By Sanjiv Chopra, M.D., MACP, Professor of Medicine, Harvard Medical School and Frank J. Domino, M.D., Professor of Family Medicine, University of Massachusetts Medical School
Colon cancer is the 3rd most common cancer in men and women in the US, and the 3rd in causing cancer death. This last statistic is sad, as colon cancer screening works; it prevents death from cancer, and is the most effective of all screening tests. Colon cancer screening should be initiated at age 50 years in both men and women.
Colonoscopy is the most effective method to address colon cancer. The bowel is prepared by taking some liquid and laxative to cleanse the colon. The patient is given gentle sedation administered intravenously, a fiber optic scope is inserted and the entire colon (large intestine) is examined thoroughly. It is usually performed by an experienced gastroenterologist. Another form of screening, called the “FIT” test, has the patient collect a small amount of stool. If positive, it could signal bleeding from a polyp or a cancer, and leads to a colonoscopy.
The vast majority of colon cancer first arises as a polyp. Polyps are usually mushroom shaped with a stalk. When they are seen on colonoscopy, they can be safely removed. The procedure is painless and carries a very small risk. Large polyps are pre-cancerous. Even if the polyp contains cancer at the tip and has not invaded the stalk, removal of that polyp by colonoscopy is, in effect a cure of colon cancer.
Very rarely, colon cancer arises from inherited conditions. Additionally, patients with longstanding inflammatory bowel disease (Ulcerative Colitis and Crohn’s disease) are at increased risk of colon cancer and need colon cancer screening by colonoscopy.
Preventing colon cancer is also within reach. Most importantly, a diet high in vegetables and fruit, and low in saturated fat, lowers the risk of developing colon cancer. Vitamin D supplementation may also reduce your risk (2,000 – 4,000 IU/day). Studies suggest a low dose of an aspirin may help lower your risk of, but aspirin may cause bleeding, so ask your doctor for their advice.
Sanjiv Chopra, M.D., is Professor of Medicine and Faculty Dean for Continuing Education at Harvard Medical School, and the author of Brotherhood: Dharma, Destiny, and the American Dream and Leadership by Example. Visit www.sanjivchopra.com.
Frank J. Domino, MD is a Professor and the Pre-doctoral Education Director for the Department of Family Medicine and Community Health at the University of Massachusetts Medical School in Worcester, MA.