Entering the Twilight Zone: Getting Comfortable With Colorectal Screenings

COLORECTAL CANCER (CRC) IS ONE OF THE MOST COMMONLYDIAGNOSED CANCERS IN THE UNITED STATES — AND THE THIRDMOST COMMON CAUSE OF CANCER DEATHS AMONG MEN ANDWOMEN COMBINED. ABOUT 100,000 CASES OF COLON CANCER,AND JUST UNDER 45,000 CASES OF RECTAL CANCER, AREDIAGNOSED EACH YEAR.

These cancers develop in the large intestine (colon and rectum), often from growths called polyps. Polyps are found in a third of all people. Initially benign, these growths may transform into cancer. In some cases, these cancers can become advanced or metastatic, breaking away from the large intestine to form new tumors elsewhere in the body. Although it is a very serious disease, colorectal cancer is preventable and can be successfully treated if detected early.

We sat down with Brown & Toland gastroenterologist Satya B. Allaparthi, MD, to discuss colorectal cancer risk and the most effective tool for its prevention and treatment – the colonoscopy.

B&T: What is a colonoscopy and why are they important?

Dr. Allaparthi: A colonoscopy involves looking at the colon from inside the body using a long, thin (about the width of your little finger), flexible tube called an endoscope. There is a tiny camera on the end of the tube through which the doctor can examine your entire colon and rectum for polyps or cancer.

If the doctor detects any polyps during a colonoscopy, he or she will remove them during the procedure. You do not feel when a polyp is removed and removing them does not affect recovery time. Removing polyps during a colonoscopy could stop colon cancer from growing or even cure it.

B&T: Who should be screened?

Dr. Allaparthi: The U.S. Preventive Services Task Force (USPSTF) recommends colorectal cancer screening starting at age 50 and earlier for African Americans (age 45). In fact, the American Cancer Society recommends screening for everyone beginning at age 45.

The risk of developing colorectal cancer increases with age, with more than 90 percent of cases occurring in those age 50 or older. All men and women at average risk for developing CRC should have a colonoscopy every 10 years.

B&T: Many patients who know they should get a colonoscopy don’t, primarily due to fears about the procedure. What are patients typically afraid of, and what do you tell them to allay those fears?

Dr. Allaparthi: Patients delay colonoscopy because it is invasive with concern for the safety of the procedure and intolerance of preparing for the procedure. Some patients also worry about high deductibles/copays and logistics (taking time off from work, arranging transportation).

Again, I recommend colonoscopy as, by far, the most sensitive test and the only test that prevents colon cancer. It’s a safe and well-tolerated procedure when done in expert hands.

B&T: In addition to colonoscopy, is there anything I can do to reduce my risk of colorectal cancer?

Dr. Allaparthi: Yes, increase your daily intake of fruit and vegetables and limit or avoid red meat and processed meat. Quit smoking and limit alcohol use. Lose weight and control type 2 diabetes through exercise and a balanced, healthy diet.

Is a virtual colonoscopy or fecal test right for you? Lookingfor some useful tips on how to best prepare for yourscreening? Read the full interview with Dr. Allaparthi at: brownandtoland.com/coloncancer.