States has the best record globally for colon screening, which should begin at the very least at age 45.
- Ask your doctor about the best screening method for you and your family history.
- If a close relative has had colon cancer, you may need a colonoscopy earlier than age 45 to catch it.
- An integrative approach to colon cancer prevention includes screenings and a plant-rich diet that is abundant in a mix of vegetables and fruits and low in processed meats and charred grilled meats.
- If you eat grilled meat, pre-marinade it in vinegar or wine and herbs like rosemary. Be sure to eat it with cruciferous vegetables to counter the colon-damaging chemicals that happen during grilling.
- Keep your microbiome healthy and your immune system working efficiently by consuming a variety of fibers and probiotics that feed and support a healthy gut (more on keeping your microbiome healthy naturally).
- Stay active and avoid being sedentary throughout the day. Even if you work out once a day, you still need to stay active throughout the day.
- Get enough sleep but not too much. Ideally, 7-8 hours a day of efficient sleep is ideal. Too much or too little sleep increases the risk of colon cancer.
Listen to the podcast with Dr. Kaczor on the NEJM study on colonoscopies.
This article is provided by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing healthcare systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following initiatives:
- Education – Reveal the unique benefits and outcomes of naturopathic medicine
- Access – Connect patients to licensed naturopathic doctors
- Research – Expand quality research of this complex and comprehensive system of medicine
Stewart is an award-winning editor, food and health journalist and best-selling author of Eating Between the Lines, the supermarket shopper's guide to the truth behind food labels (St. Martin's Press).