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Preventive Care- Colonoscopy

Preventable - Treatable - Beatable!

Colorectal cancer is the second leading cause of cancer death in the US.  Each year, it takes the lives of nearly as many women as do ovarian, cervical, and uterine cancers combined. In 2007, an estimated 74,630 women in the US will be diagnosed with colorectal cancer, and an estimated 26,180 women will die of this disease.  These are alarming statistics for a disease that is largely preventable and curable with regular screening and early detection.

It is critical that women understand that they should not wait until symptoms develop to be screened.  The fact is colorectal cancer may have no symptoms. Signs and symptoms often occur only, but not necessarily, when the cancer is more advanced.  As colorectal cancer progresses, the disease may cause the following symptoms: a change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts more than a few days; bleeding from the rectum or blood in the stool; cramping or pain in the abdomen; decreased appetite; unexplained weight loss; and weakness and fatigue.

Unfortunately, colorectal cancer screening is much less utilized than breast or cervical cancer screening, with only approximately 50% of the target population undergoing the recommended screening for colorectal cancer.  When colorectal cancer is detected in its earliest stage, the five-year survival rate is 90%.  In addition, when precancerous polyps are found and removed, colorectal cancer may be prevented all together.

Colorectal cancer screening saves lives.  Screening, beginning at age 50 for all women, is the best way to find polyps before they become cancerous, or to find an early cancer when treatment can be more effective.  The risk of developing colorectal cancer increases with age.  About 9 out of 10 people with colorectal cancer are older than 50.  Women with the following risk factors should be screened earlier—before age 50—or more often:  Family history of colorectal cancer or adenomatous polyps (a first-degree relative age 60 or younger at diagnosis or two or more first-degree relatives of any age); personal history  of colorectal cancer, adenomatous polyps or inflammatory bowel disease (ulcerative colitis or Crohn’s disease); or family history of colorectal cancer syndromes, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC).

ACOG recommends that all women age 50 and older be screened for colorectal cancer by one of the following methods:

  • Yearly patient-collected fecal occult blood testing (FOBT) or fecal immunochemical testing (FIT) or

  • Flexible sigmoidoscopy every five years or

  • Yearly patient-collected FOBT or FIT plus flexible sigmoidoscopy every five years or

  • Double-contrast barium enema five years or

  • Colonoscopy every 10 years

US Preventative Services Taskforce - www.ahcpr.gov/clinic/3rdusptsf/colorectal/
American College of Gastroenterology - www.acg.gi.org