Posts Tagged ‘cancer screening prevention’

Concerning Colorectal Cancer

March 8th, 2021

The colon and rectum are part of the body’s gastrointestinal tract. The colon makes up the first 6 feet of the large intestine, and the rectum makes up the last 6 inches. Cancers of the colon and rectum are typically grouped together as colorectal cancer because they have some characteristics in common, most notably the presence of abnormal growths called polyps.

According to the American Cancer Society, an estimated 104,610 new cases of colon cancer and 43,340 cases of rectal cancer will be diagnosed in the US in 2020, and an estimated 53,200 people will die of colorectal cancer this year. Not counting some skin cancers, colorectal cancer is the third leading cause of cancer-related deaths in the US. Approximately 4.4 percent of men and 4.1 percent of women will be diagnosed with colorectal cancer in their lifetime.

Colorectal cancers generally begin as polyps that form in the lining of the colon or rectum. Most of the time, these polyps are harmless, but over time – sometimes many years – one or more of the polyps can turn cancerous. Often, the polyps cause no symptoms, especially early on, but eventually symptoms may develop.

When they are present, symptoms of colorectal cancer may include rectal bleeding; blood in your stool or in the toilet following a bowel movement; diarrhea or constipation that won’t go away; changes in your normal bowel habits, such as size, shape or frequency; abdominal pain or cramping; bloating or feeling full; appetite changes; weight loss; and fatigue.

Cancer is the result of mutations to the genes responsible for cell growth and reproduction, and these changes cause the cells to grow out of control. Some gene mutations are inherited and passed on in families, and some are acquired during your lifetime.

There are several inherited syndromes, including familial adenomatous polyposis (FAP) and Lynch syndrome, that can lead to colorectal cancer, but most gene mutations that lead to cancer are acquired mutations. That is the case with colorectal cancer, and certain risk factors may play a role in causing the mutations that lead to colorectal cancer.

Some of those risk factors you can change and some you can’t. Risk factors you cannot change include age – colorectal cancer is much more common after age 50; having a personal history of colorectal polyps or colorectal cancer, a personal history of inflammatory bowel disease, or a family history of colorectal cancer;, race – African Americans have the highest incidence and mortality rate of all racial groups in the US; or having type two diabetes.

There are also colorectal cancer risk factors that you can change. These include being overweight or obese, being physically inactive; eating a diet that is high in red meat and processed food, not getting enough Vitamin D, smoking, and drinking a lot of alcohol.

If you have symptoms that are suspicious of colorectal cancer or if something shows up on a screening test, your doctor will likely order certain diagnostic tests for colorectal cancer. These include blood tests and a diagnostic colonoscopy, which looks at the full length of your colon.

During both screening and diagnostic colonoscopies, your doctor will remove any abnormal looking polyps and surrounding tissue to examine under a microscope to look for cancer cells. This procedure is called a biopsy. If cancer is detected, you and your doctor together will plan a course of treatment.

Treatment for colorectal cancer may include surgery, which is the main treatment for this cancer, radiation therapy, systemic therapy, or a combination of these treatments. Systemic therapy is the use of medication to kill cancer cells. The types of systemic therapies used for colorectal cancer include chemotherapy, targeted therapy, and immunotherapy.

The key to winning the battle against colorectal cancer is to find it in its early stages, when treatment is most effective. The best way to catch it early is through routine screening. The US Preventive Services Task Force recommends several screening strategies, including stool tests, flexible sigmoidoscopy, colonoscopy, and CT colonoscopy (virtual colonoscopy).

You should begin screening for colorectal cancer when you turn 50 and continue to be screened at regular intervals determined by your doctor. The timing of your screening is based on your personal risk factors for colorectal cancer. If you have multiple risk factors, you may need to begin screening at an earlier age or get screened more often.

Don’t be a statistic. Get screened for colorectal cancer and save your life!

Screening Sense

June 22nd, 2015

Woman getting a Mammogram Cancer Screening

Public Domain Image

Everybody wants to stay healthy and live a long life, and prevention of disease is one way to help you meet that goal. But some disorders, like many cancers, can’t be prevented. The next best thing is to detect them in their earliest stages when they’re most amenable to treatment. Routine screening tests are recommended for some of the more common cancers like breast and prostate.

Until recently, the guidelines for screening set by the medical community in this country were designed with maximum detection in mind. The goal was to use the most sensitive testing available in order to find every possible case of early cancer. It is a noble objective, but not without flaws. Now, the medical community is revisiting this issue.

In the May 19 issue of Annals of Internal Medicine, a group from the American College of Physicians (ACP) suggests that many medical professionals and the public have overestimated the benefits of this “high-intensity” approach to cancer screening. Increasingly, however, they are becoming more aware of the other side of the coin. Intensive screening leads to greater harm to patients and increased medical costs.

This awareness has prompted a new way of looking at the screening issue that considers the tradeoffs between benefits, and harms and costs of various screening strategies in terms of value. The authors write:

High-value screening strategies provide a degree of benefit that clearly justifies the harms and costs; low-value strategies return disproportionately small health benefits for the harms and costs incurred. Value and intensity are not the same.

The point is that although a high-intensity screening approach may, indeed, have many benefits, when objectively measured, the benefits often do not outweigh the negatives of significant harm to patients and added cost. That makes it a low-value strategy. The ACP suggests that the American medical community consider more high-value strategies when setting screening schedules. These strategies often take an intermediate level of intensity that best balances benefits with harms and costs. That might mean reserving the most sensitive tests only for people with certain risk factors for that particular cancer.

The ACP offers advice for screening recommendations for five common cancers – breast, cervical, colorectal, ovarian and prostate – in average-risk adults. These are people who have no family history or other risk factors and who do not have any cancer symptoms. Before dispensing this advice, the ACP reviewed clinical guidelines and evidence from a number of sources including the US Preventive Services Task Force, The American Academy of Family Physicians, the American Cancer Society, the American Congress of Obstetrics and Gynecology, the American Gastrointestinal Association and the American Urological Association. Most of these organizations have already embraced high-value strategies, so the ACP’s advice for screening is not earth shattering.

Screenings remain an important part of your routine preventive health care, so continue to follow your doctor’s recommendations. He or she follows the guidelines approved by the American Cancer Society or other appropriate medical organization and will have access to the most up-to-date schedule for exams. If you have questions or concerns about the necessity of a screening, bring them up to your doctor. Be smart and be your own advocate!

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