Colorectal cancer is the second leading cause of cancer-related deaths in the United States, effecting men and women equally. About 140,000 people will be diagnosed with colorectal cancer each year, and 50,000 people will die from the disease. Colon cancer develops in the lining of the colon (large intestine) and rectal cancer develops in the lining of the rectum, which is the lowest portion of the colon above the anus. Together these are referred to as colorectal cancer. Colorectal cancer arises from precancerous growths or polyps that grow in the colon. When detected early, polyps can be removed during colonoscopy before they become cancerous. The incidence of colorectal cancer has decreased as colonoscopy and screening has increased.
Most polyps do not cause any symptoms, which is why screening is so important. Occasionally a polyp may cause visible blood to appear in the stool. Sometimes blood will be detected in the stool when special testing is done on the stool sample. If a polyp is very large, it may lead to constipation or diarrhea, but this is very rare. Smoking, obesity, and drinking alcohol increase the risk of polyps. Eating a high-fat diet, red meat, and a low-fiber diet also increase the risk of polyp formation.
Getting screened is the first step in detecting and preventing colon cancer. There are several options for screening tests so talk to your doctor about which one is best for you. A colonoscopy is the only option that combines both detection and prevention. Other options include fecal immunochemical test, fecal occult blood test, and Cologuard test. These all involve a stool sample, and it is important to realize they screen for cancer not polyps. If abnormalities are found in these tests, then further testing with colonoscopy may be recommended.
Screening colonoscopy should began at age 50 for those with an average risk for developing colon cancer. If there is a family history of colon cancer or colon polyps screening should begin at age 40 or even earlier depending upon your family history. Repeat colonoscopies are recommended at intervals depending on colonoscopy findings. Follow-up colonoscopies are important for life long prevention.
An oral cleansing prep is required for a colonoscopy. An excellent bowel preparation greatly improves the ability to detect colon polyps and colon cancer. An inadequate bowel prep limits
polyp and cancer detection. Therefore, it is very important to take the preparation according to instructions.
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