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Colon Cancer: Why Screening is Important

By Kavitha Gopal, MD Email By Kavitha Gopal, MD
June 2014
Colon Cancer: Why Screening is Important

Colon cancer or colorectal cancer is cancer developing in the large intestine (the colon). The colon is the last part of our digestive tract. It absorbs water and small amount of nutrients before eliminating solid waste from our body. Cancer in the colon is the third most common cancer worldwide in both men and women, accounting for over 600,000 deaths each year. Historically, most South Asian countries maintained a relatively low number of colon cancer cases per year compared to developed nations—but this has changed rapidly over the last two decades and we are witnessing rising numbers of colon cancer per year amidst South Asian communities. One study observed colon cancer numbers among Indians in four different geographical areas: results revealed that Indian immigrants to the United Kingdom and USA have relatively higher chances of developing colon cancer, suggesting that life styles and dietary habits may contribute to development of colorectal cancer.

The majority of colon cancers arise from growths in the colon, called polyps. Once a polyp develops cancer, it will start growing through the colon wall and spread to the rest of the body. Symptoms of colon cancer include bleeding from the rectum, blood in the stool, unintentional weight loss, excessive fatigue, stomach pain or cramps, iron deficiency anemia, and change in bowel habits (constipation, diarrhea, change in stool size, etc.). Unfortunately most patients do not have symptoms for dangerously long periods depending on the location of cancer in the colon. A significant number of patients have advanced cancer before they develop any warning signs, and chance of death is very high if colon cancer is diagnosed in advanced stages. Only 1of 3 colon cancers are currently detected in the early treatable stage.

Age is an important predictor for colon cancer; the risk is 15 times higher in men and women over 50 years of age. Family history of colon cancer, personal history of colon polyps, and certain conditions like Crohn’s disease or ulcerative colitis increase the risk. Smoking, heavy alcohol intake, obesity, sedentary lifestyle, and consumption of a diet high in red meat and low in fiber escalate the possibility of developing colorectal cancer.

Fortunately, we can decrease deaths from colon cancer by adequate screening. Cancer screening is a term used to describe tests used by your doctor to detect any small cancers or prevent cancer in an otherwise healthy person. Over the last decade with the help of appropriate screening, excellent progress has been made in decreasing the number of colon cancer-related deaths. Colon cancer screening is recommended for both men and women from 50 years of age or earlier depending on risk factors. This screening is available in most medical and gastroenterology centers. Methods of screening include stool and colon examination. Colonoscopy is a procedure which allows your doctor to examine the lining of the colon for abnormalities. In addition to detecting any existing colon cancer, screening colonoscopy can PREVENT colon cancer by removing colon polyps. Even in the presence of colon cancer, if detected early, colon cancer treatment is very effective and cure is close to 90%.

All cancer screening, including colon cancer screening, should be discussed with your physician. Your risk for colon cancer, and the timing of your screening, and the anesthesia used will be evaluated based on age, family history, underlying risk factors, and medical history. Furthermore, healthy changes in diet and lifestyle will help to improve your colon health. Maintain a normal body weight and exercise regularly. The American Cancer Society recommends at least 30 minutes of exercise a day for 5 or more days a week. Consume a diet rich in fiber, fruits, and vegetables every day. Calcium-rich food and vitamin D also appear to decrease colon cancer risk. Avoid smoking and limit or avoid alcohol intake. Most of the lifestyle changes that help your heart also reduce your risk of colon cancer, but these are not alternatives to regular colon cancer screening.

Colorectal cancer used to be the second most common cancer-related death in the US. Thanks to screening, the numbers are diminishing significantly, and this cancer has now dropped to third cause of cancer-related death. So talk to your physician about colon cancer screening and take the first step in avoiding the consequences of this potentially preventable cancer.


[Dr. Kavitha Gopal is a board certified gastroenterologist with special interest in liver diseases, colon cancer screening, inflammatory bowel disease, irritable bowel syndrome, and treatment of acid reflux disorders.]

[Gulshan Harjee, M.D., is a board certified internist in private practice with an emphasis on prevention. Please email your health and medical questions for consideration in this column to: gharjee@comcast.net. The material in this column is of a general nature, and must not be construed as specific medical advice. This column rotates monthly along with the Fitness Lifestyle column by Aarti Patel.]



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