The Difference between a Colon and a Semicolon (or worse…)
By Nick Box, PA-C
This is not a discussion about punctuation. It is a discussion about colon cancer prevention. Getting screened could make the difference between a healthy colon, having a portion of your colon removed, or worse.
Think back to this time last year. One place you would not find yourself was in the colonoscopy suite. Coronavirus restrictions dramatically reduced the capacity for hospitals to provide routine preventative screening exams. The impact of these restrictions were not only felt in our community but across the country. A backlog of patients waiting for scopes quickly developed as nonessential services were postponed. It wasn’t until robust coronavirus testing was available that these procedures were allowed to resume. Late winter/early spring 2020 saw some of the biggest drops in services.
March is colon cancer awareness month and it only seems fitting to remind our community of its importance.
Colon cancer is slow growing and originates from precancerous polyps. Over time the cells that make up the polyp can become more aggressive and begin to invade the wall of the colon and surrounding tissues. They can even begin spreading to other parts of the body and become very difficult or even impossible to treat. Fortunately there is a way to identify and treat these precancerous polyps before they cause problems.
There are a few ways to screen for colon cancer. There are stool tests that can help identify biomarkers associated with cancer and precancerous polyps. This type of test will yield a positive or negative result. Screening is repeated annually or every three years depending on the type of stool test. These noninvasive tests are more accurate with every subsequent negative test. If one of these tests is positive we would follow up with a colonoscopy. A colonoscopy is a procedure during which a flexible camera is used to visualize the entire length of the colon. It can be used alone for screening purposes or can be used as a follow up of a positive stool test. The advantage of a colonoscopy over stool tests is the ability to visualize the polyps and safely remove them. Your provider will then have these polyps analyzed under a microscope and can recommend when you might need to get screened again — up to ten years in many cases.
Who should be screened for colon cancer? Beginning around the age of 50 there is an increased risk of colon cancer. Those who have a mother, father, or sibling who have been diagnosed with colon cancer before the age of 50 should be screened earlier. Those who have certain genetic conditions may also need to be screened earlier. Men and women are at similar risk for colon cancer. Those who smoke or drink alcohol are at an even higher risk.
What doesn’t work well for colon cancer screening? A CT or an MRI might be able to identify large tumors in the abdomen but are not accurate enough to identify precancerous polyps. Similarly, blood tests are more often only abnormal after a polyp has developed into cancer and are not very useful in prevention. Waiting for symptoms to develop means the window of opportunity for prevention has passed.
If you are interested in colon cancer screening, contact your primary care provider. In many cases we can schedule you for screening without the need for an office visit. You can discuss any questions or concerns you might have with your doctor either in person or from home using services like telemedicine. For those of you who postponed screening last year because of coronavirus, know that we are taking precautions to keep you and your family safe. Remember, early screening might make the difference between a colon, a semicolon, or worse.