If you had a 5 percent chance of developing a potentially fatal disease, and you could reduce this risk, wouldn’t you?
Colorectal cancer (cancer of the colon or rectum) is the second leading cause of cancer-related death in the United States, with about 50,000 people losing their lives annually. Screening could prevent approximately 60 percent of these deaths. Despite this, however, about one out of every three people is not up to date with colon cancer screening.
Over the last several years, celebrities like Katie Couric and Will Smith have brought attention to the importance of a colonoscopy. It is now common to see commercials on television featuring a talking Cologuard® box with arms and legs sitting on a toilet. But even with the increased awareness, many people would prefer to avoid the subject of colon cancer prevention.
For the past 20 years, March has been designated as National Colorectal Cancer Awareness Month. So really, there is no better time to talk about the importance of colon cancer screening.
As awful as colon cancer is, the good news is that it can be prevented. Most colon cancers begin as polyps, small growths on the inside surface of the colon. Polyps come in different shapes and sizes, and they have different microscopic characteristics. Certain polyps, called adenomas, have the potential to turn into cancer over several years.
It is important to know that colon polyps seldom cause any symptoms. Even though a person may feel well and apparently be in good health, a colon polyp could be growing and silently transforming into a life-threatening malignancy.
Fortunately, getting screened can significantly reduce your risk of getting colon cancer. Because it usually takes several years for a polyp to turn into cancer, colonoscopy with colon polyp removal (polypectomy) can very effectively prevent this type of malignancy. Additionally, timely diagnosis of colon cancer is essential, as treatment of early-stage colon cancer offers a greater than 90 percent chance of survival five years after the diagnosis.
No one will argue that getting a colonoscopy is fun or exciting, and most people hate going to the doctor’s office. But after the 20-minute exam is over, many patients marvel about how easy the procedure was and how they should have never worried about it in the first place.
In preparation for the procedure, you drink a clear liquid diet the day before, culminating with two doses of a laxative the evening before and morning of the examination. While this is usually the most disagreeable part of the process, it is also the most important. The cleaner your bowel preparation is, the better your colon examination will be. There are several different bowel preparations available and you can discuss the options with your doctor. Do not allow fear or dread of the cleansing process to increase your risk of dying from a preventable disease.
Since the procedure is done while you are sedated, the exam itself is painless and basically feels like a short nap.
In addition to the cleanliness of your colon, another critically important factor that determines the quality of your colon examination is your doctor. Each doctor who performs colonoscopies should be aware of his or her ADR, or adenoma detection rate. This doctor’s “report card” is the rate at which one or more precancerous polyps are found during a screening colonoscopy in patients 50 years and older. Current standards suggest a minimum ADR of 30 percent for male patients and 20 percent for female patients. Don’t be afraid to ask your doctor what his or her ADR is, as a higher ADR means a higher quality colonoscopy. Wouldn’t you want your house inspected by someone who is likely to find a preventable problem, so you don’t have to make costly repairs later? Your colon health should be no different. Studies have shown that for every 1 percent increase in a physician’s ADR, the risk of colon cancer decreases by 3 percent for the patient over the next year. If you are going through the process of getting a screening colonoscopy, it is vitally important the exam be done right.
The American Cancer Society recently recommended that all individuals aged 45 and older get screened for colon cancer. You might need a screening exam at a younger age if you have a family history of colon polyps or cancer, a personal history of inflammatory bowel disease, or other medical conditions. Your personal medical and family history will determine when and which type of colon cancer screening test is best for you. Additional information can be found online at websites for the American Cancer Society (www.cancer.org) and the American Society for Gastrointestinal Endoscopy, colorectal cancer awareness (www.screen4coloncancer.org).
If you haven’t done so already, talk to your doctor about getting screened for colorectal cancer. It is an easy, safe, and proven way of reducing your chance of dying from a very common and preventable disease. Having a colonoscopy will give you peace of mind. And it may just save your life.
Dr. Varanasi is a fellow of the American Gastroenterological Association and is accepting new patients at his office locations in Pittsboro and Pinehurst. To make an appointment, call 919-292-6110.