March is global Colon Cancer Awareness Month. Throughout this month, our goal is to to raise people’s consciousness of colon cancer and encourage them to undergo a screening test. Many people may have warning signs and symptoms that can lead to colon cancer.
Colon cancer is a leading cause of death worldwide. According to the cancer statistics from the CDC and National Cancer Institute in 2015, prostate cancer is the most common form of cancer in men, followed by lung cancer and colon cancer; in women, lung cancer is the most common form of cancer, followed by breast cancer and colon cancer.
A colonoscopy can be used to screen and monitor colon cancer. Today, Narrow-Band Imaging (NBI) International Colorectal Endoscopic Classification (NICE) is the most extensively validated classification used for the detection, evaluation and treatment of colon cancer. NICE is ideal for the early detection of lesions before they are elevated. It provides accurate diagnosis and treatment, requires less time for surgery, facilitates quicker recovery and reduces complications. If an abnormality is detected, it can be removed safely without the need for surgery.
With conventional white-light endoscopy equipment, colon polyps can frequently go undetected. There is also a method that was introduced later involving a contrast-enhancement technique using a dye-based method. This was introduced to enhance any contrast on the surface, but it is a time-consuming procedure. With the latest imaging technique, the light of blue and green wavelengths is used to highlight detail, just as was achieved from using dyes, so as to enhance the detection of colon abnormalities.
The NBI technique improves the visibility of tissue structures in comparison with conventional techniques. This makes it an excellent tool for diagnosing polyps whether they are hyperplastic, adenomatous or malignant. Polyps can be classified into three types:
Type 1: Cells have a regular, organized pattern and arrangement. Surgery is not required due to little likelihood of them becoming malignant.
Type 2: Cells have an arrangement of lines, like a net. They have the potential to become malignant and are usually removed completely with an electrified wire loop or knife.
Type 3: Cells have an irregular, unorganized pattern and arrangement are malignant. They are not removed with a colonoscopy, but the most appropriate technique shall be used.
Colonoscopy has been globally found to be very useful in screening and monitoring colon cancer. It allows the doctor to see the entire lining of the colon and remove polyps that are found for lab testing before they become malignant. With this technique, malignant polyps can be detected and treated early. Benign polyps are often found during routine colonoscopies and removed. Over time, if left unchecked, polyps can develop into cancer. People who are 50 or older are at higher risk; however, that does not mean that people younger than 50 have no chance of developing colon cancer. Surprisingly, according to a new study in the Cancer Journal, about one in seven colon cancer patients is younger than 50 years old. Focusing on this development, medical guidelines might have to be changed to the age of 40, instead of 50 years.
People with a family history of colon cancer or people with certain medical conditions that cause an increased risk, including colon polyps and inflammatory bowel disease, should undergo an early screening test without waiting for symptoms to appear. People with a family history of colon cancer should undergo an early screening test by using the age of onset of colon cancer in a direct blood relative and then subtracting 10 years. For example, if your father contracted colon cancer at the age of 45 years, you should have the colonoscopy screening at age 35 without waiting until age 50.
Everyone should pay attention to symptoms – whether you have chronic stomach pain, abnormal bowel movements, or blood in the stool. If these symptoms appear, consult a doctor immediately. Early detection of colon cancer greatly increases the chances for successful treatment. Eat healthy food by reducing your consumption of red meat, especially processed meat, including sausages, ham and bacon, because these increase the risk of colon cancer. Exercise regularly.
People who are 50 or older should have a regular colonoscopy screening so as to prevent and treat the cancer early. Complications may occur during a colonoscopy, but only in 1-2 cases per 1,000 procedures. A colonoscopy is recommended when reaching the specified age. The early detection of cancer greatly increases the chances for successful treatment and with less medical expense.
M.D., Faculty of Medicine, Chiang Mai University, 1996.