Last week we discussed that March was Colorectal Cancer Awareness Month. March is also Colonoscopy Awareness month. It makes sense as colonoscopy is the leading diagnostic tool that doctors have for the diagnosis of colorectal cancer.
Last week we found out that Colorectal cancer is the second leading cause of cancer and cancer deaths in the United States. It is also largely preventable.
Colorectal cancer usually starts as a benign, non-cancerous polyp. Polyps generally have little or no symptoms. As the polyp grows it can change and becomes invasive, a process that can take 7-10 years. The larger the polyp becomes, the more chance that it has cancer in it. There is a test available that will cure colorectal cancer before it invades and turns into cancer. The only catch is the test has to be done when a patient feels fine, has minimal or no symptoms, and at a time when they have other more pressing things to do. This test is nothing new and is called a colonoscopy. You know the one your doctor has probably already talked to you about if you are over the age of 50. Colonoscopy cures more cancers before they are cancers than any other screening procedure. It is the reason that the incidence of colon cancer has decreased since 1975. Studies suggest that colonoscopy can help reduce CRC incidence by about 40% and deaths by about 60%.
Colonoscopy is the gold standard of colon cancer screening. Other screening modalities can miss polyps and have a higher false-positive rate (indicating polyps present when they are not there). Furthermore, these tests do not have the ability to remove the polyps as colonoscopy does. Finally, colonoscopy has the longest interval between tests of every 10 years, provided there are no polyps found. Currently, it is recommended that everyone have a screening colonoscopy at the age of 50. If you have a family history of colon cancer, the first colonoscopy should be done either 5 years before the youngest family members’ diagnosis of colon cancer or at age 50, whichever is earlier. This is for screening only; that is there are no symptoms present. If you have symptoms, your doctor may want to perform this test earlier, before the age of 50.
Symptoms in patients under age 45 that are considered alarm symptoms for colorectal cancer include iron deficiency anemia, rectal bleeding, and changes in bowel habits (changes in frequency, consistency, color, or control of your bowels). Half of the patients presenting with early-onset colorectal cancer are less than 45 years old. The incidence of colorectal cancer in individuals under 50 years of age is on the rise.
So why do more people not take advantage of colonoscopy? Some are embarrassed, others too busy, still others have heard from their friends’ bad things about the preparation and that it was all as unnecessary because they did not find anything. For the record, the worst part of a colonoscopy is the prep. There is just no way to pleasantly take something that is going to evacuate stool from your colon overnight so that the inside of your colon can be seen. That being said, most patients who are told what to expect, find the process a little more bearable. Once the prep is complete and you arrive for the test the next morning, the actual test usually takes less than an hour. Colonoscopies are done under sedation and the majority of patients do not remember the procedure being done. As for the colonoscopy being “unnecessary”, you will only know that after you have had one; and if it is “necessary” for you, you will be glad you had one. So be sure and discuss colon cancer screening with your physician and what you should be doing to prevent colon cancer.
Dr. James Lee serves as the Coroner of Winn Parish. He is a General Surgeon and Surgical Oncologist who has been practicing in Winnfield for over ten years. Dr. Lee attended the University of Colorado for his medical degree. He completed his residency in Surgery at the University of Oklahoma before completing a fellowship in Surgical Oncology and Endoscopy at Roswell Park Cancer Institute in Buffalo, NY. Dr. Lee and his wife Scarlett live in Winnfield with their son and are active in the community.