March 14, 2006
Colonoscopy Deemed Best for Colon Cancer Check
By Anne Harding
NEW YORK -- Colonoscopy isn't only the gold standard for screening for colon cancer; it also enables precancerous growths or polyps to be removed there and then during the inspection of the colon. If everyone had regular colonoscopy, up to 90 percent of colon cancers could be prevented, experts agree.
"I really feel that colon cancer should be a disease that we should be able to wipe out," Dr. Kim Turgeon, an associate professor of gastroenterology at the University of Michigan Medical School in Ann Arbor told Reuters Health.
"Despite that, the rates are really pretty much the same every year," she added. "So many times when I make the diagnosis of colon cancer I really wish I'd met that person just a few years before that."
Every year in the US, she noted, 140,000 to 150,000 new cases will be diagnosed, and 50,000 to 60,000 people will die from the disease.
March is Colon Cancer Awareness Month, and Turgeon and her colleagues at the University of Michigan have produced a series of tips and facts about the disease. These are some of them:
Having a family member who's been treated for polyps or colon cancer makes it more likely that a person will also develop pre-cancerous or cancerous colon growths, Turgeon notes. But she adds that this is the kind of topic that often isn't discussed, even within families.
Age is an important factor. The Michigan team notes that 91 percent of colon cancers are diagnosed in people 50 or older, so anyone in that age group should be screened regularly.
If your insurance company doesn't cover colonoscopy as a screening test -- many don't -- get another test: for example, a flexible sigmoidoscopy or a test for blood in the stool known as a fecal occult blood test (FOBT). If any problems are revealed, your doctor can determine if a colonoscopy is necessary, and your insurer will probably pay for it.
But colonoscopy is the gold standard, and the American Cancer Society recommends that everyone 50 and older have the test regularly. A study by Dr. Philip Schoenfeld at the University of Michigan found that flexible sigmoidoscopy or FOBT would have missed 65 percent of advanced precancerous polyps in women.
Tests to check for cancer-related DNA or other proteins in the stool are under investigation by Turgeon and many other researchers, and could one day replace colonoscopy as a screening tool.
Virtual colonoscopy is another option, although it also requires that a person undergo colon cleansing to prepare for the test. "The name is better than the reality," Turgeon said. For now, she and her colleagues agree, standard colonoscopy remains the best option.
SOURCE: University of Michigan Health System.