Colorectal cancer screening is one of four preventive measures that the Center for Medicare and Medicaid Services (CMS) has chosen to focus on for the next three years. There is ample reason for the choice: of the more than 49,000 people expected to die from colorectal cancer in 2009, appropriated screenings could save more than half.

 

Most people would admit to knowing that colonoscopies are recommended at age 50, but many delay because they consider the procedure embarrassing or are squeamish about pre-exam preparation. If you are 50 or older and have yet to schedule a colonoscopy, take a few minutes to read about colorectal cancers, the colonoscopy procedure and the benefits of screening and early detection.

WHAT YOU NEED TO KNOW

Colonoscopies are used to diagnose a number of gastrointestinal issues, including colorectal cancers. Consider the following statistics:

• Ninety percent of colorectal cancers are curable when patients get an early diagnosis.
• High- and moderate-risk patients only account for about 25 percent of all diagnosed colorectal cases.
• The other 75 percent of people who develop the disease are age 50 or older and don’t have any risk factors.
• If everyone in America were to get his colonoscopy when recommended, then 25,000 lives would be saved each year.

Though 50 is the recommended age for most people to get their first screening colonoscopy, the American Gastroenterological Association recommends that people with a family history of colon cancer get their first colonoscopy at 40. Some ethnic groups are also at higher risk and should begin screening before age 50. Your physician can advise you on all age appropriate screening procedures. Ninety percent of colon and rectal cancers occur in patients 50 and older. If you are a patient of average risk, colonoscopies are recommended every 10 years after your first procedure.

SIGNS AND SYMPTOMS

Colorectal cancers are slow-growing, and it may be years before symptoms are detected. Therefore, regular screening is highly recommended. However, knowing what signs to look for can’t hurt.

If you suddenly begin experiencing any of the following on a regular basis, contact your physician:

• Any change in bowel movements: sudden diarrhea, bloody stools, constipation, or “thin” but solid stools;
• Unexplained weight loss;
• Stomach cramps;
• Bloating, gas, nausea, and vomiting;
• Feeling full or tired.

Because colorectal cancers are slow-growing, they are generally curable when found early on. And remember, if your colonoscopy shows no polyps or cancer, you are in the clear for a decade. If there are polyps, or even cancer, you will know, and you can begin treatment quickly.

RISK FACTORS

Although no one knows what causes colorectal cancers, there are sub-groups more susceptible than others to develop a cancer of the colon or rectum. Factors that seem to increase risk for colorectal cancers include:

• Age 50 or older
• Personal history of colon cancer or polyps
• Family history or colon cancer or polyps
• Genetic colon disorders
• Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis
• Diet high in calories and fat or low in fiber
• Obesity
• Diabetes
• Inactive lifestyle
• Heavy drinking of alcohol
• Cigarette smoking

PRACTICAL TIPS FOR YOUR COLONOSCOPY

Johns Hopkins Medicine offers advice to help you make the best of this necessary test:
• Get a head start. Consider lightening up on your food intake two days before the test, avoiding hard-to-digest items such as meat, eggs, nuts, and leafy greens. Instead, eat lots of fiber in the form of vegetables and fruits, or start the liquid diet early, so there will be less to purge.
• Stock up. Get what you will need ahead of time, including clear liquids such as chicken or vegetable broth, apple juice, and bottled water with electrolytes. Buy extra-soft toilet paper, paper towels, or disposable baby wipes (be careful not to buy cleansing wipes containing scent or alcohol).
• Be gentle to yourself. Plan to take two days off work: the day before the test and the day of the test itself.
• Stay hydrated. A recent study shows that some laxative products made with sodium phosphate may contribute to dehydration and thus cause kidney damage. All laxatives cause some water loss, so drink plenty of fluids throughout the prep and after the test. Avoid both alcoholic and carbonated drinks before the procedure, as they increase dehydration.
• Reduce the opportunity for accidents. Stay home near a bathroom during the process.
• Prepare the bathroom. Line the wastebasket with a plastic bag. Instead of toilet paper, use wet washcloths or disposable wipes, such as unscented baby wipes (check that the product is flushable). Applied generously, petroleum jelly and hemorrhoid products can ease anal soreness that might develop. Soaking in a warm tub may help as well.
• Try to relax. Most people dread the actual scoping procedure, and feelings of anxiety or concern are normal. The mild sedative given for a colonoscopy relieves those problems, and you may not even remember the process. If you are feeling especially anxious, talk to your doctor beforehand about providing a mild tranquilizer or muscle relaxant for the procedure. And keep in mind that, compared with the preparation, the colonoscopy is usually over very quickly.
• Aftercare. You may feel some mild cramping or bloating and, rarely, nausea, up to a day afterward, caused by some air left in the colon. Eat lightly for a few days.
• Be relieved. When it’s over, it’s over. If the scoping shows no polyps or cancer, you are in the clear for a decade. If there are polyps, or even cancer, you will know, and you can be treated quickly.