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Colon and Rectal Cancer  

Colon and rectal cancer is one of the most common forms of cancer in the United States. Approximately 140,000 new patients are diagnosed and 60,000 die from colon and rectal 

cancer each year. A 50-year-old person has a 5% risk of developing colon or rectal cancer and by the age of 80 a 2.5% risk of dying from it.

Colon and rectal cancer is best treated when diagnosed early. In its earliest stages (before it spreads to other organs), the cancer is often completely cured by surgery.  
 

Many physicians feel that almost all colon and rectal cancers arise from polyps. Therefore, one of the best ways of preventing the cancer is to remove the pre-malignant polyp before it turns into a cancer. While not all polyps will turn into cancers, the only sure way to prevent the development of cancer is to remove all polyps.

Screening recommendations

The National Cancer Institute, the American Cancer Society, and the American College of Physicians endorse a program for the screening of people over the age of 50 for colon and rectal cancer. There is strong evidence that appropriate screening reduces the risk of colon and rectal cancer.

Current recommendations for patients over 50 years old who are not at an increased risk of cancer include testing the stool for blood every year and performing a screening flexible sigmoidoscopy every three to five years.

Increased risk factors

Additional risk factors for colon and rectal cancer include:

    1. Family history of colon polyps or colon cancer

    2. Previous personal history of colonic cancer or polyps

    3. History of inflammatory bowel disease

    4. History of non-colon cancer.

Patients who are at high risk for the development of colon and rectal cancer should have a full colonoscopy every 5 years starting at 35 or 40 years of age in addition to testing the stool for blood every year.

Flexible Sigmoidoscopy

A flexible sigmoidoscopy is an examination of the lower third of the colon. Since over 65% of polyps and cancers occur in this section of the large bowel (colon), flexible sigmoidoscopy is a very effective screening procedure. It utilizes a flexible fiber-optic endoscope that permits the physician to examine the lower colon.

After a simple bowel cleansing with a disposable enema, the patient lies on the left side. The tube is inserted into the rectum and passed approximately 60 cm (24 inches). Since air is used to inflate the colon, the patient has a sensation of "gas" and "fullness". Frequently, as the tube goes through a turn, a quick, sharp cramp may be experienced. This is similar to a cramp one gets before a bowel movement. Most patients experience only a mold discomfort.

The examination takes less than 5 minutes to complete. The patient is able to drive immediately after the procedure and return to work the same day.

If a polyp or cancer is found, the patient will need to return for a complete endoscopic examination of the colon.

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