Columbia, SC — She was nervous as she sat in her doctor’s office and waited for the results of her colonoscopy. Her brother had died of colon cancer, and though she had no symptoms or problems, she brought her sister with her for support. Finally, she was told that she had colon cancer, and would have to undergo surgery.
Fortunately, because the cancer was caught early, her treatment was successful, and she is now cancer-free. While happy with this outcome, she wishes she had been screened earlier and had avoided the anxiety, pain and ordeal of her treatment.
This situation is not uncommon.
Each year, more than 2,100 South Carolinians are diagnosed with colorectal cancer, and nearly 800 die. It is the second leading cause of cancer death in our state and in the nation, its toll on patients and their families enormous. But it does not have to be this way. Colon cancer is largely prevented by timely screening.
A report last year in The New England Journal of Medicine showed that removal of pre-cancerous polyps during a colonoscopy cuts colorectal cancer death rates by more than 50 percent. And an in-depth study of employee benefit programs by Milliman Consultants and Actuaries has demonstrated that it makes financial sense to invest in colorectal cancer prevention, given the low cost of screening relative to the high cost of treatment.
The vast majority of cases occur in individuals 50 years of age or older. Thus, guidelines recommend that screening begin at age 50. For those with a parent or close relative diagnosed with colorectal cancer, screening should start 10 years earlier than the age at which that relative was diagnosed. African-Americans should begin screening at age 45. This is especially relevant in South Carolina since African-Americans — particularly men — are less likely to get screened and more likely to die from the disease than European Americans.
The gold standard screening method is a colonoscopy, which detects and removes pre-cancerous polyps before they progress to cancer. Other proven methods include the fecal occult blood test and fecal immunochemical test, both of which detect blood in the stool, a possible indicator of cancer. Though sensitive, these two tests may miss pre-cancerous polyps, and they are not specific to cancer, so a colonoscopy is typically required in follow-up to a finding of blood in the stool.
Unfortunately, fewer than half of those who should be screened for colorectal cancer actually get screened. It’s just not something people look forward to, or are comfortable talking about. But it is critical that we all engage in screening, both for our own sakes as well for our families. So if you or a family member is at the recommended age for colorectal cancer screening, talk to your doctor about the available options. And act. It just may save your life or that of a loved one.
Dr. Frank Berger
USC Center for Colon Cancer Research