Earlier colon cancer detection often a benefit of colonoscopy
Earlier colon cancer detection often a benefit of colonoscopy

By Dr. Deborah Blalock Comments 0
Published: March 13, 2008

Colon cancer is the second-leading cause of cancer deaths in the United States, exceeded only by lung cancer, according to a recent report by the Journal of the American Medical Association. And the American Cancer Society is projecting that nearly 150,000 Americans will be diagnosed with colorectal cancer in 2008, with nearly 50,000 of those dying from the disease.

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Dr. Deborah Blalock

Those are sobering statistics.

More than 90 percent of colon cancer cases occur in people 50 and older. For this reason, people should get tested for the disease at age 50 or earlier if there is family history of the disease.

If colon cancer is found and treated early, the five-year survival rate is about 90 percent. But because people are not getting tested, only 39 percent of cases are diagnosed in the early stage when treatment is so successful.

With March designated as Colon Cancer Awareness Month, now is a great time to be tested. Here are answers to some common questions about colon cancer screening.

Q:When should you make an appointment to have colon cancer screening performed?

A:Routine screenings should begin at age 50. For blacks, the age is 45. For those with a family history of colon cancer, screenings should begin earlier. A follow-up colonoscopy may be scheduled depending on what is found during the initial exam.

Q:After age 50, how often should you schedule a screening?

A:Every 10 years for average-risk patients without a family history of colon cancer. Every five years if there's family history, and every three to five years if pre-malignant polyps are found.

Q:Are screenings scheduled through a primary-care physician?

A:Yes.

Q:Does a specialist perform the procedure, and if so, what kind?

A:Gastroenterologists primarily perform the screening, which is called a colonoscopy. Sometimes a surgeon will perform the procedure.

Q:What is a colonoscopy?

A:A colonoscopy is an outpatient procedure in which the rectum and the inside of the lower large intestine (colon) are examined. Colonoscopies are commonly used to evaluate bowel disorders, rectal bleeding or polyps (usually benign growths) and to screen for colon and rectal cancer.

Q:What is required to prepare for a colonoscopy?

A:You will be asked to drink only a clear, liquid diet the day before the procedure. You may also be required to take medicine in pill or liquid form to cleanse the colon.

Q:What happens during a colonoscopy?

A:You are given "conscious sedation” which helps you relax and sleep during the procedure with minimal to no discomfort. The physician uses a colonoscope (a long, flexible instrument about ½ inch in diameter) to view the lining of the colon. The colonoscope is inserted through the rectum and advanced to the large intestine.

During a colonoscopy, small amounts of tissue may be removed for analysis (called a biopsy) and polyps can be identified and removed. In many cases, colonoscopy allows accurate diagnosis and treatment without the need for a major operation.

Q:What happens after the procedure?

A:You are given time to recover and then allowed to eat a light meal. The main restriction is no driving for about 24 hours after the procedure due to the sedatives administered, so a responsible adult will need to accompany you to the procedure.

Q:What issues might the screening detect?

A:Discovery of pre-malignant polyps that can be removed to prevent colon cancer, or detection of colon or rectal cancer, which in its early stages is potentially curable.

Q:What is the typical treatment for colon cancer?

A:Surgical removal of the cancer sometimes followed by chemotherapy or radiation therapy, depending on the degree of spread and/or location of the cancer.

Practicing gastroenterologist Dr. Deborah Blalock has more than 14 years of experience. She is a consulting physician with Generations Healthcare, Oklahoma City Clinic, St. Anthony Hospital and Lakeside Women's Hospital.