Preventing a Precancerous Polyp from Becoming Colon Cancer
150,000 new cases of colon & rectal cancer are diagnosed each year in the United States. Screening to identify early stage tumors or precancerous polyps is critical to optimize the chance to cure this otherwise fatal disease. Colonoscopy is the optimal way to facilitate this. Despite its excellent record for safety and detection of disease, most studies show only 50% of Americans are screened appropriately. Common reasons for lack of screening are fear of the procedure, fear of the prep, embarrassment and lack of information about the safety, need and timing of screening.
Current guidelines advise all low risk patients to begin screening for polyps and cancer at age 50. Patients in higher risk groups need to begin screening earlier. Guidelines for the relatives of patients with cancer recommend screening at an age 10 years younger than the family member with cancer.
The majority of cancers begin as a precancerous polyp which develops into cancer over time. The authors of this study have now shown that not only does a family history of colon cancer increase ones risk of developing colon & rectal cancer, but a family history of polyps as well. Consequently screening guidelines need to include this risk factor as well and these patients should also be screened at an earlier age. This information is important not only to specialists who treat colon & rectal and cancer but all primary care providers who recommend screening programs for their patients.
Editor’s Note: Jerald Wishner, MD, FACS, FASCRS, is co-director of the Institute for Robotic and Minimally Invasive Surgery at Northern Westchester. Read more about this leading-edge Westchester surgery here.