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Colorectal Cancer Questions and Answers

NEW YORK (Jun 1, 2012)

Felice Schnoll-Sussman, M.D.
Felice Schnoll-Sussman,
M.D.

From Felice Schnoll-Sussman, M.D., a gastroenterologist and Director of Research at NewYork-Presbyterian/Weill Cornell Medical Center's Jay Monahan Center for Gastrointestinal Health –

Who should be screened for colorectal cancer?

Everyone who has a colon is at risk for colon cancer – and that includes both men and women. Men and women who have no risk factors should start screening at age 50. The frequency of screening depends on the type of test used and the results found. If you have a colonoscopy and there are no abnormal results – no polyps, early cancers, or other problems – your next colonoscopy may not be for another 10 years.

Men and women with certain risk factors – such as a personal or family history of colon polyps or cancer or a personal history of inflammatory bowel disease – need to talk to their doctors about starting screening for colon cancer at a younger age and with greater frequency. For example, in those with a family history of colon cancer, we recommend that screening start 10 years younger than the age your family member was when he or she was first diagnosed.

Does colorectal cancer have symptoms?

Colon polyps and early colon cancers often cause no symptoms. This is why screening is so important. When symptoms are present, they may include a change in bowel habits; rectal bleeding or blood in the stool; a very narrow stool; persistent abdominal pain; unexplained weight loss; and/or unexplained anemia.

Why is early detection important?

Early detection is important not only in the case of colon cancer but also of pre-cancerous colon polyps. Most colon cancers develop from benign growths, or polyps, that grow over time and ultimately become cancerous. If we find and remove a potentially pre-cancerous polyp before it turns malignant, that cancer can be prevented. Also, even if the growth has turned cancerous, colorectal cancer is over 90% curable when found very early.

Are campaigns working?

As we all know, Katie Couric underwent an on-air colonoscopy in March 2000, and changed colon cancer and colonoscopies from a taboo subject to something we could talk about. Katie demystified the disease and the procedure – and a group of Michigan researchers subsequently documented a nearly 20% increase in colonoscopies nationwide after that broadcast aired. They called it the "Couric Effect."

Since that time, awareness efforts have continued and the data shows that screening rates are increasing and death rates are declining. Here in New York City, colonoscopy rates are up to about 67%. Nationwide, the screening rate has increased to between 59% and 65%. In addition, the colorectal cancer death rate has dropped by an average of 3% per year from 2003 to 2007, representing nearly 32,000 fewer deaths than expected during that period compared to 2002. So, we are making great progress, but we still have a long way to go to get everyone who should be screened to do so.

How does the Monahan Center encourage screening?

The Monahan Center has organized a number of public awareness campaigns and outreach efforts to increase colon cancer awareness and screening in the community. This March, for example, the Monahan Center and NewYork-Presbyterian partnered with Katie Couric, and the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance, and ABC to launch the Make That Call screening campaign. The message to New Yorkers was, and is, to Make That Call to your doctors to get screened for colon cancer.

And of course, in my own practice, I always tell my patients that getting screened for colon cancer could be the greatest gift they ever give themselves – and their families. I have witnessed this in countless men and women. They had no symptoms. Most had no family history. They felt great. And they were shocked to find out that they had a pre-cancerous polyp or early cancer growing in their colons. Their lives were saved because they took the time for themselves, and for their families, to get tested for colon cancer.

(Editor's note: The Jay Monahan Center for Gastrointestinal Health is named after Jay Monahan, Katie Couric's late husband. Ms. Couric was instrumental in creating the center.)

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