There is an old saying that “what you don’t know can’t hurt you.” Unfortunately, this is untrue when it comes to preventing colorectal cancer. Still, many people neglect taking a simple screening to learn whether they have this deadly disease until they begin noticing symptoms. By that time, the cancer has developed or spread, and surgery alone cannot assure a good chance for a cure. A simple screening—and the knowledge it brings—can mean the difference between a positive or fatal outcome.

The Third Most Common Cancer
The cancer of the colon or rectum, colorectal cancer, is equally common in both men and women. In fact, nearly 150,000 people were diagnosed in 2009, with almost a third of them dying from the disease. The good news is it doesn’t have to be the killer it has been! Although currently the second leading cancer killer, colorectal cancer can be prevented by having regular screenings.

A Way to Prevent Colorectal Cancer
Since colon and rectal cancer are slow-growing, they almost always develop from a benign (noncancerous) polyp that has been present for several years (perhaps five or more years). That’s why a colorectal screening provides ample opportunity to identify a polyp before it becomes malignant (cancerous) or spreads. Plus, a benign polyp can take even more years to develop into a malignant one. If a benign polyp is identified and removed before it becomes malignant, the cancer may well be prevented. Even if a malignant polyp is identified—it can often be removed before the cancer spreads, producing a favorable outcome.

Screenings Save Lives!
There are different screenings available for detecting polyps or colorectal cancer. Talk to your physician about the tests that are right for you—it could mean the difference between a positive or fatal outcome.

• High-sensitivity fecal occult blood testing (FOBT). There are two types: one using the chemical guaiac, while the other (fecal immunochemical test, or FIT) uses antibodies to find blood in the stool. The test kit is provided by a physician and is performed at home with a stick or brush to obtain a small amount of stool.The test is then returned to the doctor or lab for analysis. 
• Flexible sigmoidoscopy (Flex sig). A physician inserts a short, thin, flexible, lighted tube into the rectum, checking for polyps or cancer inside the rectum and lower third of the colon. A flex sig may be used in combination with FOBT. 
• Double-contrast barium enemas. A barium enema is administered, followed by an air enema which creates an outline around the colon, enabling the physician to see the colon on an X-ray. 
• Colonoscopy. Also used as a follow-up if anything unusual is found in any screening, a colonoscopy is an outpatient procedure that is similar to the flex sig—except the physician uses a longer tube so that the inner lining of the entire colon and rectum can be visualized. An extra benefit of this procedure is that any polyps can be removed at the same time they are found.

Although sometimes recommended, the following screening techniques are still being studied for their accuracy. Be aware that many insurance plans do not cover these screenings, and if anything unusual is found, a follow-up colonoscopy will be required.

• Virtual colonoscopies. Using a CT scanner, images of the entire colon are displayed on a computer screen for a physician to examine. 
• Stool DNA tests. An entire bowel movement is sent to a lab to be checked for cancer cells.

Are You At Risk?
Anyone aged 50 or older with or without a strong family history of colon or rectal cancer should have a screening. In most cases, additional screenings are required every 10 years if a normal colon is found. If polyps are found, more frequent follow-up is recommended.

You are at higher risk if you:

• use tobacco, are obese or are sedentary
• have a personal or family history of colorectal cancer or benign colorectal polyps 
• have a personal or family history of inflammatory bowel disease, such as long-standing ulcerative colitis or Crohn’s disease 
• have a family history of inherited colorectal cancer 
• have a strong personal or family history of cancer of the breast, ovaries, uterus or prostate.

Certified by both the American Board of Surgery and the American Board
of Colon-Rectal Surgery, Dr. Williamson is a general and colon-rectal surgeon with Mid Illini Surgical Associates. iBi