March marks National Colorectal Cancer Awareness Month. Colon cancer causes more than 600,000 deaths annually worldwide and is the second leading cause of cancer death in the U.S. However, with timely screenings, this cancer can be prevented. Dr. Bradley Morganstern, a board-certified gastroenterologist at Stony Brook Medicine, talks about what people need to know and what they can do right now about this disease.
What is the most important thing to know about colon cancer?
Colon cancer is a preventable disease. It begins with small growths called polyps which grow over time and develop into cancer over a period of seven to 10 years. Before a polyp becomes cancer, it can be easily removed with a colonoscopy. Polyps are typically asymptomatic, so it is important to follow age-appropriate screening guidelines to detect and remove polyps well before they ever become cancer. One in three individuals who should have colon cancer screening has not. It is very important to know when you should schedule your first colonoscopy and follow-up colonoscopies.
How is it detected?
There are several available screening tests available, including optical colonoscopy, virtual colonoscopy with a CT scan and stool-based tests. An optical colonoscopy is needed regardless of the initial test choice to confirm the findings of the other exams and for removal of pre-cancerous polyps. An optical colonoscopy typically takes about 30 minutes and allows the doctor to view the entire lining of the large intestines (colon).
Are colonoscopies uncomfortable?
Colonoscopies are performed under deep sedation administered by an anesthesiology team so patients should not feel any discomfort during the procedure. The preparations have become much more tolerable, thanks to low-volume bowel preparations. Most patients leave the endoscopy unit feeling back to themselves, and resume a normal work/activity schedule the following day.
What are the recommended screening guidelines?
Men and women with no family history of colon cancer should have their first screening colonoscopy at age 50, then every 10 years after that if no polyps are found. If polyps are found during a colonoscopy, then the next exam is typically scheduled three to five years later depending on the size and number of polyps.
People with a family history of colon cancer should start screenings at age 40, or 10 years earlier than the age that their relative had colon cancer, whichever is earlier. There are also studies which suggest that African-Africans have a greater risk of colon cancer and should start screening colonoscopies at age 45. Some societies, including the American Cancer Society, have suggested starting colorectal cancer screening at age 45 for all adults, but these recommendations are not considered standard of care at this time.
Colon cancer has been rising in younger individuals as well. Any individual with symptoms such as rectal bleeding, abdominal pain or unexplained weight loss should discuss these symptoms with his or her gastroenterologist. The gastroenterologist may advise having a colonoscopy, regardless of current age or family history.
Does Stony Brook offer optical colonoscopies?
Yes, we run an extremely busy endoscopy unit with six procedure rooms, and perform more than 1,600 screening colonoscopies every year. We pride ourselves on following the most up-to-date guidelines for colon cancer screening and surveillance. We have multiple options for bowel cleansers to make sure that patients have the best exam possible with minimal discomfort. We use the most current Olympus® colonoscopes, which provide a high-definition image to detect subtle polyps. Our polyp (adenoma) detection rates routinely exceed the national average.
If you are over age 50 and have not yet had a colonoscopy or are due for a repeat screening colonoscopy, you may be eligible to schedule one without an office appointment by calling Stony Brook's Direct Access Screening Colonoscopy Program at (631) 444-COLON (444-2656).