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Tuesday, March 11, 2014
Will this year be the year you choose to listen? While some of us have learned to listen to our bodies, there are still many people who don't recognize the warning signals their bodies might be sending, even when their bodies are screaming for help! While discussions of colorectal cancer may not be popular in polite circles of conversation, some refuse to listen even in the privacy of their doctor's office. Warning signals can be subtle and we must learn to recognize them.
Colorectal cancer is one of the most common causes of cancer deaths; African Americans are diagnosed with colorectal cancer at a higher rate than any other population group in the United States. Additionally, of the more than 150,000 Americans who will be diagnosed with colorectal cancer in 2006, the death rate is highest among African Americans. We know we can make a positive impact upon this deadly disease. In fact, it is curable in over 90% of cases when found early. So what are the warning signals? Who should be listening?
Everyone should be aware of their risk factors. A family history of cancer of the colon or rectum or pre-cancerous lesions, called polyps, can greatly increase your personal risk for the disease. Be proactive and talk to your family members about their health. If a close relative has had a polyp or cancer, ask your doctor for a colonoscopy at 40. If your family slate is clean, go for that exam at 50. Also, someone with a longstanding history of inflammatory bowel disease should be screened regularly for malignant change.
Signals can be received in the privacy of your bathroom or in your physician's office. A change in bowel habits can be one indication that something is amiss. Blood in a bowel movement is never normal and should be thoroughly evaluated. Blood can be obvious or it may require special testing to be detected. While the home test for blood hidden in stool is easy and private, it is fairly non-specific. A flexible sigmoidoscopy can performed and, when combined with barium enema, is a reasonable screening tool. If tests show the blood was due only to a hemorrhoid or fissure, then celebrate! Your next colonoscopy won't be necessary for 5-10 years! Regardless, resist the urge to exhaust over-the-counter preparations in an effort to avoid evaluation.
In order to reduce the deadly impact of colorectal cancer in African Americans, it is critical that more African Americans schedule preventative screening exams. Colonoscopy is by far the most accurate method for testing and can not only detect abnormalities, but can also effectively treat minor polyps, preventing or eliminating the risk of cancer from that polyp. Colonoscopy also provides diagnosis if a cancer is found, leading to the appropriate surgical treatment. African Americans are often diagnosed at later stages of the disease when fewer treatment options are available. Making the decision to schedule a preventative exam could be the difference between life and death. Innovative screening methods are also available, such as a virtual colonography. Guidelines have been established and are readily available to all physicians and patients. Talk to your physician about the screening regimen that is right for you.
Signals are sent by the colon when something is wrong, so listen up: if you are 50 and healthy, with no family history of polyps or colorectal cancer, get screened. If your family has a history of polyps or cancers, get screened at 40. If you have a chronic inflammatory condition affecting your colon, schedule regular endoscopic exams and talk to your doctor about other factors that could affect the health of your colon. If your colon is speaking to you, listen! No one dies of embarrassment, but too many of our friends die of colorectal cancer.
Last Reviewed: Jun 30, 2006
Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati