Even after Katie Couric showed us all that it’s not that bad, the thought of a colonoscopy makes most people squirm.
Unpleasant or not, colon cancer screening is essential to preventing this second most deadly cancer. It’s not enough to look out for symptoms. If you start experiencing signs of colon cancer, the disease is likely to be advanced.
“Colorectal cancer screening has not been widely adopted among the population, despite its ability to save lives. We must move past this barrier if we want to make a significant impact on this disease,” says D. Kim Turgeon, M.D., clinical associate professor of gastroenterology at the U-M Medical School.
Here, in time for Colon Cancer Awareness Month, experts from the University of Michigan Comprehensive Cancer Center share what you need to know about colon cancer:
1. It’s the second biggest cancer killer, behind lung cancer, and the third most common cancer in both men and women. More than 147,000 Americans will be diagnosed with colorectal cancer this year and some 55,000 will die from it. The earlier you can spot a cancerous tumor, the better the chance for a cure. Colonoscopy is the best tool to detect and remove suspicious polyps.
2. Colonoscopy is the best screening choice for women. Using flexible sigmoidoscopy, an alternative test, and a fecal occult blood test, which looks for blood in the stool, catches the majority of polyps in men. But U-M researchers, led by Philip Schoenfeld, M.D., found 65 percent of advanced precancerous polyps in women would have been missed with these tests. The researchers found that polyps are more likely to develop in different places in men and women, with women’s polyps occurring deeper into the colon where the sigmoidoscopy can’t reach.
3. Researchers are working on tests that are less invasive, more comfortable - and just as reliable. Researchers at U-M are looking at virtual colonoscopies, using tools such as CT and MRI to scan the colon and identify polyps. A small thin tube is inserted into the rectum and used with the X-ray scans to take two-dimensional pictures of the length of the colon. These images are put together to create a three-dimensional model. The procedure is more comfortable than a traditional colonoscopy and takes less time.
Turgeon is part of a multicenter trial to identify biomarkers in blood or stool samples that might suggest colon cancer. Finding a protein in stool samples could provide a more reliable early indicator of colon cancer without requiring a colonoscopy (but in the meantime, colonoscopy is still your best bet!).
4. Fewer than half of all men and women surveyed were up to date on their colon screenings. Women have gotten the message about yearly mammograms and Pap smears, and men know to have their prostate checked. But U-M researcher Ruth Carlos, M.D., has found colon cancer screenings lag behind for both sexes. She is leading a clinical trial that seeks to provide educational information about colon cancer screenings during mammograms in the hopes of encouraging more women to get their colon checked. She believes screenings such as mammograms and PSA tests for prostate cancer provide a teachable moment to encourage other screenings habits.
5. Colonoscopy can remove any precancerous polyps before they become malignant. All in one test, you can get tested and treated. By stopping these polyps in their tracks, periodic colonoscopy could prevent as many as 90 percent of colon cancers.
6. Age is the No. 1 risk factor for colon cancer. In fact, 91 percent of colon cancers are diagnosed in people age 50 or older. The American Cancer Society recommends people 50 or older be screened regularly for colorectal cancer. Screening methods include colonoscopy, flexible sigmoidoscopy, fecal occult blood test and digital rectal exam.
7. You can help save your friend’s life too. The U-M Cancer Center is sponsoring the Polyp Pest, a placard that hangs on your bathroom door to remind you to get your colonoscopy. When you’ve had yours, you hand the Polyp Pest off to a friend, encouraging him or her to get screened as well.
Revision date: July 8, 2011
Last revised: by Janet A. Staessen, MD, PhD