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Web letter by Dr. Andrew Katz: Colon screening can prove a lifesaver

Don’t let fear take your life. Colorectal cancer is the third-leading cause of cancer deaths in the United States. According to the American Cancer Society, more than 100,000 Americans lost their lives to colon cancer in 2012. In Indiana, more than 3,200 people were diagnosed with colon cancer, and more than 1,100 Hoosiers died. Most of those deaths could have been prevented. Colorectal cancer affects both sexes and people of all ethnic backgrounds. Fear of a simple test is responsible for a lot of those deaths.

Who is at risk for colon cancer? You are. If no one in your family has ever had colon cancer, your lifetime risk is 6 percent. If even one parent, brother or sister has had a colon polyp or cancer at any age, your risk is 10 percent. The younger the age at which the relative developed the cancer or polyp and the greater the number of relatives affected, the higher your risk.

Most colon cancers begin as polyps, mushroom-like, abnormal-cell growths in the colon lining. They are small, relatively slow-growing and, generally, do not produce symptoms unless they become a cancer. As they grow and enlarge, small amounts of blood may seep into the stool. The amount of blood is so small, however, it cannot be seen, but it may be detected by a test for blood in the stool. Polyps may continue to grow and degenerate into cancer.

It takes two to five years for a very small polyp to become an advanced polyp, and another two to five years for it to become an early cancer. However, fewer than 10 percent of polyps will become cancerous. There is currently no way to predict which ones will become cancerous. Furthermore, early colon cancer has a high cure rate with surgery, but advanced colon cancer is fatal. If polyps are detected and removed, the cancer never forms at all.

Several tests can screen for polyps and colorectal cancer. These include stool testing for blood, barium enema, flexible sigmoidoscopy, CT colonography (virtual colonoscopy) and colonoscopy. Colonoscopy is considered the most effective because it not only detects colon cancer with high accuracy, it allows polyps to be removed upon their discovery and later examined in the lab. Thus, colonoscopy may even prevent cancer.

Colonoscopy can save your life. The worst part of the procedure is getting the colon cleansed beforehand. Although some people have difficulty with the prep, most tolerate it well. The test is performed with the patient either under sedation or light anesthesia. The examination generally lasts about 20 minutes. Afterward, there is a short recovery period, then patients are discharged home to rest. The next day, most patients resume normal activities. Medicare and most commercial insurance plans cover screening colonoscopy.

March is colon cancer awareness month. If you or a loved one is at least age 50, or age 40 with a family history of colon cancer, get screened. Don’t let fear stop you.


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