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Health Information | 03/04/2019

Colorectal Cancer: Prevention is Possible

By  Dr. Daniel Mishkin
colon cancer prevention

March is Colorectal Cancer Awareness month, and as a gastroenterologist, I urge all of my patients to get educated about this cancer. The sobering facts are that colorectal cancer is the third most common cancer and the second leading cause of death from cancer in the United States. However, the optimistic news is that colorectal cancer can be prevented or caught and treated early in many people through the screening tools we have, and if everyone age 50 and older were screened regularly, 6 out of 10 deaths from colorectal cancer could be prevented.

What Is Colorectal Cancer? 

Colorectal cancer is a disease in which cancer cells form in the tissues of the colon. Most of the time, it begins with the growth of benign polyps known as adenomas. Over a period of time, these polyps can grow larger and become malignant, developing into a tumor. Because this process can take time, early detection and screening are important to identify the colon polyps before they develop into cancer.

Who Is at Risk?

The Colon Cancer Alliance (CCA) reports that about 90 percent of colon cancers occur in people aged 50+, and the median age of diagnosis is 68 in men and 72 in women; however, incidence rates in adults younger than 50 years are on the rise, from 6% of cases in 1990 to 11% of all cases in 2013. The CCA has also found that African-American men and women have a higher risk of developing colon cancer and a lower survival rate compared to Caucasians, Asians, Hispanics and Native Americans, partly because of disproportionate screening rates. The correlation between a person’s diet, weight, and exercise level and colon cancer risk is one of the strongest for any type of cancer. A person’s risk for the disease also increases with smoking, heavy alcohol consumption, a personal history of chronic inflammatory bowel disease, and/or family history. As many as one in five people with colon cancer have other family members who have had it.

What Are the Symptoms?

Oftentimes there are no signs or symptoms of colorectal cancer - that's why it's so important to get screened. However, there can be physical warning signs for colorectal cancer that should be evaluated and may potentially indicate a problem. These include:

  • Blood in or on the stool (it could be bright red or dark in color)
  • Recurring changes in normal bowel habits (experiencing diarrhea or constipation without an identified cause)
  • Thinning of the stool
  • Unexplained abdominal discomfort
  • A feeling that the bowel does not empty completely
  • Weight loss without an identified cause
  • Constant and unexplained fatigue

If you are experiencing any of these symptoms, please consult a physician in order to rule out colorectal cancer or diagnose it early for the best chance at recovery. The only proven screening method that can also remove these precancerous polyps that can turn into cancer is a colonoscopy. While a person is under a form of sedation, a doctor uses an instrument called a colonoscope to view the inside walls of the colon. If polyps are found, they can be removed before they can become cancerous.

When Should You Begin Regular Screenings For Colorectal Cancer? 

For most people who do not have a personal or family history of colorectal cancer or other risk factors, screening should begin at the age of 50. In the past year, the American Cancer Society revised its guidelines to begin screening those with average risk at age 45, due to a recent sharp increase in colorectal cancers among people between the ages of 45 and 49. But this “qualified recommendation” is based only on incidence rates and not on evidence from clinical studies. Other medical organizations, including the American Academy of Family Practitioners (AAFP) and the American Gastroenterological Association, as well as the US Preventive Task Force (USPTF), an independent organization that evaluates the efficacy of screening test guidelines, continue to recommend starting screening at age 50 for those with average risk.

Men and women with a personal or family history of colon cancer or polyps, conditions such as ulcerative colitis or Crohn’s disease, or hereditary colon cancer syndromes, should most likely start screening for colon cancer before the age of 50.

At Atrius Health, we proudly operate two state-of-the-art Endoscopy Centers located in our Kenmore practice in Boston and at our Atrius Health Endoscopy Center in Weymouth. We provide a broad spectrum of services including colonoscopy, upper gastrointestinal endoscopy and flexible sigmoidoscopy. Our team of doctors, nurses and medical assistants is very experienced and performs more than 22,000 procedure each year. Our patients consistently rate our nursing staff very highly, and our physicians pride themselves on their high quality scores year after year.

Let us help you prevent colon cancer by screening for this preventable disease. There are now multiple test options that you can use to screen for colon cancer, but we strongly recommend having a screening colonoscopy.  A colonoscopy provides both a diagnostic and therapeutic benefit by removing pre-cancerous polyps in the hopes of preventing cancer from ever developing.

About The Author

Dr. Daniel Mishkin

Dr. Daniel Mishkin, CM, FRCP(C), FASGE, FACG, AGAF joined Atrius Health in 2008. Dr. Mishkin attended medical school at McGill University School of Medicine, Montreal, Quebec, where he also completed his internship and residency. He completed his fellowship in gastroenterology at Montefiore Medical Center, part of the Albert Einstein College of Medicine, Bronx, NY. He has personal interest and experience with new technologies and specifically the evaluation of the small intestine. He makes the time to teach at Harvard Medical School where he focuses the next generation on the importance of the doctor-patient relationship.

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