Orlando F. Mills, MD, MPH

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Colon Cancer Screenings

Do I even want to have a screening test for colon cancer? 

 

There are very good reasons why the answer should be YES.

  1. Colo-rectal cancer is the second leading cause of death from cancer in the United States
  2. We KNOW that Colon cancer can be prevented by screening for this deadly disease.  Why?  Because most colon cancers begin as polyps-  non-cancerous growths within the lining of the colon. These benign growths may become cancer in 5 to 10 years. However, if they are removed during a screening colonoscopy, the cancer that may have developed is stopped in its tracks. 
  3. If detected early, colon cancer has a 90% survival rate.

 

Screening: when and how

The American Cancer Society (ACS) and all health insurance payers including Medicare recommend a colon cancer screening for all men and women ages 50 to 75 years of age.

 

Younger individuals who have a personal or family history of colon cancer, intestinal polyps, or inflammatory bowel disease should be screened earlier and more frequently.

 

Any person who experiences symptoms suggestive of colon cancer should be tested immediately. Such symptoms include, but are not limited to:

  1. Changes in bowel habits
  2. Rectal bleeding or blood in the stool
  3. Abdominal pain accompanied by diarrhea or constipation.

 

Types of screening tests

The American Cancer Society advises the following two screening options:  

  1. Fecal occult (not seen by the naked eye) blood testing every one year
  2. Colonoscopy every 10 years - you may need to have fecal occult blood tests in-between colonoscopies)


Fecal Occult Blood Tests - screening tests performed annually, you can reduce the risk of death from Colo-rectal cancer by up to 33%.

There are  two types depending on your insurance:

  1. iFOBT (immunochemical FOBT)
  2. Hemoccult Card

In either test, you obtain small samples of feces from your bowel movements and place into a collection tube (iFOBT) or “card” (Hemoccult). This is done in the privacy of your own home.  These samples are then taken to the laboratory covered by your insurance company.     

 

Colonoscopy

The United States Preventive Services Task Force has stated that the  colonoscopy is the “most sensitive and specific test for detecting cancer” 

 

The colonoscopy procedure is the insertion of a tube into the colon by a  gastroenterologist (GI doctor) referred to you by  Dr. Mills.

 

The GI office will have you come to their office for an examination and information on how to prepare for the exam.

 

You will take medication and/or fleets enema’s the evening before the examination to assist in the elimination of most if not all fecal matter from your colon.  It is important to follow the directions given to you.  This process is sometimes described as “exhausting” by patients because many people have many bowel movements following the bowel preparation. 

 

The next day you will go to the gastroenterologist’s surgical suite or the hospital (depending on insurance) for this same day procedure. 

 

An intravenous tube is placed and the colonoscopy is performed under intravenous medication sedation unless your doctor has another plan for you. 

 

Once you are sedated, the colonoscope is inserted into your rectum and colon so that the entire colon can be examined.  Some people are awake enough to watch the procedure on a video screen, however, most sleep through the entire procedure.

 

In addition to inspection of the colon, any polyps and early cancers can be removed during the procedure.  This makes the colonoscopy both a treatment technique as well as a diagnostic tool.   

 

Following the colonoscopy, you will be told to rest for about 30 minutes before you can get up and go to the bathroom to expel any gas accumulated during the procedure.

 

You will need someone to drive you home.  Complications are rare and there are usually no lasting effects after the colonoscopy. 

If there is no abnormality detected, you will be advised to have another colonoscopy in 10 years if you are between the ages of 50 and 75. 

 

Embarrassment, inconvenience?  Perhaps you heard that colonoscopy as disagreeable and uncomfortable.  But, the discomfort of this life saving screening test is better than losing your life to colon cancer.  The decision to have a colon cancer screening test is yours. Use this information to guide your conversation with Dr. Mills.

 

CEED provides free colo-rectal and prostate screening that is income based for people with no insurance. This includes colonoscopy and fecal occult blood tests. Call 732-933-3952.