On the Importance of Screening for Colon Cancer

Dr. Angela Hira, Wake Gastroenterology. Clinical interests include inflammatory bowel disease (ulcerative colitis and Crohn’s disease), acid and peptic related diseases (GERD) and colon cancer screening and prevention with a special focus in gastrointestinal conditions unique to women.

Colorectal cancer, which occurs in the colon (large intestines) or rectum, is the third leading cause of cancer death in the United States where one in 20 Americans will be diagnosed with colon cancer in their lifetime.

Drinking alcohol, smoking, obesity, low fiber-high fat diets, and a sedentary lifestyle can increase the risk of developing this disease. The risk also increases if you have a first-degree relative with colorectal cancer (or colon polyps) or has rare inherited genetic disorders. To reduce your risk, adapt a healthy lifestyle including a high fiber-low fat diet and regular exercise while limiting your alcohol consumption and tobacco use.

The America Cancer Society and the Center for Disease Control (CDC) task force encourage all adults over the age of 50 to undergo a colonoscopy (a test that looks for cancer) which can remove polyps (abnormal growths in the colon) to prevent cancer. Additionally, the American College of Gastroenterology (ACG) recommends African Americans begin screening at age 45.

Most colon cancer starts as a polyp, a small lesion less than one cm in the colon. Polyps often do not cause symptoms but over eight to ten years may grow into cancer. These growths can be easily removed during a colonoscopy, preventing the development of colon cancer.

Most patients with colon polyps are symptom-free and do not have any complaints until after the cancer develops. Other patients can have belly pain, weight loss, or blood in their stool or in the toilet after a bowel movement.

A colonoscopy is a procedure, completed by a physician, that can find polyps and remove them before they become cancerous. During the test a flexible instrument is passed through the colon to evaluate the colon walls for any abnormalities such as polyps, cancer, diverticulosis, or inflammation. It is a painless procedure that is completed typically under sedation. In order to have an adequate evaluation of the colon, patients must clean their colon with a laxative prep on the day before the procedure.

Like any medical intervention there are some risks associated with a colonoscopy, but these risks are very small. Possible complications include side effects from anesthesia, a partially torn (perforated) colon, bleeding after polyp removal, or infection. Weigh these low risks against the far more frequent complication of developing colon cancer if appropriate testing is not done.

Everyone over the age of 50 should talk to their primary medical professional about scheduling a colonoscopy. Only about 60 percent of adults over 50 are up-to-date on their colon cancer screening. The goal is to increase colon cancer screening to 80 percent in this age group by 2018. This could save more than 7,000 lives a year.

SURVIVOR SPOTLIGHT!

A stage III rectal cancer diagnosis in 2008 didn’t stop Lisa Decker of Cary from living. The only thing 10 months of treatment, including surgery, chemotherapy and radiation, could do was sideline her for a while. Her advice: “Don’t ignore the symptoms. If you do have symptoms, talk to your doctor! A positive attitude throughout chemo and radiation treatments definitely helped me. I continued with my daily life. Today, I am here, cancer free.”