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Advice for Colorectal Cancer Awareness Month

New York (Mar 21, 2011)

Who should be screened for colorectal cancer?

From Mark B. Pochapin, M.D.

Mark B. Pochapin, M.D.
Mark B. Pochapin, M.D.

The truth is that anyone who has a colon is at risk for colorectal cancer. However, over 90% of colorectal cancers occur in men and women age 50 and older. This is why men and women at average risk for colorectal cancer need to start screening at age 50. In addition, people with certain risk factors – such as a personal or family history of colorectal polyps or cancer, or a personal history of inflammatory bowel disease – need to talk to their doctor about starting screening at a younger age.

Mark B. Pochapin, M.D. is the Director of The Jay Monahan Center for Gastrointestinal Health and the Chief of Gastrointestinal Endoscopy at NewYork-Presbyterian/Weill Cornell Medical Center, and an Associate Professor of Clinical Medicine at Weill Cornell Medical College.

How can patients be screened for colorectal cancer?

From Fay Kastrinos, M.D., M.P.H.

Fay Kastrinos, M.D., M.P.H.
Fay Kastrinos, M.D., M.P.H.

A number of options for screening are available. The test that is considered by many professional societies to be "preferred," is colonoscopy. Colonoscopy examines the entire colon and rectum and can detect pre-cancerous polyps which can be removed during the procedure. The ability to remove the pre-cancerous polyps is what prevents colon cancer from developing. Colonoscopy is recommended to screen asymptomatic patients age 50 and older and those with a family history of colon cancer or polyps.

Another option for screening patients at average risk of colon cancer is flexible sigmoidoscopy. Sigmoidoscopy allows for the examination of a segment of colon and rectum, which is less than half of the entire colon. If a pre-cancerous polyp is found on flexible sigmoidoscopy, the recommendation is to proceed to colonoscopy to exclude the possibility of polyps in the remainder of the colon.

There are also fecal tests that look for blood in the stool, which is a sign that can be associated with colorectal cancer. These tests are designed to primarily detect the presence of cancer, but are less likely to detect polyps.

Radiographical imaging, including an advanced CT scan (computed tomography) of the colon and rectum is available for screening which is also known as "virtual colonoscopy." However, there are a number of unresolved issues related to this testing which may limit its use. If a polyp is found during this test, the recommendation is to have it followed by colonoscopy.

Fay Kastrinos, M.D., M.P.H. is the Director of the Hereditary Colorectal Cancer Prevention Center at NewYork-Presbyterian/Columbia University Medical Center and an Assistant Professor in Clinical Medicine at Columbia University College of Physicians and Surgeons.

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