Colon Cancer is often a silent disease that has no symptoms. On average, lifetime risk is one in twenty people will develop colon cancer. This is a cancer that is preventable. Beginning at age 50 (age 45 for African Americans according to American College of Gastroenterology), all men and women should be screened for colorectal cancer. The colorectal cancer screening tests are divided into two groups: cancer prevention tests (colonoscopy, flexible sigmoidoscopy, CT colonography) and cancer detection tests (fecal immunochemical test – FIT, stool occult blood, stool DNA tests). Everyone should discuss the pros and cons of these screening modalities with their physicians. The cancer prevention tests are preferred over the cancer detection tests.
A colonoscopy is considered the gold standard of colorectal cancer screening methods for its ability to view the entire colon and both detect and remove polyps during the same procedure. Recent studies have shown that colon cancer rates have decreased with increased screening by colonoscopy.
What is Colorectal Cancer?
Colorectal cancer is cancer of the colon (large intestine) or the rectum. It develops from adenomatous polyps (grape-like growths that can appear on the lining of the colon and rectum) that may become cancerous over time.
• Colon Cancer is the third most frequently diagnosed cancer in both men and women with an estimated number of over 135,430 new cases in 2017 (American Cancer Society)
• An estimated 50,260 deaths are expected to occur in 2017 from colorectal cancer which makes it the second leading cause of cancer related deaths when men and women are combined (American Cancer Society)
• Colon cancer is preventable – early screening allows for removal of polyps that may progress to cancer
• Colon cancer is treatable and beatable when detected early (5 year survival rate is 90% when colon cancer is found early at a localized stage and treated early)
• Less than 40% of colorectal cancers are found early because screening rates are low. Only 65% of adults, age 50-75 are current and up to date on colorectal screening (Center for Disease Control and Prevention)
Unfortunately, not everyone with colon cancer may experience symptoms early on.
Alarm symptoms may include:
• Change in bowel habits such as diarrhea, constipation, vomiting
• Feeling that your bowel does not empty completely
• Unexplained weight loss
• Constant tiredness
• Blood in stool (either bright red blood or black, tarry stools)
• Finding that your stools are more narrow appearing than usual
• Gas, bloating, fullness, cramping
Cancer does not always cause pain so it’s important not to wait to feel pain before seeing your physician if you experience any of these symptoms.
Who is at Risk?
• Men and women age 50 and older
• People with personal or family histories of colorectal cancer or benign (not cancerous) colorectal polyps
• People who smoke
• People who are overweight or obese, especially those who carry fat around their waists.
• People who are not active and don’t exercise
• People who drink alcohol in excess,
• People who eat a lot of red meat (such as beef, pork or lamb) or processed meat (such as bacon, sausage, hot dogs or cold cuts)
• People with personal histories of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
• People with family histories of inherited colorectal cancer or inherited colorectal problems
What else can be done to prevent the development of colorectal cancer?
First and foremost get screened regularly to find and remove polyps, also:
• A high fiber (vegetables) and low fat diet.
Consume a healthy diet with an emphasis on plant sources; specifically:
– Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
Eat 5 or more servings of a variety of vegetables and fruits each day.
– Choose whole grains over processed (refined) grains.
– Limit your consumption of processed and red meats.
• In addition to maintaining a healthy weight, adopt a regular, vigorous exercise plan
• Cessation of smoking
What is a colonoscopy?
Typically the most unpleasant part of having a colonoscopy is the bowel prep prior to having the procedure. This is one of the most important steps of the process. In order to safely maneuver through the natural curves of the colon and adequately see the lining, the colon must be cleaned and free of stool. You will be prescribed a cleansing method, which usually involves drinking a flushing solution, laxatives, and/or enemas. In most cases, you are asked to consume only clear liquids and eat no solid food the day before your procedure. Your physician will provide advice on which medications are safe to use up until the day of your colonoscopy.
A colonoscopy is typically an outpatient procedure. You can expect to spend less than half a day for completion. Sedatives will be administered to produce a relaxed state. Your gastroenterologist will maneuver the colonoscope through your bowel. Air is placed into the colon for distention to allow good visualization. In some people this can create cramping. Turning the colonoscope around corners of the colon can also cause discomfort. These are two of the main reasons patients are given sedation. If polyps are found in your colon, your physician will remove them. Polyp removal does not produce pain. Biopsies will also be obtained if any other abnormal tissue is seen. The exam itself usually lasts 15-45 minutes. You will recover from the medication effects quickly. You should plan not to drive a vehicle the rest of the day.