Wallop the Polyp!

The Best Way to Prevent Colon Cancer Is Through Screening

Jack Goldstein, MD, FACP, FACG
Gastroenterologist, Cooper Digestive Health Institute
Associate Professor of Medicine, Cooper Medical School of Rowan Univerisity

Colorectal cancer is the second most deadly cancer in the United States, but the good news is that it is one of the most preventable types of cancer. Yes, colorectal cancer can be prevented – not just detected – through colonoscopy.

Most colorectal cancers develop from polyps, which are abnormal growths in the colon. If polyps grow unnoticed and are not removed, they may become precancerous. The primary goal of a screening colonoscopy is to find and remove any abnormal growths or polyps. Because polyps may go through precancerous stages and eventually become cancerous, removing them during a colonoscopy eliminates the risk of polyp growth, thus preventing colon cancer. The development of more than 75 to 90 percent of colorectal cancer can be avoided through early detection and removal of precancerous polyps.

Screening is very important as most early colorectal cancers produce no symptoms. The following symptoms do not always indicate the presence of colorectal cancer, but should prompt a visit with your physician: Blood in or on the stool, change in stool caliber or shape, new onset abdominal pain, change in typical bowel habits, constipation, or frequent diarrhea.

Although colorectal cancer can present at younger ages, it is most common after age 50. It is generally recommended to get colonoscopies every 10 years beginning at age 50, but as we learn more about the role of genetics predisposing certain populations to colon cancer, some people may need to be screened earlier and more frequently.

Family history can be important in helping your doctor determine your risk of potentially developing cancer. Those who should be screened at an earlier age have a higher than average risk for developing colorectal cancer by virtue of: A personal history of colorectal cancer or colorectal polyps, a strong family history of colorectal cancer, inherited forms of colorectal polyps or cancer, predisposing conditions such as inflammatory bowel disease (ulcerative colitis or Crohn’s disease).

It is important to remember that the best screening test is the test that is done — and any test is better than no test. To determine which screening test is best for your individual needs, speak with your doctor. The gold standard is a colonoscopy which is a direct exam of the colon. It allows physicians to both detect and remove polyps. Other screening exams include stool test for blood (FIT), barium enema (X-ray), stool DNA, and CT colonoscopy. If any of these alternate tests are positive then a colonoscopy should ensue to assess further for pathology.

Remember, for average-risk individuals with no symptoms, screening should begin at age 50. If you have symptoms or increased risks, speak to your doctor. What other ways can you reduce colon cancer risks? Don’t smoke, limit alcohol consumption, exercise, and maintain a healthy weight. Also be sure to eat plenty of fruits, vegetables, and whole grains.