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more articles by Rogers, Steven Alan , MD  |  author's bio

Screening for Colon Cancer Can Save Your Life

Screening for Colon Cancer Can Save Your Life

By Steven Rogers, MD

Colon cancer is the third most common cancer, and the second most common cause of cancer death. Five percent of the population in this country will develop it. Symptoms of colon cancer show up quite late in the disease process, mainly because the colon can accommodate a large tumor before bleeding or bowel-movement changes occur. The good news is that colon cancer is really preventable.

Colon cancer always begins as a benign polyp in the colon; there are no symptoms for years. During a screening procedure called a colonoscopy, a gastroenterologist can easily find these polyps and remove them. It doesn't hurt. Once a polyp is removed, it can no longer grow into a cancer. If everyone with a family history of colon cancer got screened at age forty, and everyone else got screened at age 50, we could go a long way toward eliminating the 140,000 new cases of colon cancer each year.

As of July 1, 2001, Medicare has approved screening colonoscopies for people 65 years and older. This is a major step in colon cancer prevention in this country, and it is our hope that private insurers will decide to follow Medicare guidelines.

Right now, national medical standards call for screening of the general population to begin at age 50. There are three screening methods for colon cancer. The most thorough screening test is the colonoscopy. This is the most invasive of the three tests, but it is safe and can truly save your life. Colonoscopies are performed by all of the area gastroenterologists, and they are done at Cayuga Medical Center in the Outpatient Services Department or at Surgicare.

The night before a colonoscopy, you cleanse the colon by drinking a special fluid that will completely empty your bowels. The preparation used now is much easier to tolerate than it was even a couple of years ago.

Immediately prior to the examination, the doctor will give you medication to sedate you. You will be asleep during the procedure and will typically feel nothing. A friend or relative must be on hand to drive you home afterwards because the effects of the sedation make it unsafe for you to drive yourself. If no polyps are found during your screening colonoscopy and if you have no family history of colon cancer, you probably will not need another exam for about ten years. Not much changes in the colon over the short term.

The second colon cancer screening method is a flexible sigmoidoscopy, during which your doctor examines the lower third of your colon. More than 50 percent of colon cancers develop in the lower third of the colon, so this is a viable option for people with no family history of colon cancer and no abdominal symptoms. A sigmoidoscopy can also be done in your doctor's office. If polyps are found during a sigmoidoscopy, your doctor will recommend a colonoscopy to examine the remaining portion of your intestinal tract.

The third screening method is an occult blood test. This should be done annually starting at age 50, as part of your annual physical. This test is done at home where you capture a small sample of stool and send it in to your doctor's office on a special card. The limitations of this screening test are that most polyps don't bleed and many conditions that do produce blood in the stool are not cancer, so this test is not the most accurate.

Talk to your doctor about your risks for colon cancer. Discuss screening methods and prevention, and talk specifically about having a colonoscopy, especially if you are at risk. A family history of colon cancer makes your risk three times that of the general population. Local gastroenterologists perform about 3,000 colonoscopies a year. It is a common procedure and widely recognized as an extremely effective preventive measure for what is an often-fatal disease. Medicare's recent decision to cover the cost of screening colonoscopies in people over 65 is an important step toward eliminating this dreadful disease.

Dr. Rogers is board certified in gastroenterology and internal medicine. He is on staff at Cayuga Medical Center and is in practice with Gastroenterology Associates of Ithaca, where he can be reached at (607) 272-5011.

Dr. Rogers attended Mount Sinai School of Medicine in New York City. He completed his internship and residency in internal medicine at Massachusetts General Hospital, an affiliate of Harvard University. He completed a three-year fellowship in gastroenterology at Massachusetts General Hospital.

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