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Untitled Document
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| Colon
Cancer |
Screening Recommendations for the
General Population |
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By
Miriam Komaromy, MD
Reviewed
by Peggy Conrad, MS, CGC and Jonathan
Terdiman, MD
Last updated March 3, 2001
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Although
health professionals often talk about cancer screening and prevention
in the same breath, the terms have different meanings. Prevention
refers to methods of keeping cancer from forming. Screening, on the other hand, refers to mothods of detecting cancer while it's still small, hasn't spread to other parts of the body, and is most treatable.
In the case of colon cancer, the screening techniques used to look for cancer also allow doctors to remove the polyps that turn into cancer. Because of this, screening for colon cancer is also the best form of prevention.
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Screening
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For some types of cancer, scientists have developed good screening methods but are less certain about how to prevent the disease from occurring. Breast cancer is a good example. Although mammography serves as an excellent way to detect early cancers, researchers are just beginning to understand to perhaps prevent breast cancer from occurring.
Fortunately, in the case of colon cancer, there are excellent ways to both
screen for and prevent the disease. In fact, the primary prevention procedures
(colonoscopy
and sigmoidoscopy)
are also the most widely used methods of screening for the disease.
When doctors screen for colon cancer, they are trying to catch the cancer
in its early stages — before it has grown large or spread to other
parts of the body. When they are able to detect colon cancer in this small,
local and nonsymptomatic phase, they are much more likely to be able to stop the cancer than if they don't make their diagnosis until after symptoms have begun to appear. Screening for colon cancer has been definitively shown to reduce deaths from this disease. (For news about colon cancer screening, see Related News below |
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Guidelines
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Doctors are able to detect polyps in three ways: by looking directly inside your colon (colonoscopy or sigmoidoscopy); through X-ray visualization (double-contrast barium enema, or DCBE), and through testing your stools for blood (called fecal occult blood testing, or FOBT), which allows them to detect microscopic amounts of blood that may indicate the presence of a bleeding polyp in the colon.
There is some debate over whether colonoscopy or sigmoidoscopy is the prefered screening method for colon cancer. However, what is most important is that you and your doctor develop a schedule that is appropriate for you, and that you follow that schedule.
Currently, the American Cancer Society and the American College of Gastroenterology recommend the following screening regimens for people at average risk for colon cancer, beginning at age 50.
- FOBT every year plus sigmoidoscopy every 5 years
OR
- Colonoscopy every 10 years
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Note:
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Many clinical and policy organizations issue their own screening
and prevention guidelines. On our site we highlight guidelines that
are widely respected and recommended. However, we encourage you
to decide which guidelines are best for your personal screening
with your own healthcare provider who is most familiar with your
situation and needs. |
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References
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Hawk,
E. et al. (1999). Chemoprevention in hereditary colorectal cancer syndromes.
Cancer 86: 2551-63.
Potter, J. (1999). Colorectal cancer: molecules and populations. Journal
of the National Cancer Institute 91(11): 916-32.
Baron, J. et al. (1999). Calcium supplements for the prevention of colorectal
adenomas. Calcium Polyp Prevention Study Group. New England Journal of
Medicine 340(2): 101-7.
Gann, P. et al. (1993). Low-dose aspirin and incidence of colorectal tumors
in a randomized trial. Journal of the National Cancer Institute 85(15):
1220-4.
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