Colon Cancer Screening (cont.)
Patients with history of colorectal cancer
Individuals who have undergone colon cancer surgery
are at higher risk of developing another colon cancer in the future.
It usually is recommended that they undergo a repeat colonoscopy after 6 to 12 months and every 3 years
thereafter. Early detection and treatment of future polyps and early cancers can
significantly improve chances of survival. The annual testing of stool for
occult blood continues.
Patients with ulcerative colitis
Patients
with long standing ulcerative colitis also have a
higher risk of
developing colorectal cancer. The risk of developing colon
cancer is
proportional to the duration of disease and to the extent of
colon
involved by colitis. Thus, patients with chronic ulcerative
colitis
involving the entire colon should have a colonoscopy every 1
to 2
years after having the colitis for 10 years or more. During
the
procedure, biopsies are taken from the colon to look for
early,
microscopic precancerous changes in the cells. If precancerous cells are
detected, colonoscopy is repeated 3 months later. If still present,
doctors
may discuss with the patient the benefits of surgically removing the
colon
to prevent colon cancer. If the colitis is limited to only the
left colon,
the same surveillance program is started 15 years after the onset
of colitis. For more information, please see the Ulcerative
Colitis article.
Family history of colorectal cancer
Colorectal cancer may run in
families. Colon cancer risk to an
individual is even higher if more than one immediate family member
(parents, siblings or children) has had colorectal cancer, and/or the family
member
developed the cancer at a young age (less
than 55).
Under these circumstances, it is recommended that individuals undergo a colonoscopy every
three years
starting at an age that is 7-10
years younger
than the age at which the family member who developed colorectal cancer
at
the youngest age developed his or her cancer.
If only one immediate family member developed colorectal cancer at an advanced age, the
colon cancer risk
to the individual is still higher than average but not as
high as
if two immediate family members developed colorectal cancer or if a family
member
developed colorectal cancer at an early age. Whether and when
to perform
screening colonoscopies in these individuals are best decided jointly
by
the individuals and their doctors.
Next: What are hereditary colon cancer syndromes? »
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