Colon Cancer What is it How do you detect it

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Colon Cancer What is it? How do you detect
it?

• 50 Years Old or Older?
• Get Tested Regularly!

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Colon cancer is

• Cancer of the colon or rectum
• Your colon
• is another name for your large intestine.
• is about 6 feet long.
• turns food you eat into waste matter or a bowel
  movement as it passes through the colon.
• Your rectum
• is the last 8-10 inches of the large intestine.
• bowel movements travel through the rectum and
  pass out of the body through the anus.

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Your Colon and Rectum
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How long does it take cancer to develop, and what
are your chances?

• In most people, colorectal cancers develop slowly
  over a period of several years.
• 10 to 20 years
• Chances of developing colorectal cancer sometime
  in your life
• A man has a 1 in 17 chance.
• A woman has a 1 in 18 chance.

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Why does it develop?

• Colorectal cancer usually begins as a
  non-cancerous (or benign) polyp.
• A polyp
• is a growth inside the colon or rectum that is
  not normal.
• can be several types.
• is not always cancerous.

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When Cancer Forms in a Polyp

• It can eventually grow through the lining and
  into the wall of the colon or rectum.
• 95 percent of colorectal cancers grow from
  cancerous polyps and move into the inside layer
  of the wall of the colon and rectum.

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Importance of Screening and Early Detection

• Once a non-cancerous (benign) polyp is removed,
  it will never have the chance to develop into
  cancer.
• Regular screenings for colorectal cancer and
  removal of polyps
• Reduce a persons lifetime risk of dying by 80
  percent.
• When colorectal cancer is detected early
• It is highly curable!

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Lower Your Risk of Developing Colorectal Cancer
by

• Increasing physical activity
• Exercise at least 30 minutes a day on the
  majority of days.
• Not smoking
• In the USA, 1 in 5 colorectal cancers in men and
  1 in 8 colorectal cancers in women may be due to
  cigarette smoking.
• Improving your diet
• Limit your alcohol use.
• Limit high-fat diets.
• Limit red, charred, or processed meat.

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Age and Race Factors for Colorectal Cancer

• Age
• 90 percent of all colorectal diagnoses happen
  after age 50.
• Race and Ethnicity
• Everyone is at risk!
• Risk Rankings
• African-Americans
• Whites
• Asian Americans/Pacific Islanders
• Hispanics
• American Indians

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Personal History Risk Factors for Colorectal
Cancer

• Personal History of Cancer
• If youve already been treated for colorectal
  cancer, youre at an increased risk for
  developing it again.
• Personal History of Polyps
• If you have had a polyp removed
• You are no longer at risk of that particular
  polyp developing into cancer.
• If you have had an adenomatous polyp removed, you
  are more likely to have other polyps in the
  future.
• Adenomatous polyps are groups of polyps with
  abnormal cells that multiply and may eventually
  become cancerous.

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Having Inflammatory Bowel Disease and Type 2
Diabetes Are Risk Factors

• Inflammatory bowel disease (IBD) includes
• Ulcerative colitis and
• Crohns disease
• The overall increased risk of colorectal cancer
  for someone with IBD is estimated to be 4-20
  times higher than normal.
• Personal history of type 2 diabetes
• Increases your risk of having colorectal cancer
  and colorectal polyps by 50 percent

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Family History and the Role of Genetics

• You have a higher risk of developing colorectal
  cancer if
• One or more immediate family members were
  diagnosed with colorectal, uterine, or stomach
  cancer
• Immediate family members include
• Parent
• Sibling
• Child

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Early Detection Makes a Difference

• Approximately 56,000 Americans die from
  colorectal cancer each year.
• It is the 2nd leading cause of cancer in the
  nation.
• The most effective way to reduce your risk of
  colorectal cancer is to get screened routinely.
• Start at age 50.
• Start earlier if you are at higher risk.
• Personal health history
• Family health history

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What if something is found?

• If you have polyps
• They can be removed before they turn into cancer.
• Finding and removing adenomatous polyps can
  decrease colorectal cancers by 60-90 percent.
• If cancer is found
• It is often curable in its early stages.

