Early detection crucial in finding potentially deadly colorectal cancer
Korrie Waters
September 2, 2008
According to the federal Centers for Disease Control and Prevention (CDC), colorectal cancer is the second-leading cause of cancer-related death in the U.S. But more than 33 percent of deaths from colorectal cancer could be avoided if people over 50 had regular screening tests.
Dr. David Drozek, assistant professor of surgery at the Ohio University College of Osteopathic Medicine, agreed. “Colorectal cancer is very common, and preventable in the great majority of the cases,” he said. “The slight inconvenience and risk involved in a screening procedure is certainly worth the effort.”
To understand the importance of screening, it helps to understand what colorectal cancer is.
Colorectal cancer refers to cancer of the colon and the rectum, which together make up the large intestine. Colorectal cancer can start in any part of the intestine. According to Drozek, the majority of these cancers begin as polyps or growths inside the colon or rectum that become cancerous.
The exact cause of colorectal cancer is unknown. However, the American Cancer Society (ACS) says that many cases have associated lifestyle- and non-lifestyle-related risk factors.
Non-lifestyle related risk factors include:
• being over the age of 50
• being male
• having a family history of colorectal cancer (especially if the relative was diagnosed before age 60)
• having a personal history of chronic inflammatory bowel disease or previous polyps.
Lifestyle associated factors include:
• alcohol consumption of more than two drinks per day
• obesity
• physical inactivity
• a diet high in fat and low in fiber
• diabetes
• smoking.
Symptoms of colorectal cancer include rectal bleeding, abdominal discomfort, pain, bloating, a change in bowel habits, iron-deficiency anemia, and unexplained weight loss.
Early detection before symptoms of colorectal cancer emerge is the key to survival.
According to the American Cancer Society, each year in Athens County, a rate of 71 out of 100,000 newly diagnosed colorectal cancers will be invasive, in comparison to 54 out of 100,000 cases in the state of Ohio, making screening here even more important. Typically, screening for colorectal cancer begins at age 50 because more than 90 percent of colorectal cancers occur in individuals 50 and older. However, if an individual has a high number of risk factors (i.e. a strong family history of colorectal cancer) screening may begin prior to 50 years of age.
There are a variety of screening options for colorectal cancer; they include colonoscopy, flexible sigmoidoscopy, fecal occult blood test, and a double-contrast barium enema.
One of the most well-known colon-cancer screening options is a colonoscopy, where a physician uses a small lighted flexible tube inserted though the rectum to examine the entire colon. Colonoscopies are the preferred screening tool because they offer the option to remove a lesion during the exam process.
The American Cancer Society states that cancerous polyps detected early through screening increase the chance of survival in a five-year time period to 90 percent. In comparison, the five-year survival rate is only 68 percent if the cancer has spread regionally to the lymph nodes and 10 percent if the cancer has spread to distant sites, such as the liver. Screening with a colonoscopy should begin at the age of 50 and then be repeated every 10 years if the first one is normal.
Kathy Guinther, a colon-cancer survivor, had her colonoscopy as part of her routine medical care. “Being that none of my family had had any colon issues, I was not concerned that any problems would be found during this procedure,” she recalled.
However, during her procedure the doctors found and removed a quarter-sized cancerous mass. Guinther, whose cancer is in remission, said she “will gladly go to quarterly checkups” because she believes she is “fortunate to have had the fortitude to have the colonoscopy.”
Another option, flexible sigmoidoscopies, are similar to colonoscopies except that the instrument used to examine the colon is shorter and only examines the rectum and the lower portion of the colon. This method of screening should be repeated every five years (if normal) starting at the age of 50.
A third option, fecal occult blood tests, detect small amounts of blood in the stools that are not visible to the naked eye and that may indicate the presents of polyps in the colon. Beginning at age 50, a fecal occult blood test should be repeated every one to two years. A combination of a flexible sigmoidoscopy and a fecal occult blood test increases the chance of finding early polyps and cancers.
The final colorectal cancer screening option is a double-contrast barium enema (DCBE). DCBEs are X-ray studies that use a liquid barium sulfate enema to make it easier to see the entire colon. If a polyp or other abnormality is found, the patient is referred for a colonoscopy to be examined further.
Each one of these screening options has both advantages and disadvantages. Discuss with your doctor the best option for you. Early detection is crucial.
Free screening kits for colorectal cancer are available at O’Bleness Memorial Hospital’s visitor and patient entrance information desks, as well as at the Castrop Center information desk. O’Bleness also distributes kits free at area health fairs throughout the year. If you have any questions about colon cancer, call Kathy Trace at OU-COM, Community Health Programs, at 1-800-844-2654.
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