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Colorectal Cancer Month Focuses on Prevention

March 24, 2010

Washington Hospital Doctor Urges People Over 50 to Get Screened

Colorectal cancer is one of the most preventable cancers there is, yet it is the second leading cancer killer in the United States, according to the Centers for Disease Control and Prevention. That’s why Katie Couric underwent a colonoscopy on the Today Show years ago when she was co-anchor of the morning program. After losing her husband to colon cancer, she wanted to show the world that the invasive screening was well worth it to stay alive – and it may not even be as bad if as you think. After all, Couric did it in front of millions of viewers.

That’s also the message behind Colorectal Cancer Month in March. While diet and exercise help to reduce your risk, screenings like colonoscopies are the only sure way to prevent the disease.

"We can actually prevent the development of colorectal cancer," said Dr. Annamalai Veerappan, a gastroenterologist at Washington Hospital. "Most cancer screenings are meant to detect cancer early so treatment will be more effective. But with colorectal cancer, we are one step ahead of the game."

Colorectal cancer refers to cancer in the colon or rectum. Nearly 50,000 people die from the disease every year, according to the American Cancer Society.

Colorectal cancer usually starts with polyps in the colon or rectum. A polyp is a growth that shouldn’t be there. Over time, some of these polyps can turn into cancer.

"Eighty-five to 95 percent of colon cancers start as a polyp," Veerappan said.

Risk Factors

There are a number of risk factors that increase your chances of developing colorectal cancer, including:

Age: Younger people can get colorectal cancer, but 90 percent of people diagnosed with colorectal cancer are over age 50, according to Veerappan.

Personal history: If you have a history of inflammatory bowel disease, which includes ulcerative colitis and Crohn’s disease, your risk for developing colorectal cancer is increased.

Lifestyle: People who eat diets high in saturated fat and red meat and low in fiber are at greater risk, Veerappan said. Those who smoke and drink alcohol also increase their chances, he added.

Family history: About 5 to 10 percent of people who develop colorectal cancer have a family history of the disease, according to Veerappan. If the family member is a first-degree relative – parent, sibling, or child – it increases your risk. If the first-degree relative was diagnosed at a young age, your risk is even higher.

"We think there may be a genetically determined susceptibility to developing colorectal cancer," Veerappan said.

Reducing Your Risk

While you can’t change genetics, you can get the recommended screenings and make certain lifestyle choices to reduce your risk.

"We see a 90 percent reduction in colon cancer when we do screening," Veerappan said. "Everybody over 50 should get screened. If you have a family history, you should start at age 40 or 10 years younger than the index case in your family. In other words, if a close relative got cancer at age 45, you should start at age 35."

If you get your first screening at age 50 and have no risk factors and no polyps, you can wait until age 60 for another screening, Veerappan said. But if you have polyps or risk factors, you should get screened more often, he added.

Screening procedures include colonoscopy, sigmoidoscopy, fecal blood test, and virtual colonoscopy. According to Veerappan, the gold standard is the traditional colonoscopy because it provides the best view of the colon and rectum and polyps can be removed during the procedure.

"The goal is to find and remove polyps," he said. "Polyps are found about 40 percent of the time. Not all polyps will become cancerous, but we remove them all because we can’t always tell which ones will."

Eating a diet low in fat and high in fiber, exercising, keeping your weight down, and avoiding tobacco and alcohol can also help reduce your risk for colorectal cancer. In addition, Veerappan suggested taking aspirin, fish oil and selenium daily to prevent the development of polyps.

"It’s important to make healthy choices," he added. "But nothing replaces screening."

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