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Seasonal Health Tips - Spring


Colorectal Cancer

br Dr. Philip Lowry

March is Colorectal Cancer Awareness Month, a particularly important observation for residents of central Massachusetts. Colorectal cancer remains a significant public health problem with almost 150,000 new cases diagnosed in the United States in 2006. There were more than 55,000 deaths from colorectal cancer in 2006 making it the second leading cause of cancer death in this country. Colorectal cancer rates in central Massachusetts are slightly higher than the national average particularly emphasizing the need early detection of that disease in this area.

Dr. Philip Lowry

Symptoms of colorectal cancer may include weight loss, abdominal or rectal pain, a change in bowel habits, or blood in the bowel movements which may be either bright red or a deep maroon or black tarry color. Signs of anemia and iron deficiency may indirectly suggest the possibility of colorectal cancer even in the absence of specific symptoms, though there may be other and less dangerous explanations for any of these signs or symptoms. Certainly, any individual with any of these findings should discuss them with his or her physician and consider an evaluation to exclude colorectal cancer. Unfortunately, initiating a search for colon cancer only after signs or symptoms appear frequently identifies cancers that are more advanced and therefore more difficult to treat and cure.

The most effective strategy is to screen for colon cancer in appropriate patients before signs or symptoms appear. Patients who should be screened for colon cancer include:

  • All individuals 50 years or age or older. Even without other risk factors, almost 1 in 15 individuals will develop colorectal cancer during their lifetime with 90% of these cases occurring after 50 years of age. Therefore, even otherwise healthy patients should institute colorectal cancer screening at age 50.
  • High risk patients may need earlier or more frequent screening. These include:
    • Patients with a previous personal history of colorectal cancer or polyps
    • Patients with a family history of colorectal cancer
    • Patients with inflammatory bowel disease

A number of other factors may affect colorectal cancer development including ethnic background, diabetes, treatment for other cancers (especially radiation treatments for prostate or gynecologic cancer), obesity, smoking, and diet. Patients should review their risk for colorectal cancer with their physician and develop a strategy for initial and ongoing screening that best accounts for their particular situation.

Screening strategies may include rectal examinations, screening for blood in bowel movements, or X-ray studies especially the barium enema. Fiberoptic examinations have gained particular value as not only an effective screening tool but also an opportunity to biopsy or remove lesions from the colon to diagnose or even prevent the development of cancer. A full colonoscopy has become one of the preferred approaches to colorectal cancer screening and is well tolerated by the vast majority of patients.

With the significant incidence, unacceptably high death rate, but availability of effective procedures to catch colorectal cancer at an early and more treatable stage, it is critical that we all work together to do a better job of screening for colorectal cancer. Colorectal Cancer Awareness Month gives physicians and patients alike the opportunity to initiate or review their plans for colorectal cancer screening, and that is an opportunity that should not be missed.

Reference:

Quickfacts: Colon Cancer published by the American Cancer Society, Atlanta, GA, 2007.

More information can be obtained:

  • By telephone at the American Cancer Society at 800-ACS-2345
  • On the internet at www.cancer.org (the American Cancer Society website) or at www.cancer.gov (the National Cancer Institute Website)
  • You may also contact the Simonds-Sinon Regional Cancer Center at HealthAlliance at 978-343-5048

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