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Screening is Key to Colorectal Cancer Prevention

By Hillary Tompkins, MD
Gastroenterologist
Stomach/Intestine (Gastroenterology)

Colorectal cancer is the third most common cancer diagnosed in men and women in the United States, according to the American Cancer Society, but also one of the most preventable cancers.

When diagnosed early there is a 90 percent survival rate. However, only 40 percent of people actually follow-up to schedule a routine screening when it is recommended at age 50.

Medical researchers continue to find new evidence of the live-saving benefits of screening and early detection. In February of 2012, a study reported in the New England Journal of Medicine provided what independent researchers called the best evidence yet that colonoscopy saves lives. The study followed patients for up to 20 years and found that the number of deaths from colorectal cancer was decreased by 53 percent in people who went through screening and had polyps removed from their colon. Previous studies have shown that removing polyps could decrease the rates of colorectal cancer but did not provide data on lives saved as a result of removing them.

While not all polyps become cancerous, most colorectal cancers do begin as polyps, which grow undetected and without any outward symptoms in the colon. Occasionally colon polyps can cause blood in stools or diarrhea.

Colonoscopy

There are multiple ways to screen for colon cancer. The most recommended test, a colonoscopy, is the only test that is also able to prevent cancer by removal of precancerous polyps. A colonoscopy uses a long flexible tube with a camera and allows a gastroenterologist to examine the entire inside of your colon and rectum for polyps. If any polyps are found during this exam, the gastroenterologist is most often able to remove them immediately. Any polyps that are removed are then sent to a pathologist for testing to determine whether they are normal or potentially cancerous.

You will find out immediately after your colonoscopy what if anything was found and leave the hospital with a report and pictures from the screening exam. Results of the review of the polyps will be discussed with you as well as the recommended interval until your next recommended colonoscopy, which is based on the type and number of polyps removed as well as your family history. The good news is that it usually takes many years for a polyp to develop into colorectal cancer, which is another reason that screening has been shown to prevent colorectal cancer from developing. Other methods to screen for colorectal cancer include fecal occult blood testing, a virtual colonoscopy using CT scan technology or barium enemas. It is important to note that if any of these other screening methods yield a positive result such as blood in the stool or polyps, a follow-up colonoscopy will be recommended.

At what age should I get screened for Colon Cancer?

Although screening is recommended to start at age 50 for the general population, some people are at a higher risk for developing colorectal cancer. The lifetime risk for developing colorectal cancer is higher in men than women and increases with age. People with a personal or family history of inflammatory bowel disease, colorectal cancer or polyps, ovarian or endometrial cancers should be tested earlier. You should discuss your risk and when you should schedule a screening exam with your primary care physician.

Approximately 103,170 new cases of colon cancer and 40,290 cases of rectal cancer will be diagnosed in 2012, according to the American Cancer Society. The number of deaths from colorectal cancer has been decreasing for more than 20 years and many attribute this to regular screening and early detection. Cancers that are found earlier are easier to treat and have a much higher chance for a complete cure.

Screening for Colon Cancer...it could save your life

What are you waiting for? If you are 50 years old or older or have a history of colorectal cancer in your family, make an appointment to discuss your options for screening with your primary care physician or gastroenterologist. It could save your life.

For more information please call Dr. Tompkin's office at 603-772-5528.