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Colon and rectum cancers - the third most common cancer in the United States - are one of the few diseases where doctors can quickly remove pre-malignant polyps and malignant growths in time to save lives.
But doctors and cancer prevention organizations say many people are not getting regular screenings because of unfounded fears about the tests and misconceptions about their risk of contracting the disease. Men and women without risk factors or symptoms should be tested when they reach 50, medical experts say. But a survey by the American Cancer Society found 41 percent of people older than 50 had not had a colonoscopy or sigmoidoscopy.
"You don't have to be embarrassed about anything. To a doctor, these are all things that are part of taking care of your patient," says Ted Gansler, M.D., director of health content for the American Cancer Society (ACS). "People should realize that having these tests could save their lives."
Colon and rectal cancer myths
According to the Cancer Research Foundation of America, some of the most common myths are:
Myth 1: Colon and rectal cancers are rare forms of cancer.
Fact: Actually, they are quite common. ACS says 106,680 Americans are expected in 2006 to be diagnosed with colon cancer and 41,930 with rectal cancer. More than 55,170 people are expected to die from these cancers.
Myth 2: Colon and rectal cancers strike only older white men.
Fact: Men and women are equally affected by these cancers.
African-Americans and Hispanics are less likely to be diagnosed with colon cancer because of their geographic isolation, cultural factors and lack of access to health care services, such as cancer screenings.
Myth 3: Screening is only necessary if you have symptoms.
Fact: Screening depends on your age, your health and the health history of your family.
Without screening, you may never know if you have symptoms until the cancer has advanced because colon cancer is a "silent killer." For example, you could have blood in your stool from a bleeding polyp that cannot be seen by the naked eye. At least 90 percent of cases are believed to arise from polyps.
Nearly 90% of most colorectal cancer is believed to develop from polyps, which are mushroom-shaped growths on the lining of the colon and rectum. Screening methods can detect and remove polyps before they become cancerous.
Nearly 91 percent of patients with colon cancer survive at least five years when the disease is detected before it spreads to other parts of the body, ACS says.
However, only one in three cases of colon cancer are diagnosed at this stage, the Cancer Research Foundation of America says. The remaining two-thirds of patients come to the doctor after the disease has spread.
Do you have symptoms?
Colon cancer starts when cells in the lining of your large intestine form small growths call polyps. Polyps grow slowly and most are harmless, but some transform into cancerous tumors that can spread to your lymph nodes and other organs in your body.
The symptoms of colon cancer are:
- Rectal bleeding or blood in your stool.
- Changes in your bowel habits, such as diarrhea, constipation or narrowing of the size of your stool that last more than a few days.
- Cramping or steady abdominal pain.
- Weakness, fatigue, jaundice or poor appetite.
When should you be tested?
People who do not have increased risk factors should get their first test at age 50. Your risk of contracting colon cancer increases with age; 60 percent of colon cancer patients are 70 or older, says Bernard Levin, M.D., vice president for cancer prevention at the University of Texas Anderson Medical Center.
Knowing your family's health history will help you decide when to start testing. You are at greater risk for colon cancer and should be tested at age 40 if you or someone in your family has had:
- Benign colon polyps or colon cancer.
- An inflammatory bowel disease, such as ulcerative colitis, irritable bowel syndrome or Crohn's disease.
- Breast, uterine or ovarian cancer.
Check the ACS Web site to find out when you should be screened and what tests are best for you.
About 20 percent to 25 percent of colon cancer cases are caused by inherited abnormalities in genes, Levin says. So far, researchers have been able to identify the genes involved in 6 percent of the hereditary colon cancer cases, Levin says. Researchers also are using a test to find possible gene abnormalities by checking your stool.
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External Sources
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American Cancer Society
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Dollinger M, Rosenbaum, EH, Tempero M., et al. Everyone's Guide to Cancer Therapy, Fourth Edition, Kansas City, Missouri: Andrews McMeel Publishing, 2002
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This article was reviewed and updated June 2007.
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