MARCH IS COLORECTAL CANCER SCREENING MONTH
By: Dr. Joan Pellegrini

Colorectal cancer (CRC) is the second most common cause of cancer (excluding skin cancers) and cancer deaths in Maine. The good news is that it may be somewhat preventable. Over the last 20 years there has been a national effort to increase the number of people being screened for this disease. Also over the last 20 years there has been a decline in the death rate from CRC. It is felt that this is partly due to more people being screened for CRC. Screening allows precancerous polyps to be found and removed before they develop into cancer.

CRC starts from a small precancerous polyp which can be removed at the time of colonoscopy. If this polyp is not removed, then it becomes a cancer. Even if it is cancerous, it is better to remove it when it is still small because the procedure can be easier and there is less chance of spread to other organs. Once CRC has spread outside of the colon then chemotherapy and radiation may be needed and this makes the treatment more complicated. If CRC is found in an early stage the survival is about 75% over 5 years. The 5 year survival is much less if CRC is not found until it has already spread to other organs or lymph nodes.

Screening includes a physical exam, blood work, a digital rectal exam and imaging of the colon. It is recommended that screening including a colonoscopy start at age 50 years (for those without a family history). Unfortunately, only about half of the people who should be screened are screened. In Maine there are several obstacles to being screened: no primary care provider, no insurance, fear of the test and the results, denial, ignorance of the seriousness of CRC, embarrassment, lack of time, difficulty traveling to location for colonoscopy. The CDC (Centers for Disease Control and Prevention) recognizes that it can help with some of these obstacles. Maine CDC has funding for the CRC screening program to defray the costs of colonoscopy for someone without insurance or someone whose insurance may not cover the costs of a screening colonoscopy.

For more information:

Colon screening hotline: 1-877-320-6800
Unfortunately colonoscopy is still the standard screening tool and this requires a bowel preparation in which the patient drinks the prep in order to cleanse the colon. Admittedly, this is not pleasant but then neither is colon cancer. The vast majority of patients tolerate the prep just fine. For the others, their physician can often help by prescribing some nausea medication. The actual procedure is uncomfortable but pain medications given through an IV make it much easier to tolerate.

Although there are risks to a colonoscopy, most patients have no problem. Far less than 1% will have any ill effects.

There are diet and lifestyle changes that all of us can do to lessen our risk of colon cancer. First, if you smoke the most important thing you can do is to stop smoking. For everyone else, limit your red meat consumption and increase the fiber and vegetables in your diet. These are changes that should start at an early age and not just when problems arise,

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