Time to Show Your Guts

Contributed by Dr. Steve Ellison, Gastroenterologist at Walton Regional Medical Center.

Most people know someone who is suffering from colon cancer or has had it in the past. This should not be a surprise since 1 out of 18 people will be diagnosed with the disease sometime during their life.  In the U. S. 145,000 people are diagnosed with colon cancer each year and over 50,000 die, which makes it the number 3 cancer killer.  This is an improvement over the past decade when it was the number 2 cause of cancer death. The decline is likely due to patient awareness and having a screening colonoscopy.  The reason it has not declined more is the lack of participation in screening.  With screening you can reduce your risk of dying from colon cancer by as much as 90% making colon cancer one of the most preventable cancers in the U.S.  It has been estimated that only about 40% of the population that should be screened has been screened.

Most colon cancers grow slowly and begin as polyps.  Polyps can progress to cancer but if detected in the pre-cancerous state (adenomas) they can be removed thereby preventing their progression.  A study published in the February 23, 2012 New England Journal of Medicine showed that “removal of adenomatous polyps prevents death from colorectal cancer”.

So it is time to show your guts, specifically your colon.  Screening for colorectal cancer (CRC) should begin at age 50 for average risk individuals or earlier for patients with a family history of CRC or polyps, or at age 45 for African-Americans.  African-Americans are at risk of developing cancers at a younger age and have a lower survival rate once the diagnosis is made.  Risk factors for colon cancer include certain diseases and a family history and should be discussed with your doctor.  Symptoms of colon cancer are often absent early in the disease and are not specific.  Change in bowel habits, bloating, weight loss and rectal bleeding are some of the symptoms reported by patients, but most patients with colon cancers found on a screening exam have no symptoms. 

Colonoscopy is the best screening test for CRC detection and prevention and is usually performed by a gastroenterologist, a doctor who received special training in endoscopic procedures and CRC prevention.  Other less effective screening tests are available but only a colonoscopy allows the doctor to look directly at the colon, identify suspicious growths and remove them.  The quality of the colonoscopy is crucial in detection and removal of polyps and is not only related to experience and expertise of the doctor but also the quality of the prep.  For average risk individuals with a normal exam, a follow up colonoscopy is not required for 10 years.

Every 3 minutes someone is diagnosed with colorectal cancer in our country, and every 10 minutes someone dies from colorectal cancer.  Colonoscopy is among one of the most effective preventive tests in medicine.  Talk to your doctor and show your guts today!