By Karla Robinson, MD
With the recent passing of Dr. Malinda Sapp, wife of gospel artist Marvin Sapp, it is important that we take pause to discuss colon cancer in our community. Colon cancer is the third most common cancer in both men and women, and is the second leading cause of cancer-related deaths in the U.S. More than 60% of colon cancer deaths could be avoided with regular screenings. Screening is important because it can lead to finding precancerous growths (polyps) in the colon so that they can be removed before becoming cancerous.
The American Cancer Society reports that the death rates from colon cancer for African Americans are higher than any other ethnic groups. The diagnosis is typically made at more advanced stages when treatment and curative rates are lowest. In fact, colon cancer is most often diagnosed after it has metastasized or spread to other parts of the body. When detected at its early, localized stages, colon cancer has an 84% survival rate. Unfortunately, only 33% of colon cancers in African Americans are diagnosed at the early stages.
Who should be screened? EVERYONE over age 50.
Due to the increasing diagnosis of colon cancer at ages much younger than 50 years in the African American community, as in the case of Dr. Malinda Sapp, the American College of Gastroenterology recently changed its screening recommendations. They now recommend screening at age 50 for the average risk individual, but at age 45 for African Americans.
There are some risk factors which require more frequent screening or screening beginning at an even earlier age. These include: (1) a personal or family history of colon cancer or polyps, (2) inflammatory bowel disease, i.e. Crohn’s disease, or Ulcerative Colitis. If you are in these high risk groups, contact your doctor regarding an appropriate screening timeline for you.
There are some lifestyle factors which may also contribute to a higher risk of developing colon cancer. These include: (1) lack of regular exercise, (2) low fiber, high-fat diet
(3) being overweight, (4) alcohol use, and (5) tobacco use. These are definitely factors that are modifiable. We need to do our part to make sure we are living the healthiest life.
What are the screening tests? There are several methods of screening. These depend on your individual medical history and risk factors. Please discuss which tests are most appropriate for you with your doctor.
(1) Fecal Occult Blood Test: Checks for small amounts of blood which may not be visible in three consecutive stools. This is usually done at home with cards given to you at your doctor’s office and should be done yearly.
(2) Flexible Sigmoidoscopy: A flexible lighted tube inspects the inside of the rectum and a small portion of the colon. This should be performed every five years.
(3) Barium Enema: A series of x-rays of the colon and rectum after the patient is given an enema with barium dye. This should be performed every five years.
(4) Colonoscopy: A flexible lighted tube inspecting the inside of the rectum and the entire colon. This should be performed every 7-10 years. Biopsies can be performed and polyps can be removed during the procedure. This procedure can also be used as follow-up diagnostic testing if any of the above screening tests are positive.
At the end of the day, you have to know your body.
Our community has alarmingly high rates of colon cancer diagnoses in the 40-45 year old age group. This is the group that would not have been recommended for screening. We need to take the time to notice any unusual symptoms, and investigate them. It is also important to know your family history.
What are the symptoms? If you have ever or are currently experiencing any of these symptoms listed below, please speak with your doctor for a proper medical evaluation.
(1) Blood in the stool
(2) Sudden change in bowel habits
(3) Stools that have changed shape or are narrower than usual
(4) Unexplained weight loss
(5) Feeling of an urge to have a bowel movement, when there is no need to have one
If you are 45 years of age or older and have never been screened for colon cancer, please contact your doctor today!
This was printed in the March 25, 2012 - April 7, 2012 Edition