Showing posts with label Colon cancer. Show all posts
Showing posts with label Colon cancer. Show all posts

November 30, 2013

Colorectal Cancer Screening Numbers Too Low


Are you over the age of 50 years? Have you had colorectal cancer screening? Do you have a history of colorectal cancer in your family? If you answered yes to two of the three questions, then it is time to talk to your doctor about colorectal cancer screening. If you answered yes to all three questions, what are you waiting for, get-r-done. This is serious and needs attention. “Colorectal cancer is the second leading cause of cancer death in men and women in the United States, after lung cancer, yet is "preventable" through screening,” states CDC Director Tom Frieden, MD, MPH.

Current recommendations call for adults aged 50 years and older to be screened with one or a combination of the three following tests:

#1. A fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year

#2. Flexible sigmoidoscopy every 5 years, with FOBT/FIT every 3 years;

#3. Or, colonoscopy every 10 years.

The above are minimums for the average person, but many doctors will look to family history, grandparents, parents, and siblings before recommending any of the tests. I do not think much of #1 above as most times a positive for these tests indicates you may already have colorectal cancer and may need a section of your bowel removed.

Many doctors think #2 above is sufficient for most purposes, but again this is only doing a partial examination of the colon. If the polyps are beyond the scope of this exam, then colorectal cancer will still develop.

While many people do not like colonoscopies, this is the best test and will prevent colon cancer from developing. I can attest to the value of this, as my first colonoscopy was preformed, on a lark, at age 55 and I had four polyps, one that the oncologist stated from his experience was within about six months of being cancerous. This made a believer out of me and I have had colonoscopies regularly since then at generally every three years.

But you say #3 above says every 10 years. That is correct until the first polyp(s) is discovered. Then the polyp(s) is checked for cancer or the types of cells leading up to cancer and if this analysis is positive, you are scheduled for an exam every three years. When the polyp(s) is clean or free of cancer promoting cells, then you will be scheduled for an exam in five years. If after the first polyp(s) are discovered and you are polyp free on the next exam, you will also be scheduled for another exam in five years. This is what Medicare and most insurance companies require.

I would much prefer one or two days of discomfort every three years to know that I do not have colon cancer. “In 2012, 65.1% of US adults were up-to-date with colorectal cancer screening and 27.7% had never been screened.”

According the Dr. Frieden, “The 2012 data show that colonoscopy is now the most commonly used screening test (61.7%), the CDC said. Colonoscopy was used by more than 53% of the population in every state. There has been a "big increase" in colonoscopy screening in recent years. However, use of the other recommended tests was much lower: 10.4% for FOBT and 0.7% for flexible sigmoidoscopy in combination with FOBT/FIT.”

If you are scheduled for a colonoscopy, please be sure to discuss all medications with the doctor. There are blood thinners that need to halted several days, up to a week or more, before the procedure, Metformin needs to be stopped as well, and these should not be restarted until a few days after the procedure. There may be other medications that require this as well; therefore, please discuss this with the doctor.

April 24, 2012

Colorectal Cancer Screening – Is More Options Better?


Speaking from a patient viewpoint, yes, I can agree that some people may need more options with colorectal cancer screening. What this study is showing is that among minorities, adherence to colorectal cancer screening is poor or not done because they do not want to go the colonoscopy route.

I consider myself lucky that I went the colonoscopy route 14 years ago. I did not have any family history of colon cancer, but I had lost both parents to cancer and was just doing the colonoscopy on the spur of the moment. How fortunate I was as the oncologist declared that one of the polyps removed was about six months precancerous. I have had several colonoscopies since and except for one time have had polyps removed.

I can understand why many people resist having a colonoscopy as it is not something I enjoy either – it is invasive. However, with my personal history of polyps, I will continue to have them as often as my doctor orders them. I do not want to use the fecal occult blood testing (FOBT) as this means that the cancer already exists when the test is positive.

Not only do you have cancer when the FOBT comes back positive, if not caught early enough, the cancer may metastasize (spread to other parts of the body). I would rather be uncomfortable for a day or two and have the colonoscopy than go through the operation (very invasive) of having part of my colon removed or having chemotherapy and radiation.

For those interested, you may read about colon cancer here. There are several parts to the discussion and you may use the next button at the bottom of the printed material and read all the pages. If you feel better after reading all the material, you should have a better understanding of the different tests and laboratory tests and the pros and cons of each. You may want to consider bookmarking the page and be able to refer back to it later.

If you have a history of colon cancer in your family, please consider the colonoscopy as your prevention of colon cancer. If you have a history in your family, consider age 40 as time to start having colonoscopies. Otherwise, age 50 is the recommended age for checking out your colon.