Nearly one year ago, Kevin Jonas Sr. was diagnosed with stage II colon cancer following his first colonoscopy at age 52, according to People. He had surgery to have the mass removed and six months of preventive chemotherapy. And in December, doctors told the father of four that he was officially in remission. Now, he’s facing his next big battle: making sure his famous sons get early screening for the disease.
“I want them all to get tested as early as possible,” Jonas told People last week, referring to 30-year-old Kevin Jr., 28-year-old Joe, 25-year-old Nick, and 17-year-old Frankie. “We do have testing now that’s available, and our kids will all go in and be tested and probably go in early and actually have a colonoscopy early,” he said. Jonas also revealed that his children have actually had DNA testing done. “[I]t looks like that’s not a factor—but still, I’ll have peace of mind when they know for sure.”
Exactly how much your risk goes up depends on the number of relatives with colorectal cancer, whether they are first or second-degree, and their age at diagnosis. According to the ACS, as many as one in five people who develop colorectal cancer have other family members who have had it.
The current recommendations from the U.S. Preventive Services Task Force don't recommend regular screening until you hit 50. However, the ACS recommends earlier or more frequent screening if you have specific risk factors, such as inflammatory bowel disease or a family history of colorectal cancer.
In many cases, there is a family history of colorectal cancer that can't be linked to a specific gene mutation that researchers have identified, James Church, M.D., a colorectal surgeon at Cleveland Clinic who studies the genetics of colon cancer, tells SELF. But about 5 to 10 percent of all colorectal cases are due to a family cancer syndrome, per the ACS, meaning that we have identified the precise gene abnormalities in play.
These mutations, which are passed down from parent to child, exist in the DNA of every cell in the body, Dr. Church explains, which means they can often predispose you to other cancers as well. While these mutations don’t mean you will definitely get colorectal cancer, they can tremendously increase the probability. How much your likelihood goes up (and what other cancers you’re at risk of getting) depends on the specific syndrome.
For example, Lynch syndrome is the most common inherited syndrome that increases your risk for colorectal cancer. But it also increases the likelihood of developing cancer in places including the endometrium, ovaries, and stomach, and comes with up to an 80 percent lifetime risk for colorectal cancer, according to the ACS (depending on where the mutation is).
“These syndromes are relatively uncommon,” Dr. Church says. But if you do carry one of these genetic mutations, your risk for developing colorectal cancer may be quite high depending on the mutation and where it is—unless you take preventive action. Plus, oftentimes people with these syndromes exhibit no symptoms at all. “So people who are at risk need to know and have the cancer prevented or found early,” Dr. Church says.
However, the testing is only recommended for certain patients, Dr. Church says, like those diagnosed with colorectal under the age of 50, those with a very large number of polyps indicating a particular syndrome called polyposis, or those with an extremely strong family history of the condition. Fortunately, insurance plans typically cover these tests for people who meet the criteria (e.g. a doctor's recommendation), so it's best to check with your insurance company to make sure you qualify under your specific plan.
“We always recommend talking to a genetic counselor both beforehand and afterwards, because there are serious implications there,” Dr. Church says. A genetic counselor can help patients navigate the decision to take the test and the impact of the results. This includes the potential legal consequences, as protections vary from state to state.
For example, while there are federal laws prohibiting health insurers and employers from discriminating based on genetic testing, that’s not the case with life or disability insurance, for example. Equally important are the social and psychological implications in a family that has one of these syndromes, which may lead to feelings of guilt among children who don't inherit the mutation or anger among those who do get it.
If you are someone with an average risk of getting colorectal cancer who is not a candidate for genetic testing, it’s still good to know that there are more accurate and accessible screening tools available today when it comes to early detection than ever before.
And there's still the good old colonoscopy. “They’re still the gold standard,” says Dr. Church. Prepping for it won’t be the most fun day of your life, but the potentially life-saving test is more than worth it when the right time comes—just ask Kevin Jonas Sr.
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