(Philip M. Bonaparte, MD is a physician, ordained bishop and the Chief Medical Officer for Horizon NJ Health is the state’s largest managed health care company, committed to expanding access and enhancing the quality of health care to New Jersey’s publicly insured).

Q:  My 52-year-old husband is fairly healthy, but he has not seen a doctor for some time. I finally had him agree to get a check up and his doctor recommended that he get a colonoscopy to screen for colon cancer or colorectal cancer. What is this test and why is it needed?

A:  First, let me commend you on loving your husband enough to encourage him to be pro-active and to take charge of his health.

Though there are other less invasive methods of colorectal cancer screening, medical groups recommend a complete colonoscopy as the most effective screening method for detecting colon cancer. The colon or large bowel is the last portion of your digestive or GI tract. A colonoscopy is a fairly routine, safe, and quite effective procedure used to look inside your colon in order to examine the lining of the colon and rectum to visually detect any problems.

Generally, colonoscopies are performed on an outpatient basis, with minimal inconvenience and discomfort. A complete colonoscopy requires bowel preparation before the screening exam, but your husband will be happy to know that the test is painless and is usually less than an hour. In order to help the patient (your husband) relax, an intravenous or IV line is used to add medication.

The colonoscopy can help detect or even painlessly remove a suspicious-looking polyp or growth for analysis, thus avoiding unnecessary surgery. Polyps are grape-sized growths that can be found on the lining of the colon or rectum, which can potentially become cancerous. A colonoscopy can also help determine what further diagnostic tests might be needed, if any.

Colorectal cancer, also known as colon cancer, is a cancer of the colon or rectum and it is the second leading cause of cancer deaths in the US for both men and women. A colonoscopy screening test is recommended for anyone over 50 or at age 45 for African Americans, due to a higher incidence rate at a younger age. For anyone with a family history of colon cancer, screening should start at the age of 40 or 10 years younger than their youngest relative who was affected at the time of the diagnosis for colon cancer. For average and high risk individuals, any and all potential pre-cancerous polyps should be removed. (American College of Gastroenterology-ACG)

According to the American Cancer Society (ACS), overall cancer deaths in the US are decreasing, especially colorectal cancer deaths. From 2004 through 2005, experts saw a downward trend in cancer deaths. From 1998 to 2004, among men and women, deaths from cancer of the colon and rectum decreased. The data also shows that early detection contributed to this decrease in colon cancer deaths. Early detection of colorectal cancer, when it is most treatable, directly results in improved survival, exceeding 90 percent when detected at the earliest stage. (ACS).

Despite the studies that show colorectal cancer screening plays such a key role in reducing colorectal cancer deaths, these life-saving tests are not as commonly used, as they should be. Far too many individuals are unaware or do not take advantage of simple, preventive screening. (American College of Gastroenterology-ACG).

In a study, published in The Lancet Oncology ( February 18, 2008 ), a correlation was found between the insurance status and the stage of the cancer diagnosed. Patients who were uninsured were “two to three times more likely to be diagnosed at late stages (Stage III or Stage IV) than at Stage I.” Their study shows a definite disparity among the cancers that could be detected early through screening, including colorectal cancer.

We may not know exactly what causes colorectal cancer, but we can look at the risk factors to specific steps to help reduce those risks. Screening, for early detection is definitely one of those steps. However, you and your husband can take control of your diet and exercise habits. Eat plenty of fruit, vegetables, whole grain foods and reduce or limit your consumption of high fats. The recommendation from the American Cancer Society (ACS) is a good lifestyle improvement you can do. The ACS recommends at least 30 minutes of physical activity on 5 or more days of the week and 45 to 60 minutes of exercise on 5 or more days of the week is better.

Your husband is very fortunate to have someone who cares and someone who can motivate him to take the simple, but necessary steps for living a longer, healthier life. Families, neighbors and friends must also be proactive in helping to educate or, at the very least, encourage their loved ones about the impact and importance of screenings that are proven measures for saving lives.

Although men and women are equally affected, there are disparities in incidence and death rates related to racial, ethnic groups and economically-disadvantaged groups.

• Low-income and/or minority individuals bear a higher burden of cancer mortality than do higher income, non-minority individuals
• African Americans are 34% more likely to die of cancer than Whites
• African Americans are more likely to die from cancer than other ethnic minorities (e.g. Asians, Hispanics)
• African American women are more likely to die from breast and colon cancer than any other ethnic group
• African American men are more likely to die from colon, lung, and prostate cancer than any other ethnic group (US Department of Health and Human Service, 2000)

These disparities can be reduced, when we educate and expand access to care.

http://www.cancer.org

For more information on colorectal cancer and recommended procedures:

American College of Gastroenterology –

COLON CANCER RESOURCE KIT FOR PHYSICIANS & PATIENTS

AMERICAN CANCER SOCIETY-Overview of Colon Cancer

American Gastroenterological Association

Disclaimer: The information contained in this column is of a general nature and cannot substitute for the advice of a medical professional. Even if a statement made about health is accurate, it may not apply to you or your symptoms. This article should not be construed as an attempt to offer or render a medical opinion or otherwise engage in the practice of medicine. Readers are strongly advised to seek the advice of a qualified medical professional.