Prevent colon cancer with screenings

Periodic screening is the best cure for colon cancer.

“When caught early, colon cancer is a curable disease,” says Dr. David Laird, a board-certified surgeon at Jackson Surgical Associates.

“Unfortunately, too many people are not being told to get colon screenings or they are not listening to that advice,” he says. “We are still seeing a lot of advanced colon cancer because it wasn’t caught earlier in a screening.”

The need for colon cancer screenings is proven in the statistics: The five-year survival rate for the patient with a superficially thin lesion is 97 percent. The rate drops to 90 percent if the cancer reaches the next stage, but is still confined to the colon. The five-year survival rate drops to 40-75 percent if the cancer has metastasized and spread to the lymph nodes.

It is frustrating for a surgeon like Dr. Laird to see advanced colon cancer when he knows it could have been easily prevented. His mother was diagnosed with the disease in 1989 – in the days before colon screening was aggressively pushed – and died of the disease four years later.

Under the recommendation of the American Cancer Society, aggressive screening started in the last 10 years, Dr. Laird says, and it has saved many lives.

For those people who have no symptoms and no immediate family history of colon cancer, screening should begin at age 50 with a colonoscopy, Dr. Laird says. As of July 2001, Medicare pays for a screening colonoscopy for asymptomatic, average-risk patients every 10 years, starting at age 50, because it is cost effective and it saves lives, he says. These asymptomatic patients also should have a yearly fecal occult blood test and a flexible sigmoidoscopy test every three to five years.

The screening regimen is different for people who have symptoms, such as blood in the stool or a change in bowel habits, or if an immediate family member had colon cancer. Those with symptoms need to schedule a colonoscopy right away with their family physician or gastroenterologist; those with a family history should schedule their first colonoscopy at least 10 years before the age their family member was diagnosed with the disease, Dr. Laird says.

Routine screenings will detect polyps, an abnormal growth in the colon that could become cancerous. “It is hard to say how long it takes the polyp to become cancerous or how long it takes a cancerous lesion to metastasize,” Dr. Laird says, pointing out the reason for routine screenings.   

If a polyp is found during screening, it is removed and sent to a pathologist for biopsy. The patient should then have another colonoscopy in one to three years.

If the polyp is cancerous, Dr. Laird said, the patient will be referred to a surgeon, who will remove that affected portion of the colon and connect the colon together again. A colostomy is needed in those rare cases when the tumor is too close to the anus, he says. If the cancer has spread, the patient also will have chemotherapy, he adds. With rectal cancer, a patient may have chemotherapy and radiation to try to shrink the cancer before surgery is done.