Everything You Need To Know To Keep Your Colon Healthy
What do President Ronald Reagan, Pope John Paul II and Charles Schultz (creator of the Peanuts cartoon strip) all have in common? They were all diagnosed with colon cancer.
Colorectal cancer is a common and lethal cancer in the country. Worldwide, colorectal cancer is the second most common cancer in women and the third most common in men. Approximately 1 in 3 people who get the disease will not survive. That is why early detection and treatment is critical.
As with most cancers, routine screening is the best way to identify potential issues early. Not only does screening offer peace of mind, colorectal screening is unique in that it also provides the benefit of the removal of precancerous polyps (growths on the lining of the large intestine) during the procedure, which can prevent colorectal cancer and even death from the disease.
The gold standard for the detection and removal of precancerous polyps and early colon cancer is the colonoscopy. The rationale behind getting a colonoscopy screening is simply that most colorectal cancers arise from adenomatous (pre-cancerous) polyps that progress, growing larger and turning cancerous, over the course of 7 to 15 years. That’s why it’s so important to remove the polyp before it becomes cancerous.
How common colorectal cancer? The lifetime incidence for a patient at average risk for the disease is a little more than 4%, with 90% of those cases occurring after the age of 50. For African American patients, the incidence is higher, but overall, rates have declined by 3 to4% per year over the last 15 yrs. And although mortality is also higher in the African American population, it has declined progressively since 1985 due to earlier detection and more effective treatments.
When should I start getting screened for colorectal cancer?
Without a family history of colorectal cancer, all guidelines recommend screening begin at age 50, with the American College of Gastroenterologists has recommending age 45 for the African American population. If there is a family history, the following rules apply: Patients with one first degree relative (mother, father, brother, sister) diagnosed under the age of 60, or two first degree relatives of any age, screening should start at age 40 or 10 years younger than the youngest relative was diagnosed, with follow-up colonoscopies every five years thereafter. For a first degree relative over 60 years old or two-second 2nd-degree relatives of any age, begin screening between 40 and 50 years old, then every 5 to 10 years.
When should I stop getting screened?
Age 75 is the accepted standard for patients who are of average risk. Patients between the ages of 75 to 85 who have never been screened would likely benefit from a single screening colonoscopy. However, screening exams are not recommended for patients over 85, as the cost and health risks increase. Most guidelines would recommend that screening stop when life expectancy is less than 10 years.
Are there other screening options? ?
Not many people know there are at least five ways an individual may be screened, but not all have the same effectiveness in detecting early colorectal cancer.
1. Stool Testing: Performed yearly, this test detects blood in the stool, which could suggest an issue. 2. Stool DNA Testing: Performed every one to three years, this test looks for center genes that are sometimes found in colon cancer cells.
3. Flexible Sigmoidoscopy: Performed every five years, this procedure uses a thin, flexible tube equipped with a small light and camera to view the rectum and lower colon.
4. CT colonography: Performed every five years, this screening, also known as a virtual colonoscopy, uses low dose radiation CT scan to provide an interior view of the colon.
5. Colonoscopy: As mentioned above, colonoscopies, with the use of a thin tube equipped with a light and camera, are generally performed every 10 years.
The idea of colonrectal screening can make some people uncomfortable, but with the help of medication and technology, there’s no reason to dread these procedures.
Who is at risk for developing colorectal cancer?
Risk factors for developing colorectal cancer are typically environmental and genetic factors. Lack of physical activity, red meat consumption, obesity, cigarette smoking and alcohol abuse can increase your risk. In addition, certain hereditary/genetic conditions, a personal medical history of colon polyps, and either Ulcerative Colitis or Crohn's Disease can lead to an increased risk, as well.
What can I do to decrease my risk?
Being physically active and maintaining a healthy weight, taking vitamins with folic acid, consuming a diet low in saturated fat and high in fiber, and not smoking are all ways to decrease your risk of developing colorectal cancer. And if you’re 50 years old or meet the parameters for being high risk, then getting your regular screening colonoscopy is important!
It’s important to be proactive and raise the issue with your family doctor to determine if you are a candidate for screening. You may also call our office at [insert phone number] to schedule your screening colonoscopy today.
Dr. William Caddick is Medical Director for gastroenterology and hepatology at CaroMont Health. He practices at CaroMont Gastroenterology & Hepatology and CaroMont Regional Medical Center in Gastonia and the CaroMont Endoscopy Center in Belmont.
The data for this article has been extracted from guidelines set forth by The American College of Gastroenterology, the US Preventive Services Task Force, and the American Gastroenterologic Association.