Disease Prevention in Women (cont.)
Cancer of colon and rectum / polyps of colon and rectum
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.
Colon cancer is preventable by removing colon polyps before they turn
cancerous. Colon cancer is curable if resected before the cancer spreads.
Screening tests
- Stool occult blood test:
Stool 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 by the test, and many positive tests are not caused by cancer.
- Flexible sigmoidoscopy:
Flexible sigmoidoscopy is a relatively quick and easy office procedure that
allows direct visualization and biopsy of suspicious lesions from the
distal portion of the
colon, but causes some discomfort, and is not as thorough as
colonoscopy.
- Colonoscopy:
Colonoscopy allows visualization of the entire
colon and is the most complete and thorough test, but often requires intravenous
sedation, is much more
expensive, and is not covered by some insurance for screening. Although
screening colonoscopies may have a slightly higher risk of complications than
flexible sigmoidoscopies, both screening tests are very safe when performed by
trained professionals.
Who to test and how often
All healthy subjects should have stool occult blood tests and flexible
sigmoidoscopy at age 50, followed by stool occult blood annually and flexible
sigmoidoscopy every five years.
Alternatively, instead of flexible sigmoidoscopy, all healthy subjects can
undergo screening colonoscopy at age 50 and then every 10 years if tests remain
normal and there is no prior history of polyps or cancer.
Higher risk subjects (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 have been
documented to reduce colon cancer mortality by:
- Preventing colon cancer by identifying and removing polyps before they
become cancerous
- Increasing cancer cure rate by identifying early cancer at a treatable
stage before the cancer has spread (metastasized.)
Next: Bladder cancer »
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