Kentucky ranks fourth in the nation for colon cancer deaths, but both incidences of colon cancer and deaths from the disease are largely preventable through a number of screenings options.
Colon cancer usually starts with polyps, small growths on the lining of the colon, which can be removed to prevent cancer from developing. Because the early stages of colon cancer show no signs or symptoms, regular screening is critical to prevention.
The American Cancer Society recommends regular screening for colon cancer beginning at age 50 for whites and age 45 for blacks. Earlier and more frequent screening may be recommended for those at high risk due to factors such as a history of inflammatory bowel disease or family history of colon cancer or polyps.
Colonoscopy is the most common screening option. A colonoscopy allows a physician to look at the entirety of the colon using a flexible scope with a camera attached. The exam usually takes 20 to 30 minutes and the patient is sedated.
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A colonoscopy does require some preparation by the patient in order to clear the colon. This involves drinking some liquids to clean the bowel.
For patients who are not candidates for a colonoscopy, for example those who cannot be sedated, a fecal immunochemical test (FIT) can be used to identify hidden blood in the stool, a sign of colon abnormalities. A benefit of these tests is that stool samples can be collected at home and no prep or sedation is needed.
FIT tests can, however, show a false positive in patients who may have other reasons for traces of blood in the stool, for example patients who are on a regular aspirin regimen.
The Food and Drug Administration also recently approved the use of a stool DNA test, called Cologuard. A gastroenterologist can order the test and it can be performed in the comfort of a patient's own home.
Many patients ask about the option of a "pill cam" or capsule endoscopy for colon cancer screening. However, capsule endoscopy is mostly for viewing the small intestine and does not allow physicians to see the colon wall in its current state. Virtual colonoscopy, in which a CT scan or MRI image of the abdomen is used to evaluate the colon, is an option usually reserved for patients who cannot safely undergo traditional colonoscopy.
It is best to discuss screening options with your physician to determine the ideal approach for you.
Remember that catching colon cancer or polyps before there are symptoms is critical to preventing or curing the cancer.
Screenings have caused colon cancer rates in adults over age 50 to decrease by about one percent each year since 1975, according to U.S. National Cancer Institute data. While that trend is promising, recent research shows that rates have risen among adults under the age of 50.