March has been designated Colorectal Cancer Awareness Month. What better time to explore some important information about gastrointestinal health?
While colorectal cancer and digestive health in general are often uncomfortable topics of conversation, it is imperative that people are educated on such issues, as raising awareness can save lives.
Colorectal cancer, also referred to as colon cancer, is the second leading cause of cancer-related death in the United States among cancers that affect both men and women. Only lung cancer occurs with a higher frequency for both sexes. The risk of developing colorectal cancer increases with advancing age, with more than 90 percent of colon cancers occurring in people aged 50 or older. More importantly, colorectal cancer is one of only a few cancers that can be prevented through screening.
Screening can find polyps — small, abnormal growths in the lining of the colon — so that they can be removed before they ever have a chance to turn into cancer. When discovered early through routine screening, even abnormalities which have advanced to colon cancer are highly treatable. Since colon polyps typically do not cause any symptoms, screening is all the more important.
The primary tool for screening is colonoscopy. Colonoscopy is a procedure performed by physicians with advanced training in endoscopic techniques that allows for the examination of the large bowel with a small camera on the tip of a flexible tube passed through the anus. It allows for the direct visualization of the lining of the colon and grants the opportunity for biopsy or removal of polyps.
Colonoscopy can allow for the detection and removal of polyps as small as 1 millimeter or less. Once polyps are removed, they can be studied with the aid of a microscope to determine if they are precancerous or not.
Current guidelines recommend that everyone have screening colonoscopy performed by age 50. There are, however, a few exceptions to this general guideline. A family history of colon polyps or colon cancer can increase your risk. Therefore, if a family history is present, screening should begin at age 40, or 10 years earlier than the age at which the family member was diagnosed, whichever is earlier. Additionally, African-Americans without a family history should begin screening at age 45.
Colonoscopy involves a preparation at home the night before to cleanse the colon. There are several different types of preparations available that can be tailored to individual needs. The colonoscopy itself is completed with the use of moderate sedation, allowing for a safe and comfortable experience and is typically completed over about 30 minutes.
After a brief recovery period, you are able to return home. You are, however, restricted from certain activities, including working and driving, for the rest of the day. This is for your safety, after having received sedation.
Once the initial colonoscopy is complete, your physician can make recommendations regarding the most appropriate interval between colonoscopies, taking into account any family history and any abnormal findings on the initial examination. For those without any family history and a normal screening colonoscopy, most sources recommend that the colonoscopy be repeated after seven to 10 years.
For those with any symptoms attributable to the digestive tract, these screening recommendations are not applicable. Any symptoms, such as abdominal pain, diarrhea, constipation, blood in the stool, thin stools or other changes in digestive function, regardless of age, should be reported to your physicians right away so that appropriate evaluation can be initiated.
Dr. Geoffrey Raymer is a board-certified gastroenterologist with Southeastern Indiana Gastroenterology in Columbus. He also serves as the medical director of endoscopic services at Columbus Regional Hospital.