Risk of colon cancer should be scarier than a colonoscopy.
March is Colon Cancer Awareness Month. Unfortunately, colon cancer doesn't just occur in March - it occurs the year around and in all people, regardless of age, gender and race.
Colon cancer is the third most common cancer diagnosis in the United States, and is the second leading cause of cancer death. Colon cancer occurs in 6 percent of the population, or about one person out of 17.
Nationwide, only about half of the people who need to be screened for colon cancer are up to date on their screening. Oregon, with an up-to-date screening rate of about 60 percent, is a little better than the national average. But still, about 40 percent of Oregonians who need to be screened haven't been.
Colon cancer screening typically starts at age 50. Earlier screening is recommended for patients of African-American descent and people with a family history of colon cancer and certain other diseases, such as inflammatory bowel disease.
Colon cancer is, theoretically, extremely preventable, but the appropriate screening needs to be done. Recent studies show that colonoscopy - the gold standard for colon cancer prevention and screening - produces a reduction of nearly 55 percent in colon cancer as a result of screening and polyp removal.
Since colonoscopy became the gold standard, rates of colon cancer across the United States have been reduced. The incidence of no other cancer is declining faster than colorectal cancer.
That decline is attributed to the detection and removal of precancerous polyps during a colonoscopy. Colonoscopy is the one and only preventive test that has been shown to significantly reduce the incidence of colon cancer, as well as mortality from this disease.
Many of the issues for colon cancer screening arise from fear of colonoscopy - fear of the risks of the procedure, fear of the procedure itself and fear of what the procedure will find.
The biggest risk of the procedure - death - occurs in 1 case out of 3,000 to 30,000. The chance of dying in a car accident is about 1 of 84 during one's lifetime, but this does not stop people from driving. Yet a small fear stops people from having a procedure done that can prevent colon cancer.
The procedure itself involves medications designed to make people as comfortable as possible and to result in a pleasant and relaxed experience.
The worst part of the procedure is the preparation, or "clean out," period. There have been some advances in this aspect of the procedure, but it's still not the most enjoyable experience.
Fortunately, it's needed only once every 10 years. One day of inconvenience in exchange for a marked reduction in mortality related to colon cancer is worth the not-so-pleasant clean-out period, which lasts less than a third of a day.
The findings of the procedure are usually minor, with cancer found in 6 percent of patients and polyps in 15 percent to 25 percent of patients. Various other diagnoses also can be made as a result of colonoscopy, including hemorrhoids, diverticulosis and inflammation, to name a few.
While I understand patient anxiety, I think the fear of not acting should outweigh the fear of a colonoscopy, given the risk of having or developing colon cancer.
Colon cancer is a killer. It does not discriminate, and it does not wait - but it is preventable. If you haven't had your colonoscopy, please talk to your primary health care provider about a referral and help out not only yourself, but your family and friends as well.
Jonathan Myers is a physician for Eugene Gastroenterology Consultants.
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|Title Annotation:||Guest Viewpoint|
|Publication:||The Register-Guard (Eugene, OR)|
|Date:||Mar 8, 2014|
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