Report stresses options for colon cancer screening: MedlinePlus

Report stresses options for colon cancer screening

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_109438.html(*this news item will not be available after 05/31/2011)

Wednesday, March 2, 2011
Related MedlinePlus Pages

Colorectal Cancer
Women's Health Checkup
By Amy Norton

NEW YORK (Reuters Health) - Women should be aware that they have several options for colon cancer screening, and not only the often-dreaded colonoscopy, according to a new report from the American College of Obstetricians and Gynecologists (ACOG).

The statement does not veer from guidelines from major medical groups like the American Cancer Society and the American College of Gastroenterology -- which consider colonoscopy the "preferred" screening test.

However, ACOG does stress that doctors should tell women about all of their colon cancer screening options -- which include fairly simple at-home tests that detect blood in the stool. And women should choose the test they are most willing to follow through with, the ob/gyn group says.

"A lot of people don't know they have several options, and so some may not get screened at all," said Dr. Cheryl B. Iglesia, who chaired the ACOG committee that wrote the new document, published in the group's journal Obstetrics & Gynecology.

In general, experts recommend that adults at average risk of colon cancer start routine screening at the age of 50, through any of several standard tests or a combination of tests.

Those include colonoscopy, flexible sigmoidoscopy and fecal occult blood testing (FOBT). (Some tests now under development -- like "virtual" colonoscopy, done by CT scans, and fecal DNA testing -- are not yet recommended for widespread use.)

Colonoscopy, done every 10 years, can find and remove polyps -- growths in the colon that can potentially become cancerous. Because of that, many medical groups consider colonoscopy the preferred screening method.

The lifetime risk of developing colon or rectal cancer is one in 19 for men and one in 20 for women, according to the American Cancer Society. More than 50,000 Americans died of the disease in 2010.

However, when it comes to lowering your risk of death from colon cancer, colonoscopy, flexible sigmoidoscopy (every five years) and an annual FOBT are all effective. In fact, the U.S. Preventive Services Task Force -- a federal expert panel -- recommends that adults at average risk of colon cancer choose any of the three methods.

"It is nice to know that you have alternative to colonoscopy, and people should be aware of them," Iglesia said.

Many people, she noted, are turned off by the preparation for colonoscopy, which involves taking strong laxatives the day before to clean out the colon. Sigmoidoscopy requires a similar preparation, but the procedure -- which only views the lower portion of the colon -- is less extensive, can be done without sedation and has a lower risk of complications.

Serious complications from colonoscopy are uncommon, but include perforation of the colon and bleeding. One study found that for every 1,000 colonoscopies, roughly three result in a serious complication.

"So there are risks," Iglesia said.

Stool-based blood tests, she said, while not "pleasant," are non-invasive and fairly simple.

FOBT detects hidden blood in the stool, which can be a sign of colon cancer. Positive results prompt a follow-up colonoscopy. The test involves taking stool specimens at home and mailing them to the doctor's office or medical lab.

But while stool tests are the simpler, safer option, Iglesia stressed that you also have to "do them right," and repeat them annually.

The bottom line, she said, is that women (and men) should discuss the pros and cons of all colon screening options with their doctors.

People at higher-than-average risk of the cancer -- due to a strong family history, for example -- may need to start colon cancer screening sooner or have it more often. And colonoscopy is often the recommended method.

SOURCE: http://bit.ly/dOAgZB Obstetrics & Gynecology, March 2011.

Reuters Health
(c) Copyright Thomson Reuters 2011. Check for restrictions at: http://about.reuters.com/fulllegal.asp
Report stresses options for colon cancer screening: MedlinePlus