Colon Cancer: Myths vs. Facts
The second biggest killer is preventable—so why do so few get screened?
Did you know that if detected early, cancer of the colon or rectum is one of the few cancers that’s highly curable?
That means that a large portion of the nearly 50,000 deaths in 2008 might have been avoided with a quick, painless screening. In fact, according to the Centers for Disease Control and Prevention, over 60 percent of colon cancer deaths can be prevented every year. Colon cancer stubbornly remains the second biggest cancer killer in the United States.
Myths Affecting Colon Health
“Women think it’s a man’s disease; they may confuse it with the prostate,” says Dr. Tara Troy, a gastroenterologist with the group Associates in Gastroenterology and Liver Disease. Dr. Troy’s group performs procedures at both the main Northwestern Lake Forest Hospital campus and at the new Lake Forest Endoscopy Center in Grayslake. Both facilities offer new state-of-the-art digital imaging equipment.
“But men and women are affected equally,” she says. “Thousands of women get this disease, and about half of them die from it.”
According to Dr. Troy, there are several myths and attitudes that keep people from getting screened:
- The incorrect perception among women that colon cancer is “a man’s disease” similar to prostate cancer. Men and women are affected equally by colon cancer.
- They believe they should have symptoms. Most people with colon polyps or even the early stages of colorectal cancer experience no symptoms—get screened even if you feel healthy.
- Hesitation, embarrassment, or lack of time to discuss with the Primary Care Physician (PCP).
“It’s an awkward subject for a lot of people,” says Dr. Troy. “But this conversation can be a lifesaver.”
Screen at age 50 or sooner
“The main risk for colon cancer simply comes from getting older. So everyone should get screened for colon cancer starting at age 50. And if you’re African American, the latest recommendation is age 45,” says Dr. Troy.
However, she cautions, this is a general guideline. A person with a family history of colon polyps or colorectal cancer, personal health conditions such as ulcerative colitis, Crohn’s disease, or certain symptoms, may need an evaluation earlier.
Dr. Troy: “For example, if you’re 40 years old and experiencing abdominal pain, a change in bowel habits, or rectal bleeding, you should talk to your doctor about possibly needing an examination sooner.”
Colonoscopy – still the best screening option
Colonoscopy provides a direct view of the entire colon and allows for the detection and removal of polyps. Polyps are small fleshy growths lining the colon and rectum that grow slowly and can become cancerous. Other options are now available, such as a stool test or barium enema. There’s also a virtual colonoscopy using a CAT scan, and a flexible sigmoidoscopy, which is a limited test looking at just the last third of the colon.
So, which option should a patient choose?
“There are many test options available and your health care provider can explain more and help you decide what test is best for you. Importantly, the colonoscopy is the only test that allows for detection and removal of polyps at the same time that you’re screening for them,” says Dr. Troy. “However, the preparation, which is the part most people are anxious about, is actually the same for all of the imaging tests. And if polyps are detected on another type of colon imaging, they’re going to need the colonoscopy anyway to remove them.”
Dr. Troy is quick to point out another misconception about colonoscopies: that they might be painful or embarrassing. “You’re sedated throughout the procedure,” she says. “In fact, most patients say ‘it’s a piece of cake’ and that the preparation is the only hard part.”
For these reasons, along with the test’s accuracy, the American Gastroenterological Association still considers colonoscopies “the gold standard” for screening.
Preventing colon cancer
There is no way to completely eliminate the risk of developing colon cancer, but a regular screening is the single most important thing you can do to lower your risk.
“You have a 1 in 18 chance of getting the disease. Those are significant numbers,” says Dr. Troy. “But with screenings we can remove the tissue that can lead to cancer and risk stratify you—determine whether your body is a ‘polyp maker’ and take appropriate preventative measures.”
She adds one final, often overlooked benefit: “It’s a good thing to do for your family, too. Knowing your risk gives your children and relatives powerful information for prevention.”