March is Colon Cancer Awareness month for good reason. Colon cancer is all too common. In 2011, more than 135,000 people in the U.S. were diagnosed with this disease and over 51,000 of them died.

The risk factors for colon cancer include: a family history of colon cancer, inflammatory bowel disease, a low intake of fruits and vegetables, a diet that’s low in fiber and high in fat, being overweight or obese, drinking excessive amounts of alcohol and smoking.

Colon cancer can be tough to catch because often there are no symptoms. When there are, these include a change in bowel habits, abdominal pain and anemia, which can be due to blood loss that’s easily seen in the stool but can also be less obvious. Late in the game there may be weight loss.

Related: 10 Health Symptoms Women Should Never Ignore

Screening: The saving grace

It may be the “butt” of many jokes, but a colonoscopy is the gold standard for colon cancer screening. For this procedure, a doctor snakes a thin tube that’s about 5½ feet long into the colon. The hose has a camera on the end for viewing the inner lining of the colon. You’ll prep for a colonoscopy the day before by taking laxative-like medications to completely clean you out. During the procedure you’ll be given conscious sedation and feel little to no discomfort.

In my practice, I’ve had many patients who were reluctant to go through a colonoscopy ask if there are alternatives. There are two, but each comes with a catch:

Virtual colonoscopy — basically a CT scan of the colon. The preparation is the same as for a standard colonoscopy, but there’s no scope. Instead a radiologist introduces a tiny amount of air through the rectum and then takes pictures. It takes about 10 minutes.

The catch: If a virtual colonoscopy picks up a polyp, you’ll have to go through a regular colonoscopy anyway. That means added expense and another prep.

Related: Have You Had Your Colonoscopy? They’re Not as Bad as You Think

A new test called Cologuard. For this test you receive a kit for collecting a stool sample at home. When you send the sample back, it will be tested for any DNA or genetic material from abnormal cells that might be present. Cologuard is a fairly accurate test. If it’s negative, the odds of having colon cancer are very low. The test costs $600 — a lot less than a colonoscopy, which can cost around $4000, and a virtual colonoscopy, which is about $900.

The catch: If the test is positive you will definitely need a colonoscopy. If the colonoscopy is negative, you may need many additional tests to search for cancer in the gastrointestinal tract.

Put it on your calendar

The risk of colon cancer is highest for people over 50, so this is the age when screening is recommended. However, if you have a first-degree relative (parent or full sibling) who’s had colon cancer, your doctor will recommend that you have your first colonoscopy earlier — when you’re 10 years younger than your family member was when he or she was diagnosed. In other words, if your father was diagnosed with colon cancer at age 50, you would be advised to have a colonoscopy at age 40. The reason for this is that colon cancer grows very slowly. It’s possible to catch it as a polyp before it even becomes cancerous.

Colon cancer screening is a very effective way to reduce the incidence of colon cancer. However, it can only do that if all of us are screened. I would like to see everyone consider screening as a rite of passage for turning 50. Let’s make colon cancer a rare disease rather than the second leading cause of cancer death in the U.S.

Related: Men: Step Up and Be Screened

Robin Miller, MD, is a practicing integrative medicine physician at Triune Integrative Medicine in Medford, Oregon. She is a medical reporter for KOBI-5 NBC and has appeared on "The Doctor Oz Show." She is co-author of "The Smart Woman's Guide to Midlife and Beyond."

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