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Maureen Hewitt, MD, Hematology Oncology
The Chester County Hospital and Health System

Published: March 25, 2013

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. It is expected to cause approximately 51,000 deaths this year alone. The death rate, however, has been trending downward for more than 20 years, in part due to colorectal cancer screening. Screening is one of the most powerful tools for preventing colorectal cancer, since it enables cancer to be found earlier, when it is in its most treatable stage. Many people with colon cancer experience no symptoms in the early stages of the disease, which makes routine screening even more important.

A colonoscopy is the best screening test currently available to detect colorectal cancer. During a colonoscopy, a physician inserts a long, thin, flexible tube into the colon and examines the interior lining of the large intestine for polyps or other abnormal growths in the lining of the colon. Any polyps seen are removed, which prevents them from growing and potentially becoming cancerous. A colonoscopy is recommended beginning at age 50 for both men and women if there are no known family risk factors for colon cancer. Screening at an earlier age may be appropriate if there is increased risk of developing colorectal cancer due to a known family history.

Persons concerned about their family or personal history of cancer may benefit from a cancer risk assessment, which is performed by a Genetics Counselor. The Genetics Counselor will review the person's family history to determine if genetic testing may be appropriate, as well as develop a plan to monitor the person's health on a follow-up basis based on level of risk. Individuals with certain genetic syndromes, such as familial adenomatous polyposis (FAP), and hereditary non-polyposis colon cancer (HNPCC or Lynch Syndrome) may require screening at a much earlier age than what is recommended for the general population. Individuals who have a family history of colon cancer without any of these known genetic syndromes may be advised by their physician to start screening approximately 10 years prior to the age when their family member was diagnosed. In addition, persons with inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, may need to begin screening at an earlier age and on a more frequent basis. Age, race, ethnicity and lifestyle can also increase a person's chance of developing colon cancer.

Significant strides have been made in the treatment of colorectal cancer but the best chance for cure is through early detection by screening colonoscopy. Screening, early detection and advances in treatment have improved outcomes, resulting in more than one million colorectal cancer survivors in the United States today.

This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.

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