March is National Colorectal Cancer Awareness Month.
Among cancers that affect both sexes, colorectal cancer (cancer of the colon or rectum) is the second leading cause of cancer deaths in the United States. It has been estimated that every year some 145,000 Americans are diagnosed with colorectal cancer and more than 50,000 die from the disease.
Fortunately, incidences of colorectal cancer and the number of consequent deaths has slowly declined as colonoscopy screenings become more of a routine examination given to adults when they reach middle age. And the screening procedure itself is improving: current methods not only enable diagnosis of colon cancers at early and treatable stages, but more importantly these screening prevent the actual development of cancer through the detection and removal of pre-cancerous polyps.
Precancerous polyps and colorectal cancer often do not cause symptoms, thereby making regular screening tests important. If symptoms for colorectal cancer are present, it may include:
- blood in the stool
- abdominal pain
- change in bowel habits
- unexpected weight loss.
These symptoms should always be discussed immediately with a physician.
Several tests are available to screen for colorectal cancer, either alone or in combination. It is recommended that patients discuss available options with their health care provider and decide which modality is best. Tests that detect pre-cancerous polyps, such as a colonoscopy, are often preferred given its ability to remove polyps and thus reduce the risk of developing cancer. There are non-invasive options available, such as stool tests looking for blood or DNA abnormalities, which are effective in detecting early stage cancers if submitted on a regular basis. These test will require a colonoscopy if any abnormality is found.
Colonoscopy is a procedure that allows a physician to see the lining of the colon and remove abnormal polyps. A clean colon is very important in detecting small polyps, so patients must prepare for their colonoscopy by avoiding solid food for 24 hours and by taking a laxative solution that will cause temporary diarrhea. During the exam, sedative medications are provided so that patients are comfortable. Most patients sleep during the whole examination and awake afterwards without memory of the test. It is generally a safe procedure, with serious complications such as significant bleeding or a tear of the intestinal wall being exceedingly rare (about one in 1,000.)
Specific screening recommendations depend on one’s risk for colorectal cancer. Those at average risk for colorectal cancer should begin screening at age 50. Those at increased risk for colorectal cancer, including those with a family history of colorectal cancer or polyps at a young age, should typically begin screening at age 40, or 10 years younger than the earliest diagnosis. It has been suggested that African Americans begin screening at age 45 as opposed to 50 and those with Inflammatory Bowel Disease need to have a regular screenings based on the duration and extent of their disease.
At Pentucket Medical Associates, we are fortunate to provide to our patients a state of the art outpatient endoscopy center, where we are able to perform colonoscopies in a comfortable setting Mondays through Fridays. We use updated high-definition endoscopes along with CO2 insufflation, insuring both a comfortable and a high quality examination. Procedures typically take 30 minutes and patients can expect to be home in 2 hours or less.
The majority of insurance plans including Medicare provide coverage for colorectal cancer screening. Local healthcare providers or a gastroenterology office are good sources of information for further questions or concerns. Online resources include the American Gastroenterological Association (www.gastro.org), the American College of Gastroenterology (www.acg.gi.org) or the American Cancer Society (www.cancer.org).