As a gastroenterologist at Hallmark Health System I see firsthand the effects that colon cancer can have on patients and their loved ones. Colon cancer is the second leading cause of cancer deaths in the US for both men and women, behind only lung cancer.  The good news is that this is a very preventable and treatable cancer if screening guidelines are followed. According to the American Cancer Society, last year more than 50,000 Americans died from the disease and that death rate could be cut in half if all of those who were due for a screening had one.

Safe, highly effective screening is available. March is Colon Cancer Awareness Month and recognition months such as these give us the opportunity for dialogue to spread the word and, hopefully will serve as an incentive to book that overdue screening.

Colon cancer typically develops with precancerous growths called polyps inside the colon.   Over time the polyps can develop into cancer. In early stages, colon cancer shows no symptoms, so we rely on finding the polyps as early as possible. A colonoscopy is the most effective way of spotting these polyps. Although other screening tools are available, none are considered more effective or offer the real-time removal and/or biopsies of polyps and other suspicious growths.

During the procedure, the vast majority of polyps that are detected are removed.  Polyps that are very large or with cancerous features can be too high risk to be removed during the procedure, but biopsies can still be safely taken for analysis.   All removed polyps and tissue samples are then sent to a pathologist for review. The total number of polyps removed and the final polyp pathology results will then help determine the timing of your next surveillance colonoscopy (ranging from several years up to 10 years).

When you do have a colonoscopy, be sure to follow the preparation process closely in order to get the best results. This includes avoiding solid foods the night before and taking a laxative preparation prior to the exam.

There are some misconceptions about the procedure, but it is very safe. It is a same-day procedure performed under sedation so patients experience very little to no discomfort during or after the procedure.

We typically recommend starting colon cancer screening at age 50 for most individuals. Those considered at higher risk (family history of colon cancer or inherited forms of colorectal polyps/cancer, personal history of chronic inflammatory bowel disease) should be screened earlier.   Studies suggest that African-Americans are also at higher risk for colon cancer compared to other ethnic groups and therefore should begin regular screenings at age 45.

Everyone should be encouraged to consult with his/her doctor to set up the appropriate screening schedule.

There are changes that you can make to your lifestyle as well to reduce your risk from developing colon cancer.

• Get screened
• Maintain a healthy weight
• Maintain an active lifestyle
• Smoking/nicotine abstinence
• Drink alcohol in moderation
• Adopt a healthy diet with lots of fiber, whole grains and 2 ½ cups of fruits and vegetables each day. You should also limit the amount of red meat in your diet.

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Hallmark Health and the Boston Bruins have teamed up to fight colon cancer.

Click here to watch our public service announcement.

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Some more valuable information regarding Colorectal Cancer…

Colorectal Cancer Screening Basic Fact Sheet

What Is Colorectal Cancer?

Colorectal cancer is cancer that occurs in the colon or rectum. Sometimes it is called colon cancer. The colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.

It’s the Second Leading Cancer Killer

Colorectal cancer is the second leading cancer killer in the United States, but it doesn’t have to be. If everyone aged 50 years or older had regular screening tests, at least 60% of deaths from this cancer could be avoided. So if you are 50 or older, start getting screened now.

Who Gets Colorectal Cancer?

• Both men and women can get it.
• It is most often found in people 50 or older.
• The risk increases with age.

Are You at High Risk?

Your risk for colorectal cancer may be higher than average if:

• You or a close relative have had colorectal polyps or colorectal cancer.
• You have inflammatory bowel disease.
• You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer.

People at high risk for colorectal cancer may need earlier or more frequent tests than other people. Talk to your doctor about when to begin screening and how often you should be tested.

Screening Saves Lives

• If you’re 50 or older, getting a colorectal cancer screening test could save your life. Here’s how:
• Colorectal cancer usually starts from polyps in the colon or rectum. A polyp is a growth that shouldn’t be there.
• Over time, some polyps can turn into cancer.
• Screening tests can find polyps, so they can be removed before they turn into cancer.
• Screening tests also can find colorectal cancer early. When it is found early, the chance of being cured is good.

Colorectal Cancer Can Start With No Symptoms

Precancerous polyps and early-stage colorectal cancer don’t always cause symptoms, especially at first. This means that someone could have polyps or colorectal cancer and not know it. That is why having a screening test is so important.

What Are the Symptoms?

Some people with colorectal polyps or colorectal cancer do have symptoms. They may include:

• Blood in or on your stool (bowel movement).
• Stomach pain, aches, or cramps that don’t go away.
• Losing weight and you don’t know why.

If you have any of these symptoms, talk to your doctor. These symptoms may be caused by something other than cancer. However, the only way to know what is causing them is to see your doctor.

Types of Screening Tests

Several different screening tests can be used to find polyps or colorectal cancer. Each can be used alone. Sometimes they are used in combination with each other. The U.S. Preventive Services Task Force (USPSTF) recommends colorectal cancer screening for men and women aged 50–75 using high-sensitivity fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy. Talk to your doctor about which test or tests are right for you. The decision to be screened after age 75 should be made on an individual basis. If you are older than 75, ask your doctor if you should be screened.

• High-Sensitivity FOBT (Stool Test) – There are two types of FOBT: One uses the chemical guaiac to detect blood. The other—a fecal immunochemical test (FIT)—uses antibodies to detect blood in the stool. You receive a test kit from your health care provider. At home, you use a stick or brush to obtain a small amount of stool. You return the test to the doctor or a lab, where stool samples are checked for blood. How Often: Once a year.
• Flexible Sigmoidoscopy – For this test, the doctor puts a short, thin, flexible, lighted tube into your rectum. The doctor checks for polyps or cancer inside the rectum and lower third of the colon. How Often: Every five years. When done in combination with a High-Sensitivity FOBT, the FOBT should be done every three years.
• Colonoscopy – This is similar to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can find and remove most polyps and some cancers. How Often: Every 10 years.

** Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests.

Other Screening Tests in Use or Being Studied

Although these tests are not recommended by the USPSTF, they are used in some settings and other groups may recommend them. Many insurance plans don’t cover these tests, and if anything unusual is found during the test, you likely will need a follow-up colonoscopy.

• Double Contrast Barium Enema –  You receive an enema with a liquid called barium, followed by an air enema. The barium and air create an outline around your colon, allowing the doctor to see the outline of your colon on an X-ray.
• Virtual Colonoscopy – Uses x-rays and computers to produce images of the entire colon. The images are displayed on the computer screen.
• Stool DNA test – You collect an entire bowel movement and send it to the lab to be checked for cancer cells.

Will Insurance or Medicare Pay?

Many insurance plans and Medicare help pay for colorectal cancer screening tests. Check with your plan to find out which tests are covered for you. To find out about Medicare coverage, call 1-800-MEDICArE (1-800-633-4227) or visit www.medicare.gov.

The Bottom Line

If you’re 50 or older, talk with your doctor about getting screened. For more information, visit www.cdc.gov/screenforlife or call 1-800-CDC-INFO (1-800-232-4636). For TTY, call 1-888-232-6348.

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

CDC Publication #99-6949 • Revised March 2014