#391 ‒ Colorectal cancer screening: importance of early screening, colonoscopy as a screening and preventive tool, and how to build a personalized strategy

Hey, everyone. Welcome to a sneak peek episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the episodes in full along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe. So without further delay, here's today's sneak peek of the episode. Welcome to a new episode of The Drive. In today's episode, I'm diving into colorectal cancer screening. Why colorectal cancer is one of the most preventable cancers we know of and why getting screening right matters so much. In this episode, I'm gonna discuss many things, but among them, how colorectal cancer develops, why colonoscopy is uniquely valuable as both a screening and preventive tool, the troubling rise in early onset colorectal cancer, and how to think clearly about the growing menu of noninvasive screening options and their limitations. If you're not a subscriber, you'll only be able to listen to a sneak peek here. So without further delay, I hope you'll enjoy today's episode of The Drive. Colorectal cancer or CRC as we'll abbreviate it, is the second leading cause of cancer death in The United States, and it's projected to be responsible for roughly fifty five thousand deaths this year according to the American Cancer Society. That puts it behind only lung cancer as far as cancer mortality. And yet, unlike many other cancers, CRC is arguably the most preventable cancer we know of. And the reason for this is that CRC follows a well characterized slow progression from completely normal tissue to a benign polyp to a precancerous polyp to frank malignancy. And that progression almost always takes years, often a decade or more. And because the colon is a hollow organ and sits outside the body, as crazy as that sounds, we can directly access and visualize it. We have the ability to not only detect those precancerous lesions, but also remove them before they ever become cancer. So no other common cancer screening test can make that claim. A mammogram can detect breast cancer. A low dose CT scan can detect lung cancer, but neither of those are able to look directly at the cancer. And so a colonoscopy can not only do that, but it can also remove the precancerous lesion in the first place. And yet a 2020 CDC estimate claims that sixty eight percent of colorectal cancer deaths may be prevented with screening even at the traditional recommended intervals. Again, that statistic should stop you cold. We're talking about a cancer that in most cases gives us a decades long window to intervene, and we're still losing nearly seventy percent of people out of that fifty five thousand deaths a year because they never walked through the front door to get a colonoscopy. Even more, I would argue that this number could be closer to one hundred percent, I e one hundred percent reduction …