Sev­eral op­tions avail­able for more com­fort­able colon can­cer screen­ing

Record Observer - - Senior Satellite - By DR. NAEEM A. NEW­MAN

Col­orec­tal can­cer is the third most com­monly di­ag­nosed can­cer, and cause of death from can­cer, in the United States. Ac­cord­ing to a re­cent study by the Amer­i­can Can­cer So­ci­ety, the rate of col­orec­tal can­cers, lo­cated in the colon or rec­tum, is on the rise for peo­ple un­der 50. But de­spite that trend, ex­perts project al­most 60 per­cent of new di­ag­noses in 2017 will be for those 65 years old and up.

March is Na­tional Colon Can­cer Aware­ness Month. A good time to re­mem­ber that col­orec­tal can­cer can be pre­vented by de­tect­ing pre­can­cer­ous polyps, which are small, ab­nor­mal growths in the colon. Polyps can be re­moved dur­ing a colonoscopy. Many peo­ple have no symp­toms of early col­orec­tal can­cer. Screen­ings are im­por­tant be­cause they can de­tect can­cer at an early, cur­able stage. Stud­ies show a lower death rate from col­orec­tal can­cer among peo­ple who get screened com­pared to those who do not.

You have sev­eral screen­ing op­tions — the most ef­fec­tive one is the one you will fol­low through with.

Fe­cal Screen­ing Tests Fe­cal screen­ing tests can find tiny amounts of blood in stool that can ei­ther be a sign of large polyps or can­cer. Your health care provider will de­ter­mine if you need this screen­ing ev­ery year or ev­ery two years. You can take these types of tests at home with a kit and in­struc­tions from your doc­tor’s of­fice. If your re­sults are pos­i­tive, you will need to fol­low up with a colonoscopy.

Colonoscopy Many stud­ies show the rate of can­cer death is 68 to 88 per­cent lower for peo­ple who have a colonoscopy com­pared to those who do not. This is be­cause ex­perts can re­move polyps dur­ing the colonoscopy, be­fore polyps can be­come can­cer­ous. A polyp is con­sid­ered a pre-can­cer­ous le­sion. Re­mov­ing them is a pri­mary pre­ven­tion strat­egy. This screen­ing can also de­tect can­cer in an early, cur­able stage.

CT Colonog­ra­phy A CT Colonog­ra­phy is a pro­ce­dure us­ing imag­ing or x-rays to pro­duce a de­tailed im­age of the colon and rec­tum. A CT Colonog­ra­phy can be ef­fec­tive in de­tect­ing raised polyps. How­ever, this type of screen­ing is not as good as a colonoscopy for de­tect­ing flat polyps, which are harder to rec­og­nize. Also, with CT Colonog­ra­phy, if a polyp is dis­cov­ered it can­not be re­moved right then. You will need a colonoscopy to re­move the polyp.

Blood-Based Tests The Food and Drug Ad­min­is­tra­tion re­cently ap­proved a blood-based col­orec­tal can­cer screen­ing test. How­ever, more stud­ies are needed to eval­u­ate the longterm ben­e­fit of this screen­ing tool.

The U.S. Pre­ven­tive Ser­vices Task Force rec­om­mends you start get­ting screened when you turn 50 if you are at av­er­age risk for col­orec­tal can­cer. The guide­lines sug­gest a stool test an­nu­ally or ev­ery three years, or a colonoscopy ev­ery 10 years, or a CT Colonog­ra­phy ev­ery five years. If you are be­tween 76 and 85 years old, talk to your doc­tor about the risks and ben­e­fits of screen­ing. You should stop screen­ing af­ter 85 years of age.

The task force rec­om­mends ear­lier and more fre­quent screen­ing if you’re high risk. If you have a direct rel­a­tive di­ag­nosed with col­orec­tal can­cer be­fore 60 years of age, you should have a colonoscopy when you turn 40, or when you’re 10 years younger than the rel­a­tive’s age when they were di­ag­nosed. Whichever is ear­lier.

There is no “best” strat­egy for col­orec­tal can­cer screen­ing. The best test to screen for colon can­cer is the test you can com­plete con­sis­tently.

Naeem A. New­man, MD, is a sur­gi­cal on­col­o­gist at Anne Arun­del Med­i­cal Cen­ter. To reach his prac­tice, call 443-4813717.

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