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Dont want to get screened?

• Embarrassed?
• Doctors need to know about changes in your bowel
  habits or rectal bleeding.
• Everyone has private parts, and its important
  to keep them healthy!
• Dont want bad news?
• Getting screened can find bad things early, which
  increases the amount of time you can spend with
  your family. They need you!
• Doctor didnt say you need to get tested?
• Bring it up with him or her its important!

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What test do I take to get screened?

• There are several tests to screen for colorectal
  cancer.
• Some tests are used alone, while others are used
  in combination with other tests.
• Talk to your doctor about which type of test is
  best for you!

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Fecal Occult Blood Test (FOBT)

• Recommended to be done yearly
• Checks for hidden blood in the stool
• Your doctor gives you a test kit
• At home, you place a small amount of your stool
  from 3 bowel movements on test cards.
• You then return the cards to your doctors office
  or a lab where the stool samples are tested for
  hidden blood.
• If blood is found, a colonoscopy will be needed.
• A disadvantage of this test
• The test is often negative in people who have
  adenomatous polyps and colorectal cancer.

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Flexible Sigmoidoscopy (Flex Sig)

• Recommended every 5 years
• Examines the lining of your rectum and lower part
  of your colon
• Uses a thin, flexible, lighted tube called a
  sigmoidoscope
• It is inserted into your rectum and lower part of
  your colon.
• If polyps or lesions are found, a follow-up test
  is needed.
• Disadvantages
• Patient discomfort but not painful
• Only looks at lower part of colon, therefore
  polyps in the upper colon can go undetected.
• If a polyp is found, it needs to be followed by a
  colonoscopy to remove the polyp.

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Combination FOBT and Flex Sig

• Some experts recommend using both of these tests
  to increase the chance of finding polyps and
  cancers.
• It is recommended every 5 years.

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Colonoscopy

• Similar to the Flexible Sigmoidoscopy except
• It allows the doctor to look at the lining of
  your rectum and entire colon.
• Done as an outpatient procedure
• Done with conscious sedation
• An IV line is inserted to help you remain calm
  and comfortable. Some patients sleep though the
  procedure.
• Not everyone needs sedation.
• Uses a thin, flexible, lighted tube called a
  colonoscope
• It is inserted into your rectum and colon.
• The doctor can also find and remove polyps and
  some cancers using the colonoscope.
• It is recommended every 10 years for
• Individuals with no family or personal history of
  colon cancer and no symptoms.

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Colonoscopy (continued)

• Procedure takes 1530 minutes.
• May take longer if polyps are removed.
• Called a polypectomy
• A wire loop is passed through the scope to cut
  the polyp from the lining of the colon using an
  electrical current.
• Polyps are collected and
  sent to the lab for
  evaluation.

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Double Contrast Barium Enema (DCBE)

• This test allows the doctor to see an x-ray image
  of the rectum and entire colon.
• First you are given an enema with a liquid called
  barium that flows from a tube into your colon,
  followed by an air enema.
• The barium and air create an outline around your
  colon, allowing the doctor to see if anything is
  wrong.
• Recommended every 10 years.
• Many disadvantages
• Detects only 50 percent of adenomatous polyps
  greater than 1 cm in size and only 33 percent of
  polyps .5 cm in size
• May miss up to 15 percent of colorectal cancers
• Does not allow removal of polyps

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Worried about How Much It Will Cost?

• If you are 50 years old or older and have
  Medicare
• You are eligible for colorectal screenings!
• For more information, call or visit
• 1-800-MEDICARE (1-800-633-4277)
• http//medicare.gov/Health/ColonCancer.asp
• If you have private insurance
• Most insurers are now paying for some form of
  colorectal screening
• Often including screening colonoscopy

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Think about the future

• Your family needs you.
• If youre 50 years old or older
• Get screened!
• You have the power to determine your future!
• Any questions?

Written by Courtney J. Schoessow, MPH February
2006
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