Colorectal Cancer:An Often Preventable Disease
John M. Dalena, MDDirector, Atlantic Gastroenterology
at Summit Medical Group
Chairman, Morristown Medical CenterDepartment of Gastroenterology
Date
About Colorectal Cancer
• Colorectal cancer (CRC) is a common, sometimes deadly disease It is the leading cause of cancer death
• 1 in 3 people who develop colorectal cancer die from the disease
• It accounts for almost 10 percent of all cancer deaths
Who gets CRC?
Colorectal cancer is uncommon in people at average risk who are age ≤50 years
But by age ≥50 years, risk of the disease increases for all people • 90 percent of cases occur in people
age ≥50 years
What are risks for CRC?
• Although risk for CRC is mostly acquired, genetic factors can have a role
• Other risk includes: Age Gender, with more women than men getting CRC Family history Ethnicity and racial background Geographic area Smoking Dietary and exercise habits
More About CRC Risk
• Risk for CRC is greater if you have: History of colorectal cancer or polyps Inflammatory bowel disease, including
• Crohn’s disease• Ulcerative colitis
Familial adenomatous polyposis (FAP) Hereditary nonpolyposis colon cancer
(HNPCC) or Lynch syndrome
Do you solemnly swearto follow my advice?
Screening Matters!
• Having risk for CRC does not ensure you will get the disease
• Having little risk for CRC does not ensure you will not get the disease
The Good News
Colorectal cancer deathsare declining in the United States!
•Screening is key Data show an estimated 53 percent of the
reduction in colorectal cancer deaths likely result from screening and early detection
Between 1987 and 2010, screening is likely to have prevented the disease in ≤500,000 people
Reducing CRC Risk
• Know your risk • Get screened• Eat a diet
Low in saturated fat, cholesterol, and red meat High in fiber and calcium
• Exercise and be active• Don’t smoke• Reduce stress
CRC Screening
• Helps your doctor find precancerous tissues and remove them before they become cancerous
• Helps your doctor find and remove CRC in its early stages before it has spread
Prepping for Screening
• Is not as difficult as you might think! It’s relatively quick It’s worth the trouble because
screening can save your life
Importance of Proper Prepping
Your doctor cannot conduct your colonoscopy unless your colon
is completely clean!
Types of Screening
• Flexible sigmoidoscopy
• Optical colonoscopy
• Double-contrast barium enema
• Computed tomography (CT) colonography (virtual colonoscopy)
Stool-based Tests
• Guaiac-based fecal occult blood test
• Immunochemical-based fecal occult blood test
• Cologuard fecal DNA testing
Which test is best?
Colonoscopy is the gold standardfor early detection of polyps and cancer.
When to Be Screened
• At age ≥50 years and every 10 years thereafter if you are at average risk If you have a adenomatous polyp,
your doctor will likely advise you to be evaluated in less than 10 years
More Frequent Screening
If you have a personal or family history of CRC or adenomatous polyp
If you have a genetic syndrome increasing CRC risk• Hereditary nonpolyposis CRC (HNPCC)
• Familial adenomatous polyposis (FAP)
• One or more first-degree relatives with CRC
• Two or more second-degree relative with CRC• IBD causing pancolitis or long-term (≥8 years) disease• Other health problems that required radiation therapy
The Bottom Line
Know your risk,
live a healthy lifestyle,
and get screened!