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more articles by Lemberg, Brent D. , MD  |  author's bio

Colorectal Cancer is Easily Preventable

Save Yourself from Colorectal Cancer

By Brent Lemberg, MD

 

Did you know that 40,000 to 50,000 people in the United States will die of colon cancer this year? It is the second most common cause of cancer death in this country, with 150,000 new cases diagnosed annually. The good news is that in the past 10 years the incidence of colorectal cancer has begun to decline. The reason is that about a decade ago, gastroenterologists started to perform many more screening colonoscopies as health insurance companies began to cover the cost.

 

How have screening colonoscopies affected the drop in colon cancer?

 

Colon cancer always starts with a polyp, which is a small mass of tissue that develops on the inside wall of the colon. In the earliest stage these polyps are typically not cancerous, cause no symptoms, and can be removed easily during a routine screening colonoscopy. However, if not removed, in 10 to 15 years these polyps can grow into cancer. With the increasing national awareness of the role of screening colonoscopies in early detection and removal of polyps, more people are getting screened regularly and fewer people are developing colon cancer.

 

Who is most at risk for colorectal cancer?

 

Colon cancer does not discriminate. It affects both genders and all ethnic groups, though the risk for colon cancer is higher among African-Americans. Your risks also increase if you are over the age of 50: the average age of newly diagnosed colorectal cancer patients is 60 to 65 years of age. Having said that, no matter what age you are you should see your doctor if you have rectal bleeding because this cancer does occur in people as young as 30.

 

Is a colonoscopy the only way to screen for polyps in the colon?

 

The best screening test is the standard optical colonoscopy. During this examination, a small tube with a tiny light source is inserted into the rectum. It is slowly advanced through the entire length of the colon, allowing the gastroenterologist to thoroughly examine the walls of the large intestine. While there are other screening modalities, they are not as good.

 

In the past few years, there has been a lot of buzz about virtual colonoscopy, which uses CT scanning to visualize the colon.  A study published in the New England Journal of Medicine in September 2008, examined the efficacy of virtual colonoscopy as compared to standard colonoscopy. The researchers found that virtual colonoscopy missed 10 percent of polyps bigger than one centimeter. A polyp this size has a high risk of being cancerous and is one we would definitely remove during a standard colonoscopy. The study also found that virtual colonoscopy missed up to 22 percent of polyps between 6 and 10 millimeters.

 

Shortly after this study was published, the US Preventative Services Task Force came out with a position paper stating they did not recommend virtual colonoscopy. The paper went on to say that optical colonoscopy, which is performed with an endoscope, is the preferred method of examination. In addition to missing a higher percentage of polyps in the first place, should a polyp be discovered through virtual colonoscopy, the patient would then have to undergo a standard optical colonoscopy to have the polyp removed.

 

If you are 50 years old, please talk to your doctor about scheduling a screening colonoscopy. If you have a family history of colon cancer or if you are African-American, you should schedule your first colonoscopy at age 40. Having regular colonoscopies every ten years reduces your risk of colon cancer by 90 percent.

 

Dr. Lemberg is a board-certified gastroenterologist on staff at Cayuga Medical Center and in practice with Gastroenterology Associates of Ithaca. He can be reached at (607) 272-5011.

 

 

 

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