23rd Medical Group advises on colorectal cancer Published April 10, 2009 By Dr. Jessie Kirby 23rd Medical Group MOODY AIR FORCE BASE, Ga. -- Colorectal cancers are a common cause of death and disability in the United States. According to the American Cancer Society, it accounts for 10 percent of new cancer cases diagnosed in both males and females and 8 percent of all cancer deaths. It is the fourth leading cancer killer in the U.S., behind breast, lung, and prostate cancer. Approximately 5 percent of the general population will develop colorectal cancer at some point in their life. There are several factors that can influence a person's risk for colorectal cancer to include age, family history, diet and other digestive illnesses. A person's age is the most common risk factor associated with colorectal cancer. Colorectal cancer is rare in individuals who are younger than age 40 and the incidence of new cases starts to increase then, but most cases are diagnosed after age 50. Another risk factor is based upon where a person lives, with the highest number of reported cases being in North America and Europe and the lowest numbers from Africa and Asia, which may be explained by differences in diet for each region. Family history of colorectal cancer or having an inherited condition can also increase a person's risk. These patients are required to undergo special screenings. Lastly, contracting another illness, such as inflammatory bowel disease, may increase the risk for colorectal cancer. There are several options available to screen for colorectal cancer. The method recommended for individuals will depend on medical history and risk. A colonoscopy is recommended if a close family member has colorectal cancer. Other screening methods include flexible sigmoidoscopy with or without stool blood testing, stool DNA testing, barium enema and virtual colonoscopy. Barium enema is used very infrequently because of the large number of large polyps that it misses. Stool blood testing is useful, but is most often combined with other screening methods. Virtual colonoscopy is a special exam using computerized axial tomography to create a 3D picture of the colon. However, virtual colonoscopy may miss a large number of flat lesions. It is not widely used and is not covered by much major insurance. The recommended screening schedule for colorectal cancer screening is a colonoscopy every five to 10 years and a flexible sigmoidoscopy every five years. They allow visual examination of the colon and allow for removal and analysis of any polyps that are found. Flexible sigmoidoscopy examines the last 60 cm of the colon, as approximately two thirds of advanced polyps are found there. Some patients who have advanced polyps on sigmoidoscopy need to follow-up with a colonoscopy to examine the entire colon. Sigmoidoscopy offers several benefits such as less sedation and recovery. Also, there is less chance of perforating the colon than in colonoscopy. Patients are encouraged, regardless of risk, to begin colorectal cancer screening at age 50. Consult a doctor about risks if there is family history. While colorectal cancer cannot be prevented, early detection through appropriate screening can drastically improve survival and quality of life.