March 14, 2006

CORRECTED — Colonoscopy deemed best for colon cancer check

Edited to remove "and the American Cancer Society
recommends that everyone 50 and older have the test regularly"
from the ninth paragraph to clarify. Corrected version follows.

By Anne Harding

NEW YORK (Reuters Health) - 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. 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.