Colorectal Cancer: Facts and Screening
Did you know that colon cancer is the 4th most diagnosed cancer in men and 3rd most diagnosed in women worldwide? That means that over 1 million people develop colorectal cancer every year worldwide. In the US, the number of cases are rising, especially in younger patients. While those statistics seem quite scary, colorectal cancer is the ONLY preventable cancer. It is also highly treatable if detected early.
How does it develop? Nearly all colorectal cancer starts as a colorectal polyp. A polyp is a small overgrowth of tissue, that slowly increases in size. Some will become cancerous, while others will not. This is why we perform colonoscopy. We are not LOOKING for a cancer, we are looking for these little polyps so we can remove them to prevent them from turning into a cancer.
What is my risk? I often hear patients say “oh, well I feel fine, I have no family history of colon cancer.” That’s wonderful, but the reality is that only 20% of colon cancers are linked to a family history. Unfortunately, the majority of these colorectal cancers are spontaneous. Aside from a family history, patients who have a history of inflammatory bowel disease (Crohn’s colitis, Ulcerative colitis) can also have a baseline increased risk. What we do know from years of research, is that a poor diet is linked to an increased risk of cancer. This includes a diet low in fruits and vegetables, high red meat, smoked foods, and cured meats. Obesity and increased alcohol intake are also associated with increased risk of cancer development.
What are symptoms of colon cancer? Most of the time, people will have no symptoms. But some patients complain of vague abdominal pain, a progressive (and constant) change in bowel habits, bloody stools, and unexplained weight loss. Blood per rectum is the most common reason people decide to see their doctor.
What is a colonoscopy like? I had my first colonoscopy at age 38. It really is not that bad!!! The day before, you will be on a clear liquid diet (broths, jello, water, Gatorade, etc). In the evening, it is time to clean out that colon. This is the most important part!!! That colon needs to be clean as can be so we can look inside and examine all of it clearly. The bowel prep is not as bad as people say it is, and the benefit definitely outweighs the temporary inconvenience. The next day, you come in and you will enjoy a wonderful nap courtesy of our anesthesia staff. You will not remember or feel a thing. Meanwhile, I will take my colonoscope and carefully inspect your colon and rectum. I will check for a few things, but I will be on a hunt for polyps, removing them one by one as they come along. These polyps are collected and sent to a lab for examination.
It is important to keep in mind, that only about 20-25% of all patients having a colonoscopy will have polyps. That means that the vast majority of patients who come for a colonoscopy won’t have to have another for 10 years!
When should I get a colonoscopy? High risk patients (genetic mutations, first degree relative with cancer under age 60, inflammatory bowel disease) will start at an earlier age. If you are at normal risk, then screening starts at age 45. That being said, if you have any concern (rectal bleeding, etc), then see your doctor sooner than later!