The list of celebrities who developed colon or rectal cancer are well published (those who died of the disease are marked with a *) and include United States President Ronald Reagan, US Supreme Court Justice Ruth Bader Ginsburg, All-Star baseball players Eric Davis and Darryl Strawberry, anchor-person Katie Couric’s husband*, Charles Schultz (Peanuts Comic developer)*, Elizabeth Montgomery (Samantha in Bewitched)*, Milton Berle* (Comedian), Sharon Osbourne (wife of Ozzy), Tony Snow (news anchor)*, Vince Lombardi (American football coach and legend)*, Corazon Aquino (Philippine President)*, Pope John Paul II*, and countless others as it’s a leading cause of cancer death in the Western World.
Such notoriety has brought much-needed public awareness to this highly preventable and often secretive disease. The misperceptions that colorectal cancer is a rare and unpreventable disease affects only the elderly, or those with poor nutrition or dietary habits are rapidly disappearing. In fact, colon and rectal cancer is the third leading cancer affecting women and men in the United States and is the second leading cause of cancer-related death in the US. More importantly, colon and rectal cancer is potentially preventable with proper screening since pre-cancerous polyps (the growth in which cancer develops) are removed during a screening colonoscopy.
Thus, it is important for the public to understand that colorectal cancer can strike any person, regardless of age, ethnicity, or dietary intake. In the United States, the lifetime risk of developing colorectal cancer is 5 to 6%. The incidence of colorectal cancer rises with age, a family history of colorectal cancer, a family history of advanced polyps, a personal history of polyps or colorectal cancer, a history of pelvic irradiation, or long-standing inflammatory bowel disease. In addition, the rate of colorectal cancer in the African American population is higher than in the US population at large.
In the United States in 2017 it is anticipated that there will be 95,520 new cases of colon cancer and 39,910 new cases of rectal cancer. 52,260 deaths are expected in 2017, second in frequency only to lung cancer. In fact, each year in the United States more women die of colorectal cancer than of breast cancer. Colorectal cancer is the third leading cause of cancer-related deaths in women in the United States and the second leading cause in men.
Importantly, colorectal cancer is potentially preventable, and this is the rationale behind screening: by removing precancerous polyps, future cancers can be prevented. Colonoscopy is the ‘gold-standard’ for screening. Colonoscopy is more sensitive than other screening techniques, and, because of the ability to endoscopically-remove polyps, it is therapeutic.
Screening for the general population should begin by the age of 50. For African Americans, screening should begin at the age of 45. For individuals in a higher-risk category such as a family history, screening should begin earlier.
What is a colonoscopy?
A Colonoscopy is an examination of the inside of colon using a thin, flexible fiber-optic instrument, which relays images to a monitor for interpretation. During the exam, carbon dioxide is gently introduced into the colon to separate the normally collapsed tube for viewing. The colon must be cleansed prior to the exam for optimal viewing. Polyps (potentially precancerous growths) can be removed during the procedure (using pincers or snares) and sent for microscopic inspection.
As strange as it seems, a colonoscopy is generally a good experience, and the preparation is not challenging. During the exam, you will be sedated by an anesthesiologist and won’t remember the 20-minute procedure.
Having a good quality colon-screening test is essential, and your life may depend on it. The quality of your colonoscopy depends on:
- The person performing the exam
- The thoroughness of your colon cleaning preparation
- Your colon (this you have no control over and is for me to worry about). Twisty colons or diseased colons can be difficult to exam thoroughly.