You're approaching your 50th birthday, or have
passed it, and you know it's time to ask your doctor about
a colon-cancer screening.
If you're hesitating or reluctant to be screened, you
shouldn't be. The tests you should have depend on your age
and whether you are at greater risk of getting colon cancer
because of your personal or family health history.
What's the importance of being tested for a disease you
may not have, and never get? The American Cancer Society
says:
- Screening methods can quickly detect and remove polyps
- the mushroom-shaped growths on the lining of the colon
and rectum - before they become cancerous.
- The symptoms of colon cancer - such as hidden blood in your
stool - are often not readily apparent. Without a thorough
examination, you may never know if you have the disease until it has advanced to other parts of your body.
Recommended screenings
According to the American Cancer Society, men and women with
no known risk factors or symptoms should undergo one of the three
screening options beginning at age 50:
- Fecal Occult Blood Test (annually) and a sigmoidoscopy
(every 5 years). You can do the fecal occult blood test at
home to see if there are invisible amounts of blood in your
stool. During a sigmoidoscopy, a 2-foot-long lighted tube is
inserted into the lower third of your colon. More than half of
all polyps are detected in this area. The test takes about 10 to 20
minutes, and is usually done in your doctor's office
without anesthesia.
- Barium enema (every 5 to 10 years). Your large
intestine is coated with barium sulfate, then injected with air
and x-rayed to locate abnormal growths. The test takes about
30 to 45 minutes.
- Colonoscopy (every 10 years). This procedure, which
takes about 30 to 60 minutes, is the most invasive, but also the
most accurate, and is usually performed in a hospital. The doctor
probes all 5 feet of your large intestine with a flexible tube
while you are sedated. The tube, which is about as thick as a
finger, is equipped with a light and connected to a video display
monitor for your doctor to view the inside of your colon. The
colonoscope can also be used to remove small polyps and stop
bleeding. The day before the test, you'll have to stick to
a liquid diet and follow your doctor's instructions for
cleansing your bowel and intestines.
- A digital rectal examination should be done at the
same time as the sigmoidoscopy, barium enema, and
colonoscopy.
You should consider a different testing schedule (more
frequent exams starting before you are 50) if you or someone in
your family has had:
- Benign colon polyps or colorectal cancer.
- An inflammatory bowel disease, such as ulcerative colitis,
irritable bowel syndrome, or Crohn's disease.
Visit the American Cancer Society Web site (http://www2.cancer.org) to find out more about your suggested
screenings.
Advances in testing
Researchers are developing a "virtual
colonoscopy," in which an MRI or CT scan is used to
make a computer-generated, three-dimensional image of your colon,
says Bernard Levin, MD, vice president for cancer prevention at
the University of Texas Anderson Medical Center. "It is
potentially very useful,'' says Levin, but the test
may not be ready for another 5 years.
Researchers are also trying to perfect a test to find possible
gene abnormalities by checking your stool. About 20% to 25% of colon cancer cases are caused by inherited abnormalities in
genes, and so far, researchers have been able to identify the
genes involved in 6% of the hereditary colon cancer cases,
Levin says.
Some studies have shown that people who regularly use aspirin
and other non-steroidal, anti-inflammatory drugs (NSAIDs) have a
lower risk of colon cancer, the American Cancer Society says.
Some anti-inflammatory drugs are effective in reducing the size
of pre-cancerous polyps, Levin says, but "other studies have not
convincingly proven that aspirin is beneficial. The data on
aspirin is not entirely conclusive yet.''
Prevention guidelines
Besides regular cancer screenings, here are some other tips
from the American Cancer Society and Cancer Research Foundation
of America on how you can lower your risk of colon cancer:
- Eat a low-fat diet with 5 or more servings of fruits and
vegetables, and 25 to 30 grams of fiber daily. Research suggests
that certain fruits and vegetables - such as oranges, spinach,
corn, strawberries, bananas, and apples - contain antioxidants
that reduce the risk of cancer by preventing cell damage from
"free radicals," which are unstable compounds
produced by ordinary biological processes in the body. Whole
grain breads, cereals, and nuts and beans are good sources of
fiber.
- Eat foods with folic acid, a cancer-fighting B vitamin found
in multiple vitamin supplements, and foods rich in foliate, such as fortified breakfast cereals, enriched bread, rice, pasta, fruit juices, green vegetables, and beans. You'll want to
take a multi-vitamin supplement, since you'll get only half
of your daily-recommended amount of folic acid (400 micrograms)
from the foods you eat.
- Drink alcohol only in moderation, and don't smoke.
- Exercise at least 20 to 30 minutes 3 or 4 days a
week.
