Importance of Screening Colonoscopy
Cancer
of the colon or rectum is the second leading cause of cancer deaths in the
United States. Even
though colon cancer can develop in young, nine out of ten people diagnosed with
the disease are above the age of 50. Every year, about 140,000 Americans are
diagnosed with colorectal cancer, and about 50,000 people die from the disease.
Cancer of the colon and rectum is
preventable, if the population is screened starting at the age of 50.
According to the
Centers for Disease Control and Prevention, more than 20 million adults in the US
never had the recommended screening colonoscopy for the disease, which places
the population at higher risk of colon cancer.
According to the American
Cancer Society, more than 95% of colon and rectal cancers are adenocarcinomas
which starts in the gland cells lining the inside of the colon and rectum. This year, 96,830 new cases of colon
cancer, 40,000 new cases of rectal cancer, and 50,310 deaths from
the cancers combined are expected (CDC, 2014). The
American Cancer Society believes that the population need to have colon cancer
screenings regardless of health insurance coverage.
- a disease in which normal cells in the lining of the colon or rectum begin to change, grow without control, and no longer die
- usually begins as a noncancerous polyp that can become a cancerous tumor
Who needs screening?
- age 50-75: screening used
- annual high-sensitivity FOBT
- sigmoidoscopy every 5 yrs combined with high-sensitivity FOBT every 3 yrs
- colonoscopy at intervals of 10 years
- age 76-85: against routine screening, considerations may support screening in individuals
- age >85: against screening
Colon polyp to cancer takes about 10 years
What are the risk factors?
- polyps (a noncancerous or precancerous growth associated with aging)
- age
- inflammatory bowel disease (IBD)
- diet high in saturated fats, such as red meat
- personal or family history of cancer
- obesity
- smoking
Colon Cancer Deaths
- Colorectal cancer is the third most common cancer in both men and women
- the second leading cause of cancer deaths in Texas in men and women combined
- in 2009, it was estimated that 9858 Texans would be newly diagnosed with invasive colorectal cancer, and 3477 would die of the disease
Colorectal cancer cases by risk history
What are the symptoms
- early colon cancer usually has no symptoms
- advanced colon cancer symptoms:
- a change in bowel habits: diarrhea, constipation, or a feeling that the bowel does not empty completely
- bright red dark blood in the stool
- stools that appear narrower including frequent gas pains, bloating, fullness, and cramps
- unexplained weight loss, constant tiredness, or unexplained anemia (iron deficiency)
Preventing and detecting colon cancer
- digital rectal examination
- colonoscopy (currently the best way to prevent and detect colorectal cancer)
- sigmodidoscopy
- CT colonography/virtual colonoscopy
- fecal occult blood test
- double contrast barium enema
How is colon cancer treated?
- surgery!!
- the tumor, along with the adjacent healthy colon or rectum and lymph nodes, is typically removed to offer the best chance for cure
- can offer cure if cancer is only in the colon
Complications/recovery
- 3% anastomotic leak
- 5-10% infection
- 5% ostomy
- 2-5 days in hospital
- 4-6 weeks recovery
- little change in bowel habits if only part of colon removed
Follow up
- doctor's visits for 5 years
- lab test: carcinoembryonic antigen (CEA) measurements are recommended
- colonoscopy one year after removal of colorectal cancer
- surveillance colonoscopy every three to five years to identify new polyps and/or cancers
- CT chest/abdomen for advanced cancer
References
Centers
for Disease Control and Prevention (2014). Colorectal cancer Retrieved
from
http://www.cdc.gov/cancer/colorectal/
The American Cancer Society
(2014). American Cancer Society Guidelines for the Early Detection of Cancer.
Retrieved from
http://www.cancer.org/cancer/colonandrectumcancer
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