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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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In this Article

• Disease prevention in men introduction
• High blood pressure (hypertension)
• Hypercholesterolemia, hyperlipidemia, dyslipidemia
• Type II diabetes mellitus
• Human immunodeficiency virus (HIV)
• Cancer of colon and rectum /polyps of colon and rectum
• Prostate cancer
• Glaucoma
• Melanoma and other skin cancers
• Bladder cancer
• Disease Prevention in Men Index

Colorectal cancer is the second most common cause of death from cancer overall, and ranks third in both women (after lung and breast cancer) and men (after lung and prostate cancer).

Scientists believe that majority of the colon cancers develop from colon polyps (precancerous growths on the inner surface of the colon). After turning cancerous, the cells can then invade or spread (metastasize) to other parts of the body. If these polyps are identified and removed before they turn cancerous, colon cancer can be prevented. Colon cancer is curable if it is surgically removed before the cancer spreads.

• Stool occult blood test: A fecal occult blood test is a chemical test to detect trace amounts of blood in stool. It is inexpensive and easy, though not always accurate. Some cancers are not detected with this test, and many positive tests are due to conditions other than cancer.
  
  
• Flexible sigmoidoscopy: A flexible sigmoidoscopy is a relatively quick and easy office procedure that allows direct visualization and biopsy of suspicious lesions from the distal (end) portion of the colon. The drawbacks include some discomfort and is not as thorough as colonoscopy.
  
  
• Optical colonoscopy: Optical colonoscopy is the isualization of the entire colon. This is the most complete and thorough test, but often requires IV sedation, much more expensive, and is not covered by some insurance for screening.
  
  
• Virtual colonoscopy: Virtual colonoscopy is a less invasive procedure utilizing CT scan to construct virtual images of the colon that are similar to the views of the colon obtained by direct colonoscopy. The drawbacks to virtual colonoscopy are that it cannot remove polyps, and is not as reliable as optical colonoscopy in detecting small polyps, finding flat cancers, or polyps that are not protruding.

Who to test and how often

• All healthy adults should have stool occult blood tests and flexible sigmoidoscopy at age 50, followed by stool occult blood annually and flexible sigmoidoscopy every 5 years.
  
  
• Alternatively, instead of flexible sigmoidoscopy, all healthy persons can undergo screening colonoscopy at age 50 and then every 10 years if no prior history of polyps or cancer.
  
  
• Those at higher risk for colon cancer (individuals with family history of colon polyps and cancer, long standing ulcerative colitis, or prior personal history of colon polyps or cancer need colonoscopy earlier and at shorter intervals.

Benefits of early detection

Stool occult blood test, flexible sigmoidoscopy, and colonoscopy are documented to reduce colon cancer mortality by:

• Preventing colon cancer by identifying and removing polyps before they become cancerous; and
  
  
• Increasing the cancer cure rate by identifying early cancer at a treatable stage before the cancer has spread (metastasized).