Colorectal Cancer Prevention Can Be As Easy As Having a Screening Test

The number of colorectal cancer diagnoses in the United States has been decreasing steadily for the past several decades, and scientists at the American Cancer Society say that the declines are likely due to increased screening for the disease.

Colonoscopy is considered the gold standard for colorectal cancer screening. The test can detect colorectal cancer in its early stage, when the disease is highly curable, and it helps prevent the disease by locating and removing polyps (precancerous growths) before they can develop into cancer.

“A colonoscopy is preventative medicine at its best,” confirms Felice H. Schnoll-Sussman, MD, associate professor of clinical medicine at Weill Cornell Medicine. “It can save you from developing colon cancer.” However, even though it’s clear that colonoscopy literally saves lives, many women don’t get screened because they have anxiety about the preparation for the test, and they fear that the results may be a diagnosis of cancer.

The Colonoscopy Procedure

During a colonoscopy, a thin, flexible tube with an attached video camera is inserted into the rectum. Your doctor threads the tube throughout the entire length of the colon (large intestine), looking for abnormal growths and areas of inflammation or bleeding. Tissue samples may be collected for analysis, and any abnormal growths are removed. A colonoscopy takes about 30 minutes, and patients are given a sedative so they are asleep during the procedure.

Preparation for the procedure requires clearing out all contents of the colon so the camera can get the best possible view of the walls of your colon. The prep involves following a clear liquid diet the day before the exam and taking laxatives. The prep may be unpleasant, but it is safe, short-term, and has no side effects.

Preparing for the Prep

Before you start your prep, which begins the day prior to the procedure, stock up on clear broths, fruit juice, jello, ice pops, and/or soft drinks to consume while you are fasting, but avoid anything that is red or purple in color.

If your doctor has prescribed a liquid laxative, it may have an unpleasant taste that’s difficult to get down; ask your doctor what can be mixed with the laxative to improve the taste. If you’re concerned that you can’t drink all of the laxative, ask your doctor if you can take the laxative in pill form instead. Make sure your schedule is clear and you can stay at home once you’ve ingested the laxative; if possible, declare one bathroom “yours” until you leave for the procedure the next day.

Screening Schedule

Routine colonoscopies are recommended for women beginning at age 50 and continuing up until at least age 75. Begin exams earlier if you have a family history of colon cancer or a personal history of inflammatory bowel disease.

If the results are normal and no polyps are detected, retesting is recommended every 10 years. If any polyps are found, your doctor may recommend rescreening every three to five years.

For adults age 76 or older, the benefits of colorectal screening are less clear, since it takes about 10 years for a new polyp to develop into cancer. If you’re in this age group, discuss the pros and cons of having a colonoscopy with your doctor.

Other Screening Options

If you are unwilling or unable to undergo a colonoscopy, other tests are available. An increasingly popular test is Cologuard, an at-home test that can detect blood and/or abnormal DNA that may be shed into your stool from cancer or polyps.

A test that can detect hidden blood in the stool is a fecal immunochemical test (FIT). However, colonoscopy remains superior to FIT in locating non-advanced tumors, and if FIT detects blood, a colonoscopy will be required for further investigation.

Finally, you may be a candidate for a “virtual colonoscopy,” in which a small tube is placed in the rectum to inflate the colon and a computed tomography (CT) scan takes images of the colon. A colon cleanse is still required, but a CT colonography is not as invasive as a colonoscopy. However, if any polyps are detected, you’ll need a conventional colonoscopy to remove it.

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