Shared from the 6/24/2018 Connecticut Post eEdition

HEALTH

New rules on screening applauded

Doctors welcome step toward detecting colon cancer earlier

Early detection is the key when it comes to battling most cancers. But with colorectal cancer, timely screenings could actually prevent cancer from developing.

It’s one of the reasons the American Cancer Society has lowered the recommended screening age for those at average risk for colon cancer from 50 to 45 — a decision applauded by local doctors. “We’ve been having more and more young people come in with colon cancer,” said Dr. Scott Thornton, surgical director of the Norma Pfriem Cancer Center at Bridgeport Hospital.

He blamed this largely on diet coupled with genetics, and said earlier screening will allow doctors to prevent more cancers. Colonscopies, the method of screening for colon cancer, is unique among screening methods, Thornton said.

“Mammograms and PSAs (used to detect prostate cancer) catch cancer early,” Thornton said. “Colonoscopies find cancer before it’s cancer.”

Basically, he said, colonoscopies can detect pre-cancerous polyps and remove them before they become problematic. “If we remove the polyps, you can’t get cancer,” Thornton said.

Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, according to the cancer society, which estimates more than 97,000 new cases of colon cancer and more than 43,000 new cases of rectal cancer will be diagnosed this year. Colorectal cancer is the third leading cause of cancer-related death in men and women in the U.S., and ACS estimates 2018 will bring more than 50,000 such deaths this year.

In Connecticut alone, the cancer society estimates that there will be 1,520 new colorectal cancer cases in 2018, and 460 deaths.

Colon cancer takes time to develop and typically follows numerous warning signs, making it one that could easily be prevented if patients get screened regularly, said Dr. Shahzad Zafar, a colorectal surgeon at Stamford Hospital.

“It is a totally preventable cancer,” he said. “Colon cancer develops from an adenoma, which is a benign polyp that over the course of a number of years becomes the carcinoma, which is the cancer. So, there is time to detect the polyps and remove them before they become cancer. In essence, you can prevent colon cancer if people get the colonoscopy on time and follow through with continued screening.”

The American Cancer Society’s decision came after “looking closely at evidence that new cases of colorectal cancer are occurring at an increasing rate among younger adults,” the organization said in a statement. “A beginning screening at the age of 45 for adults of average risk will result in more lives saved from colorectal cancer.”

The ACS describes average-risk individuals as those who do not have:

A personal history of colorectal cancer or certain types of polyps

Those who do not have a family history of colon colorectal cancer

Those who do not have a personal history of inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease

Those who do not have a confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis or Lynch syndrome

Those who do not have a personal history of having radiation to the abdomen or pelvic area to treat a prior cancer.

The most obvious sign that something is wrong, Zafar said, is bloody stool or rectal bleeding.

“One of the most important things for people to know is if you see blood when you go to the bathroom, or have blood coming from your rectum, that is a very ominous sign that you should not ignore, regardless of your age,” he said. “That is a sign that you need to go and see a doctor and get worked up.”

However, most people with colon cancer don’t have symptoms during the early stages of the disease, Zafar said.

“That is why changing the screening age from 50 to 45 is so important, because a lot of those who develop the cancer at a younger age will actually have no symptoms, and if they’re waiting until 50 or 51 to get tested, we are likely to miss that window where we can either prevent it or catch it at an early stage,” Zafar said.

Though a colonoscopy is considered the “gold standard” for colon cancer screening, the American Cancer Society said there are a number of tests a patient can undergo, including stool tests, DNA-based testing or a CAT scan.

However, Zafar said colonoscopy is the best route.

“The colonoscopy is the best test because it’s not just diagnostic, it’s also therapeutic. You can visualize the entire area, you find any polyps that may be there and you can remove them at the same time,” he said.

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