It has often been said that colorectal cancer is the most preventable cancer, yet the least prevented cancer. Globally, colorectal cancer is the third most common cancer in males and second most common in females. Recently, we have seen a decrease in the incidence of colon cancer in individuals over age 50 due to screening programs.
Colon cancer is often asymptomatic until late in the disease process. Common symptoms include abdominal pain and bloating, change in bowel habits (constipation or diarrhea), blood in bowel movements, fatigue, or change in caliber of stool. Because this cancer is asymptomatic until too late, being screened is of the utmost importance. Early diagnosis of colorectal cancer is vital because it carries a better prognosis and rate of survival at five years. Risks from having a colonoscopy are very minimal if performed by a trained professional.
Currently there are two colorectal cancer screening tests that have been proven to decrease the risk of colon cancer over time if performed at appropriate intervals. Colorectal cancer screening should start at age 50 for Caucasians and age 45 for Black and Hispanic individuals. The FIT (fecal immunochemical test) should be done on a yearly basis for people without a family history of colon cancer in a first-degree relative and patients who do not have symptoms. All other individuals should receive a colonoscopy. A colonoscopy is performed while the patient is sedated and requires a colonic purge the day before the procedure. Colonoscopies allow for direct visualization and possible removal of colon polyps, growths that can develop into cancer over time. A colonoscopy is appropriate for all patients undergoing screening if there is no history of adverse reactions to anesthesia.
Follow-up testing is only needed if the physician found concerns on the initial test. If the FIT test is positive, a colonoscopy should be scheduled. If colon polyps are found on colonoscopy, scheduling a repeat colonoscopy should be done at an interval based on how many polyps, how large the polyps are and what they look like under the microscope. Colonoscopies are one of the few screening modalities that are able to remove a precancerous lesion in its infancy to prevent colon cancer in the future.
March is Colorectal Cancer Awareness Month, a time to draw attention to colon cancer and the importance of preventative screenings. If you have any questions or concerns, or would if you would like to schedule a visit with Dr. Viviano, please call (814) 866-3986 to schedule an appointment today!
Brian Viviano, D.O., is board-certified in Internal Medicine and Gastroenterology. He received his medical degree from West Virginia School of Osteopathic Medicine and completed his residency at Millcreek Community Hospital (MCH). Dr. Viviano completed his fellowship in Gastroenterology at MCH where he also served as Chief Fellow. He received his Masters of Medical Education from Lake Erie College of Osteopathic Medicine where he also serves as adjunct clinical assistant professor of Internal Medicine and Gastroenterology. Dr. Viviano specializes in video capsule endoscopy, inflammatory bowel disease and chronic liver disease including hepatitis.