Colon cancer is largely preventable as long as a person gets screened appropriately, said a gastroenterologist from the NCI-designated Dan L Duncan Cancer Center at Baylor College of Medicine.
Despite new options for screening, there is plenty of evidence to support that a traditional colonoscopy is still the best method of prevention, said Dr. Bincy Abraham, assistant professor of medicine – gastroenterology at BCM.
March is National Colon Cancer Awareness Month. It serves as an opportune time for everyone to be reminded and educated on the importance of colon cancer screening, Abraham said.
Do not delay screenings
"Many people have a 'better-late-than-never attitude' about screening, but in some cases, it is too late and the patient is faced with diagnosis, surgery and potential spread of the cancer," said Abraham.
The later a person gets screened, the higher the chances for more advanced, deadly forms of colon cancer.
When to get screened?
Screening should start at age 50 for the general population.
African-Americans should start screening at age 45 because they are at a higher risk of developing colon cancer.
Additionally, if a person has a family history of colon cancer, he or she should be screened 10 years earlier than the age of that family member's diagnosis.
Abraham encouraged a discussion with your family physician/primary care provider on your risk and when you should get screened.
What does screening look for?
Colonoscopies enable physicians to see any polyps on the colon through an endoscope (a thin, flexible device that is inserted into the colon) while the patient is under anesthesia.
"If polyps are identified, they are usually removed at the time of the procedure so they do not get a chance to grow into cancer, thereby preventing colon cancer," said Abraham. "Depending on the size, number and type of polyp(s), a repeat colonoscopy is recommended to monitor for any new growths that can occur."
If no polyps are found, the next colonoscopy screening can be done in 10 years for normal risk groups.
If polyps are found, follow-up usually ranges from three to five years, however some may need more frequent screening, she said.
Different types of screening
There are alternative screening options available including:
- Barium enema: special X-rays of the colon and rectum.
- Virtual colonoscopy: a CT scan image of the colon that does not require the use of an endoscope.
- Flexible sigmoidoscopy: using a lighted scope, the procedure allows a physician to see inside the sigmoid colon and rectum.
Abraham said having a traditional colonoscopy is ideal because it allows the physician to view the entire colon and it is both diagnostic and therapeutic.
For example, a barium enema or a virtual colonoscopy could miss small polyps. "If polyps are found, the patient would still have to undergo preparation and schedule for a colonoscopy to remove them." A flexible sigmoidoscopy only looks at a small portion of the colon and it could miss polyps or cancers in the right side of the colon.
Advances in preparations
Many avoid screening out of fear of the procedure and the discomfort of the preparation prior to it, said Abraham.
"There is good news on that front," she said. "Bowel preparations have improved and we are seeing less and less patient dissatisfaction with the procedure."
Instead of a gallon of fluid prep the evening before, physicians are advocating a variety of split preparations with smaller volume of fluid preparations.
"There are a couple of different options," said Abraham. "When you schedule your screening, make sure to ask about this."
To schedule a colonoscopy at the Baylor Clinic, call 713-798-0950.