A 59-year-old piano teacher with a well-controlled seizure disorder had been a patient of Orly Avitzur, medical adviser to Consumer Reports, for 13 years before the doctor stumbled upon the woman’s secret. She discovered it only because she asked the patient when she’d had her last colonoscopy.
The subject was out of Avitzur’s scope as her neurologist, but she was glad she broached it. The patient reluctantly told her that she had a debilitating fear of colon cancer. Her mother had died of the condition in middle age, and she was so afraid it would happen to her that she had avoided seeing her internist for a decade and had put off visiting her gynecologist for even longer. She was an intelligent woman, but she was letting fear get in the way of her health.
The woman’s reaction is not unusual. Colon cancer is the second-leading cause of cancer death in the United States, and 90 percent of cases can be detected (and often nipped away) through screening. Yet 38 percent of adults age 50 and older have never had a colonoscopy or sigmoidoscopy, and 79 percent have never had a fecal occult blood test. Fears, anxieties and other psychosocial factors are often barriers to screening, according to a 2012 study in the American Journal of Health Promotion. Fear also has been found to delay diagnosis of other cancers, including lung cancer, and to contribute to delays in seeking emergency care for heart attacks and strokes.