Screening for Colon and Rectal Cancer

There has been a significant increase in the interests in, and the attention to, colon cancer in recent years. Colon cancer is deserving of this attention, since it is the second most common cause of death due to cancer in the United States. Many celebrities have been affected by colon cancer, and they now are beginning to share this experience with the public. This is helping to decrease the fear, embarrassment and “tight-lipped” approach many people have to colon cancer. These celebrities include:

1. Former President Ronald Reagan, who survived colon cancer during his presidency;
2. Katie Couric of NBC’s Today Show, whose husband died of colon cancer in his early 40’s;
3. Baseball stars Darryl Strawberry and Eric Davis;
4. Charles Schultz, creator of the “Peanuts Gang”;
5. Sharon Osbourne, wife of rock star Ozzie Osbourne;
6. President George W. Bush, who has a history of pre-cancerous colon polyps and took time from the “War on Terrorism” to have his colonoscopy.

Medicare, and other health insurers, recognize the importance of colon cancer and colon cancer screening. Medicare has recently included colon cancer tests as covered benefits for Medicare recipients. Many insurers are following Medicare’s lead, and are also providing coverage for colon cancer screening.

The American Cancer Society has recommended colon cancer screening for everyone 50 years of age or older. Unfortunately, only a small portion of the population receives proper advice and screening related to colon cancer. Screening exams are done before the development of symptoms, since waiting for symptoms is waiting too long. Colon cancer screening is unique in that a pre-cancerous growth can be found and destroyed. This is helpful in preventing cancer, rather than just finding the cancer early. This is a very important advantage of colon cancer screening when compared to breast, cervical, or prostate cancer screening. Therefore, it is important for everyone regardless of the presence of symptoms or family history, to undergo colon cancer screening.

There are three types of colorectal screening programs.

1. The most basic screening program is comprised of a yearly stool test for blood and a flexible sigmoidoscopy (a short endoscopic examination) performed every five years. These are the least invasive means of evaluating the colon and, as such, may miss some tumors. Therefore, this is only appropriate for patients who have average risk for colon cancer. Average risk is defined as patients who have reached the age of 50 and do not a personal or family history of colon polyps, colon cancer, colitis, or symptoms related to the colon (bleeding, change in bowel habits).
2. The combination of flexible sigmoidoscopy and barium enema examination (x-ray) of the entire colon is another acceptable screening program. The testing is more involved and, therefore, has less likelihood of missing tumors. This combination of tests should be performed at five-year intervals.
3. Colonoscopy is an endoscopic examination of the entire lining of the colon. This allows the lining to be directly seen. Abnormal areas may be biopsied, and polyps may be removed during the procedure. Colonoscopy is considered the most accurate way of examining the colon. It is performed at ten-year intervals provided that symptoms or family history do not change during that period.