Cancer Prevention


Spring 2004, Issue 3

Home

From the Editors

Calendar of Events
 
Colorectal Cancer

What You Should Know

Each year, over 146,000 Americans will be diagnosed with colorectal cancer, making it the third most common cancer in both men and women. And nearly 57,000 Americans will die from this disease. The key to success in reducing the number of these deaths is prevention. Early detection is integral to that process. An awareness of risk factors, a knowledge of signs of the disease, and adherence to screening guidelines can help reduce your chances of developing this malignancy. Two good places for more information on colorectal cancer are the National Cancer Institute of the National Institutes of Health at www.cancer.gov and the American Cancer Society at www.cancer.org .

Risk Factors
  • Family history of colorectal cancer
  • Personal history of colorectal cancer
  • Personal history of polyps or inflammatory bowel disease
  • Hereditary conditions, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer
  • Age 50 or older
  • A diet based mainly on animal sources, rather than fruits, vegetables, and grains
  • No exercise.
  • Obesity
  • Tobacco use
Signs of Possible Colorectal Cancer
  • Change in bowel habits.
  • Bloody stool
  • Unusually narrow stools
  • Diarrhea
  • Constipation
  • Feeling that the bowel does not empty completely.
  • Abdominal discomfort, such as cramps, gas pains, fullness, or bloating
  • Vomiting
  • Constant fatigue
  • Unexplained weight loss
Adapted from the American Cancer Society (www.cancer.org) and the National Cancer Institute of the National Institutes of Health (www.cancer.gov). Please visit these Web sites for complete information.


Colorectal Screening Guidelines

The colorectal screening guidelines shown below were developed by the American Cancer Society (www.cancer.org ). You can use this information to discuss your own screening options with your physician.

American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer - Average-Risk Women and Men Ages 50 and Older
Test
Interval
(beginning at age 50)
Comment
Fecal occult blood test (FOBT) and flexible sigmoidoscopy
FOBT annually and flexible sigmoidoscopy every 5 years
Flexible sigmoidoscopy together with FOBT is preferred compared with FOBT or flexible sigmoidoscopy alone. All positive tests should be followed up with colonoscopy*
Flexible sigmoidoscopy
Every 5 years
All positive tests should be followed up with colonoscopy*
Fecal occult blood test
Yearly
The recommended take-home multiple sample method should be used. All positive tests should be followed up with colonoscopy* †
Colonoscopy
Every 10 years
Colonoscopy provides an opportunity to visualize, sample and/or remove significant lesions.
Double contrast barium enema (DCBE)
Every 5 years
All positive tests should be followed up with colonoscopy


*If colonoscopy is unavailable, not feasible, or not desired by the patient, double contrast barium enema alone, or the combination of flexible sigmoidoscopy and double contrast barium enema are acceptable alternatives. Adding flexible sigmoidoscopy to DCBE may provide a more comprehensive diagnostic evaluation than DCBE alone in finding significant lesions. A supplementary DCBE may be needed if a colonoscopic exam fails to reach the cecum, and a supplementary colonoscopy may be needed if a DCBE identifies a possible lesion, or does not adequately visualize the entire colorectum.

† There is no justification for repeating FOBT in response to an initial positive finding.
 
Back to Top
 
New York-Presbyterian. The University Hospitals of Columbia and Cornell