Are you over 45 and hesitant about scheduling a colonoscopy? Did you know there are now several types of screenings that you should discuss with your primary care provider? Join Matthew Grossman, MD, interventional endoscopist at Atlantic Health System, for a conversation on the importance of getting a screening and the latest technology to support this important procedure.
Why is it important to get screened for colon cancer?
Dr. Grossman says that early detection is the key to preventing pre-cancerous lesions, also known as adenoma polyps, from developing into cancer. Screenings give doctors the ability to find these polyps, remove them and prevent cancer from forming. Very few cancers provide doctors with this level of forewarning and patients should know that a screening is their best defense against a serious condition.
Atlantic Health System gastroenterologist Dr. Matthew Grossman discusses the importance of getting a screening.
Are there different screening options for colon cancer?
There are different types of tests, but according to Dr. Grossman, the gold standard is a colonoscopy because it diagnoses and treats polyps and cancer during the same procedure. During a colonoscopy, a patient is put under sedation and a camera is painlessly inserted into the rectum, up to the top of the colon. While the camera is slowly withdrawn, the doctor examines the colon, looking for pre-cancerous polyps, and removes those they may encounter.
Another option for those that don’t want to prepare and undergo sedation for a colonoscopy is Cologuard. This screening is a DNA test combined with a chemical test for blood in the stool. According to Dr. Grossman, while it is highly effective to detect polyps and early cancers, if the Cologuard results indicate the need for further testing, the patient would be recommended for a colonoscopy.
How effective is a colonoscopy in detecting cancer?
Dr. Grossman says a colonoscopy is the most effective way to detect cancer. “If there is something to be found, we'll probably find it on a colonoscopy close to 100% sensitivity…” Because of its efficacy, a colonoscopy is recommended once every 10 years. Cologuard, by contrast, is recommended once every three years.
Is colon cancer preventable if it is detected early?
If colon cancer is found during a colonoscopy at its earliest or pre-cancerous stage, Dr. Grossman says a simple endoscopic resection, or removal, can effectively treat the polyp. Using a snare that resembles a metal lasso, a technician can quickly strangulate the polyp and remove it. Electricity or a clip is used to prevent bleeding. The polyp is sent to the lab to determine if it is benign or cancerous. About one in four screenings reveal polyps, and advanced cancers are found in between .5% and 1% of screenings. If a more advanced stage cancer is discovered, the patient is referred to an oncologist for additional care.
What is the recovery time from a colonoscopy?
The recovery time is very short. Dr. Grossman estimates that within 10 minutes a patient is awake from the anesthesia, with no memory of the procedure. He says it feels like a great nap. Patients are asked not to drive home from their colonoscopy but can generally resume a normal day of activity.
What advice do you have for those who are hesitant to get a colonoscopy?
Dr. Grossman recognizes that it may be unpleasant to think about colon cancer but urges people to be mindful of the risks. “…there's a lot of fear when it comes to discussing cancer. It's not lunchtime conversation. But at the same time, we have to be serious. We all have colons, right? …this is a part of the body that's prone to cancer…We're all at risk.” He adds that modern technology gives us the advantage of detecting colon cancer early, and that everyone who is eligible should get a screening.
Are some people more predisposed to colon cancer than others?
The number one risk factor for colon cancer is age. Environmental factors play a role, but simply getting older is the primary reason people develop colon cancer. Dr. Grossman says people are developing colon cancer earlier, and therefore the recommended age to get a screening is 45 years. Approximately 20% of total colon cancers occur in people under the age of 55. The earlier a person gets screened, the earlier colon cancer can be detected and treated.
Are there obvious signs or symptoms of colon cancer?
According to Dr. Grossman, patients with colon cancer may experience involuntary weight loss, fatigue, change in bowel habits, bloating, and constipation. Rectal bleeding or blood in the stool could also be a sign of colon cancer. Patients should reach out to their primary care physician if any of these symptoms are reoccurring.
Are some people genetically predisposed to colon cancer?
While age is the primary factor for developing colon cancer, genetics and family history are strong factors that can elevate your risk. Dr. Grossman says if you have a family member who had colon cancer below the age of 60, then you should begin your screening colonoscopies at age 40. If that family member was younger than 50 when they were diagnosed, you should start your screening 10 years before they were diagnosed. In addition, if a close family member had high grade polyps, which, according to Dr. Grossman means “…polyps with dysplasia under the microscope starting to look like cancer…”, you should begin your colonoscopy screening 10 years prior to when the polyps were diagnosed.
Where can I find more information about colon cancer?
Atlantic Health System has a dedicated site about colon cancer screenings, prevention and treatment. Visit: www.atlantichealth.org/colorectal.
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