Colon Cancer Screening: What You Should Know
By Alan S. Peterson, MD
What is a colonoscopy?
A colonoscopy is a test that checks the colon for cancer or polyps (finger-like growths). To do this, your doctor looks into your rectum and colon with a long flexible tube with a camera at the end of it.
If your doctor finds growths, called polyps, these can be removed at the time of the colonoscopy. The removal of the polyps does not cause pain. Sometimes these polyps are benign, which means they are not cancer causing, however, sometimes polyps are cancerous or can turn into cancer (precancerous).
Who should get one?
You should be tested for colon cancer at age 50 if you have no personal or family history of bowel or colon cancer. You should begin testing earlier than age 50 if there is a family history of colon cancer or polyps. The age you should begin getting tested depends on how many family members have had bowel cancer or polyps and their ages when they were diagnosed. Your doctor can help figure this out for you.
If the results of your colonoscopy are normal, you don’t need to have another one for 10 years. You will need to be screened more often if you have polyps removed that are precancerous (adenomas) or obviously if you have colon cancer.
What if I have polyps removed that are not cancer?
You will need to have another colonoscopy if you have any polyps removed. How often depends on the type of the polyps you had, how big they were, and how many you were found to have.
Once again, if your polyps were completely benign and not precancerous (adenomatous), one usually suggests a follow-up colonoscopy in 10 years. However, if you’ve had adenomatous polyps or if you’ve had a true cancer or carcinoma found at colonoscopy, you will need to have colonoscopies more frequently.
There are some families that inherit genes that cause multiple polyps in the colon. If you are in a family with this diagnosis, you not only should be getting your colonoscopies more frequently, but be getting them at a much earlier age.
Many of you have probably heard about a new technique called Virtual Colonoscopy. This does not require a prep. More research is being done especially in view of the more recent findings that some colon cancers and polyps can be flat and not stick out into the lumen (or opening) of the bowel. This can make them more difficult to discover. Only further research will determine whether or not Virtual Colonoscopy can discover these as well as the colonoscopy that is presently being done.
If you had surgery to remove part or all of your colon, you will need further colonoscopies after the surgery at a frequency to be determined by your physician.
Where can I get more information?
Obviously your primary care physician or your gastroenterologist is an excellent resource. The Academy of Family Physicians website at http://familydoctor.org or the American Cancer Society at http://www.cancer.org are also excellent resources.
Colon cancer for most of the population is a preventable disease. Once you get over the initial anxiety of the “unknown” concerning a colonoscopy, most of my patients feel that it is not such a burden, especially in view of the fact that this can prevent an early demise from a metastatic or spreading tumor that originates in the intestines.
Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.