Colon cancer screening can save you life.

Byline: GUEST VIEWPOINT By Craig Chamberlain, William Wu and Dee Tvedt The Register-Guard

Most of us have been, or will be, touched by colon cancer, the nation's second leading cause of cancer deaths. The American Cancer Society reported in January that cancer deaths dropped for a second year in a row, and noted a significant decline in colorectal cancer mortality. Although this is great news, the society estimates that in 2007, approximately 154,000 Americans will be diagnosed with colon cancer, and more than 52,000 will die.

That number could be cut in half if Americans followed the cancer society's screening recommendations.

In 1999, the United States Senate designated March as National Colorectal Cancer Awareness Month. Each March brings an opportunity to emphasize the importance of screening for this lethal cancer, because it is very curable if detected early.

However, if it is not detected before it has spread outside the colon, the prognosis for lengthy survival is poor. Don't wait for symptoms such as pain, rectal bleeding or a change in bowel pattern; they may not be present until the cancer is advanced.

Virtually all colorectal cancers begin as polyps - small, usually benign, growths arising from the lining of the colon. Some polyps can grow, mutate and develop into a cancer. It typically takes from five to 10 years for this to occur. This slow progression means there's time to find and remove these growths before they turn into a malignancy.

Because most colon cancers occur in people 50 or older, the American Cancer Society recommends that screening begin at that age. People who are at higher risk (such as those who have a family history of colon cancer) may need to be screened earlier.

Several screening options exist, but colonoscopy - which uses a long flexible scope to examine the entire colon - is the only test that can not only diagnose abnormalities, but remove polyps or early cancer at the time of the procedure.

The American Cancer Society states, `Colorectal cancer screening by colonoscopy is regarded as the gold standard because this procedure is the most highly sensitive compared to other tests; examines the entire colon; and allows for screening, diagnosis and removal of polyps in a single visit.' It is covered by Medicare and by most insurance plans.

Performed under sedation, colonoscopy is generally more comfortable than other screening procedures. There is a slight risk of complications, the value of colonoscopy is clear. All other tests may need to be followed by colonoscopy if abnormal or questionable results are obtained.

Colonoscopy is the most expensive of all the screening tests, but it is cost-effective. A review prepared for the U.S. Preventive Services Task Force in 2002 found that all types of colon cancer screening (including a colonoscopy every 10 years) are effective in reducing premature deaths and can be done at an acceptable cost to society. The cost of preventing each colon cancer death compares favorably with the cost of such widely accepted interventions as Pap smears or mammograms.

The National Cancer Institute reports that about half of Americans age 50 and older are being screened for colon cancer. People avoid screening for many reasons: lack of time, modesty, fear and simple denial.

A number of celebrities have raised awareness of colon cancer and the importance of screening: Katie Couric, Heidi Klum, Eric Davis, and The Register-Guard's own Bob Welch have spoken about the subject. As Couric testified before the U.S. Senate Select Committee on Aging in March 2000, `A lot of people don't want to talk about it. Colons. Rectums. Bowels. Not exactly the stuff of cocktail party conversation. ...

`But if you recall, not long ago people felt uncomfortable talking about breast cancer ... and men rarely discussed their prostates. Now these cancers are routinely discussed with family, friends and, most importantly, doctors. We have to do the same for colon cancer.'

It is important for us to put aside our squeamishness and move into an informed dialogue about colon cancer screening. Maintaining good health involves many things - screening for colorectal cancer should be one of them.

We need to spread the word: colon cancer is preventable; colon cancer screening saves lives; colonoscopy is the gold standard.

Craig Chamberlain and William Wu are physician partners of Eugene Gastroenterology Consultants. Dee Tvedt, a certified gastrointestinal registered nurse, is the education coordinator at the Oregon Endoscopy Center.