March Is Colon Cancer Screening Month

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March is colorectal cancer awareness month. Colorectal cancer is the second-leading cancer killer in the United States, yet it is one of the most preventable types of cancer. Colorectal cancer is often curable when detected early.

Most early colorectal cancers produce no symptoms, which makes screening an excellent tool to prevent this cancer. Some possible symptoms like recent new abdominal pain, blood in or on the stool, a change in stool size, or shape or a change in bowel habits do not always indicate the presence of colorectal cancer but they are reason to visit a physician. When colon cancer does cause symptoms, it may cause vague abdominal pain, constipation, symptoms of obstruction such as bloating or cramps and fatigue as a result of anemia from chronic blood loss.

Most colorectal cancers develop from initially benign polyps which are abnormal growths in the colon. There are several types of colon polyps, some of which have the potential to become cancer and some that do not. If pre-malignant polyps grow unnoticed and are not removed, they may become cancerous. Screening tests can find polyps for removal before they turn into cancer. The development of more than 75 to 90 percent of colorectal cancer can be prevented through early detection and removal of precancerous polyps. Colon cancer screening with removal of polyps can prevent the development of colon cancer making colon cancer screening the only cancer screening test which can prevent cancer from occurring. Even when large colon cancers are found during screening, they can be surgically removed and if there has been no significant spread, these cancers can also be cured.

The lifetime risk of colorectal cancer is roughly equal in men and women and the risk of developing colorectal cancer increases with age.

Despite this, women are less likely to undergo colon screening. Colorectal cancer is most common after age 50 but it can strike at younger ages. Most recently and for unclear reasons, there has been a surge of colon cancers amongst people in their 30s and 40s.

The preferred colorectal cancer screening is colonoscopy every 10 years. For normal risk individuals, the American College of Gastroenterology recommends colonoscopy every decade beginning at age 50, and age 45 for African Americans. Colonoscopy is recommended for individuals of any age who are at higher than average risk for developing colorectal cancer due to a personal history of colorectal cancer or colorectal polyps, a strong family history of the disease, inherited forms of colorectal polyps or cancer and such chronic digestive conditions as Crohn’s disease or ulcerative colitis. For those with a family history of colorectal cancer, testing should begin at age 40 or 10 years younger than the age of the youngest affected relative, whichever is earlier. For both average and high risk individuals, all potential pre-cancerous polyps should be removed.

If appropriate, readers should consult their physician to discuss colon cancer screening. With an educated public and a willing medical team, we can hope to dramatically decrease the incidence of colon cancer and perhaps even eliminate colon cancer in the future.

David Bernstein, MD, FAASLD,FACG, AGAF, FACP, is the chief of hepatology and Sandra Atlas Bass Center for Liver Diseases and a professor of medicine at Hofstra-Northwell School of Medicine.

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