Preventing Colon Cancer – A Lost Opportunity
March is colorectal cancer prevention month, but just because it's over that doesn't mean that you should wait to get your colon checked. Over 150,000 people in the United States develop colon cancer each year. However, in the vast majority of patients, colon cancer is thoroughly preventable. The only method shown to prevent colon cancer and decrease the risk of dying from colon cancer is looking for and removing polyps. Polyps are benign, non-malignant, pre-cancerous growths that occur on the wall inside the colon.
Mutations in DNA, the genetic code of colon cells, caused by a combination of high fat diets, toxic environmental factors, viruses, and hereditary factors result in polyps. Many people at some point in their life will develop a polyp. Most people do not develop polyps until age 45-55. However, there are exceptions. Polyps can develop in the colon in 25-30 year olds whose only symptom is occasional bleeding from the rectum. Once a polyp develops, it generally grows, possibly causing constipation and decreasing the size in the caliber of the stool. Polyps must be removed as it is thought that they will develop into cancer in 5-10 years if left in the colon.
Colonoscopy is a procedure that enables a physician to examine the lining of the colon (large bowel) for abnormalities by inserting a flexible tube that is about the thickness of your finger into the anus and advancing it slowly into the rectum and colon. Incredible technology allows the gastroenterologist to visualize (on TV) the entire colon as the colonoscopy is performed. Combined with modern anesthesia, the procedure is often painless, taking less than 25 minutes. If polyps are seen, they are removed with special catheters. The process is entirely painless.
Most medical societies, including The American Cancer Society and The American College of Physicians, recommend an endoscopic screening of the colon in all persons over the age of 50. It is believed that a single colonoscopy is "protective" for 5-10 years if no polyps are found. If polyps are found, as they often grow back, repeat examinations to remove recurrent polyps are necessary at shorter intervals, 1-3 years, depending on the size of the polyp.
The information provided above represents the results of intense clinical and scientific study. If colonoscopies were appropriately applied, only a fraction of people currently suffering from colon cancer would die. Colonoscopy is more effective in preventing colon cancer death than mammography is for preventing breast cancer death. Due to implementation of colonoscopy, polyp removal, there has been a 25 percent decrease in colon cancer in the New York area during the last decade. Unfortunately, every day, people are diagnosed as having colon cancer when a simple exam would have prevented the disease.
Scott Tenner is Associate Professor of Medicine, State University of New York, Governor, American College of Gastroenterology and Director, Medical Education and Research, Maimonides Medical Center.
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