The American Cancer Society estimates that 50,000 people will die from colon cancer this year. Many deaths can be prevented if the cancer is found through screening in an early stage and treated. That's why they are urging anyone over the age of 50 or with high risk factors to be screened this month, which is National Colon Cancer Screening Month.

"The most important thing for the public to know about colon cancer screening is that you usually don't have symptoms until late in the process," says Shari Moore, CGRN, an experienced nurse at Seton Medical Center Williamson specialty trained to provide care for patients who are undergoing diagnostic or therapeutic treatment or procedures.

"That's why it's important to screen people before they begin having symptoms. We can catch most cancers in the early stages and prevent deaths or serious illness," she adds.

What is Colon Cancer?

Colon cancer almost always starts with a polyp, according to the American Cancer Society. A polyp is an abnormal mass that forms as a result of cells dividing without the usual controls. Finding and removing polyps can stop cancer before it starts.

Screening can find polyps that may eventually become cancerous as well as some cancers in an early stage before they spread to other parts of the body.

"Forty percent of colon cancers found at a late stage have already metastasized to the liver or the brain," adds Shari.

You can find out more about colon cancer screening in GoodHealth.com's online health encyclopedia. The American Cancer Society and the National Cancer Institute both offer added details on colon cancer, screening and other topics.

Who Is At Risk?

You have the power to prevent colon cancer by being screened. If your are 50 or older, cancer experts recommend you be tested regardless of race or gender.

If you have any of several other risk factors, you should be screened regardless of your age. They include:

1. Personal history of
   • colorectal cancer;
   • polyps in the colon or rectum;
   • cancer of the ovary, endometrium or breast;
   • ulcerative colitis or Crohn disease.
2. Close relative (parent, sibling, child) with colorectal cancer or polyps.
3. Hereditary conditions such as familial adenomatous polypsis (FAP) or hereditary nonpolyposis colon cancer (HNPCC; Lynch Syndrome).

Diet and exercise history also may be important. Research indicates that colon cancer may be linked to high fat, low fiber diets. In addition, regular exercise has been shown to decrease risk of developing this type of cancer. People who are sedentary may be at increased risk.

Endoscopy Services at SMCW

Seton Medical Center Williamson opened with a full range of state-of-the-art endoscopy services, which include colon cancer screening in addition to caring for people with life threatening gastrointestinal disorders.

Common endoscopic procedures include EGD (esophagus, stomach and duodenum), Colonoscopy (colon), Bronchoscopy (lungs), and ERCP where gallstones can be removed in a non-surgical manner or diagnose cancers and other disorders related to the liver and pancreas.

Shari leads a skilled staff of Seton Family clinicians who specialize in diagnosing conditions of the gastrointestinal system.

"We have the state-of-the-art high definition digital imaging equipment. Screenings are performed under sedation so patients are kept comfortable," says Shari.

Colonoscopys and other colorectal screening tests are performed at most Seton Family hospitals.

Comparing Colorectal Screening Tests

Your doctor can talk about the risks and benefits of the different types of screening examinations. Screening tests include fecal occult blood test (FOBT), sigmoidoscopy, colonoscopy, double contrast barium enema (DCBE), or digital rectal exam (DRE). The National Cancer Institute created the following table outlining some of the advantages and disadvantages of the colorectal cancer screening tests.

Test	Advantages	Disadvantages
Fecal Occult Blood Test (FOBT)	No preparation of the colon is necessary. Samples can be collected at home. Cost is low compared to other colorectal cancer screening tests. FOBT does not cause bleeding or tears in the lining of the colon.	This test fails to detect most polyps and some cancers. False positive results are possible. ("False positive" means the test suggests an abnormality when none is present.) Dietary and other limitations, such as increasing fiber intake and avoiding meat, certain vegetables, vitamin C, iron, and aspirin, are often recommended for several days before the test. Additional procedures, such as colonoscopy, may be necessary if the test indicates an abnormality.
Sigmoidoscopy	The test is usually quick, with few complications. Discomfort is minimal. In some cases, the doctor may be able to perform a biopsy (the removal of tissue for examination under a microscope by a pathologist) and remove polyps during the test, if necessary. Less extensive preparation of the colon is necessary with this test than for a colonoscopy.	This test allows the doctor to view only the rectum and the lower part of the colon. Any polyps in the upper part of the colon will be missed. There is a very small risk of bleeding or tears in the lining of the colon. Additional procedures, such as colonoscopy, may be necessary if the test indicates an abnormality.
Colonoscopy	This test allows the doctor to view the rectum and the entire colon. The doctor can perform a biopsy and remove polyps during the test, if necessary.	The test may not detect all small polyps and cancers, but it is the most sensitive test currently available. Thorough preparation of the colon is necessary before the test. Sedation is usually needed. Although uncommon, complications such as bleeding and/or tears in the lining of the colon can occur.
Double Contrast Barium Enema(DCBE)	This test usually allows the doctor to view the rectum and the entire colon. Complications are rare. No sedation is necessary.	The test may not detect some small polyps and cancers. Thorough preparation of the colon is necessary before the test. False positive results are possible. The doctor cannot perform a biopsy or remove polyps during the test. Additional procedures are necessary if the test indicates an abnormality.
Digital Rectal Exam (DRE)	Often part of a routine physical examination. No preparation of the colon is necessary. The test is usually quick and painless.	The test can detect abnormalities only in the lower part of the rectum. Additional procedures are necessary if the test indicates an abnormality.

Talk to Your Doctor

To find out more about colon cancer screening, talk to your own physician who can answer your questions and arrange the procedure. Many insurance companies cover colon cancer screening. "Insurance is pretty good about paying these days, so screening is not something to put off," says Shari.

Virtual Colonoscopy

New screening tests are on the horizon that use special x-ray equipment and a computer program to produce images of the colon. Because it is less invasive and does not require sedation, virtual colonoscopy may cause less discomfort and take less time than conventional colonoscopy.

However, as with conventional colonoscopy and DCBE, thorough preparation of the colon is necessary before the test. If polyps are found, the patient will need a conventional colonoscopy to remove them.