Screening for Colon Cancer Can Save Your Life
by John Sabel, MD, FACP, FACG, AGAF, American College of Gastroenterology
Colon cancer is the second leading cause of cancer deaths in both men and women with an estimated 1,709 cases in Colorado in 2007 and 630 deaths. However, colon cancer is preventable by detecting polyps and removing them before they develop into cancer.
In Colorado, organizations such as the American Cancer Society and the Colorado Clinical Guidelines Collaborative have emphasized early screening and because of this we are beginning to see an increase in the number of patients screened each year. However, compared to breast cancer screening, the numbers are dismal. Seventy percent of women in Colorado by the age of 40 have been screened for breast cancer, but less than 50 percent of individuals have been screened for colon cancer by the age of 50. There are many misconceptions about colon cancer. Some people believe that colon cancer is a man's disease, that it strikes people only in their 70s, and there must be symptoms associated with either polyps or cancer. All of these ideas are incorrect.
Colorectal cancer begins as a polyp, which is a small benign growth that may evolve over a time period of seven to ten years into cancer. Sometimes these polyps grow faster, particularly in those with uncommon genetic syndromes. Patients with multiple family members affected with colon, uterine or ovarian cancer, or early onset of colon cancer, may develop polyps or cancers even in their 30s; however, an average individual usually is not affected until their 50s or even 60s.
Screening with colonoscopies and removing polyps has been shown to significantly lower the risk of colon cancer. The American Cancer Society, the College of Gastroenterology and multiple other national organizations recommend screening for colon cancer in an average-risk individual at age 50 and then every ten years if results are normal. However, if there is a strong family history cancer or an early onset of cancer, then screening should begin earlier and continuing about every five years.
Screening options include colonoscopy or flexible sigmoidoscopy and barium enema. Virtual colonoscopy and fecal DNA studies have been suggested, but final data on the efficacy of these two tests are still pending. In fact, colonoscopy is the only screening in which polyps can also be removed. Colonoscopies are safe, well tolerated and performed on an outpatient basis, plus they are covered by Medicare and most major insurance carriers.
Do the right thing for yourself! Get screened and encourage your friends and family members to be screened too. It may save your life and theirs. Preventive efforts such as a better diet with more fruits, vegetables and less red meat plus weight control, smoking cessation and use of calcium, aspirin and folic acid all may help; however, the only true way to prevent colorectal cancer is to get screened.
Dr. John Sabel, board certified in both internal medicine and gastroenterology, practices at South Denver Gastroenterology and is a physician leader with Swedish Medical Center's Center for Diseases of the Liver and Pancreas.