eHealth Connection | Cooper University Hospital

Adam B. Elfant, MD, performs a colorectal cancer screening at the Cooper Digestive Health Institute in Mount Laurel.

Each year, more than 140,000 Americans are diagnosed with colorectal cancer, according to the American Cancer Society. The second leading cause of cancer-related deaths in the United States, colorectal cancer starts in either the colon or the rectum and affects men slightly more than women. The lifetime risk for developing colorectal cancer is about 1 in 20 (5.1 percent). This year, colorectal cancer is expected to cause nearly 50,000 deaths.

“Despite the staggering statistics, there is optimistic news,” explains Adam B. Elfant, MD, a gastroenterologist at the Cooper Digestive Health Institute in Mount Laurel, N.J., and New Jersey Governor of the American College of Gastroenterology. “Thanks to better, more regular screenings, more aggressive treatment of polyps, and improved surgical and cancer treatment, the death rate from colorectal cancer has been steadily decreasing for more than 20 years. There are now more than one million colorectal cancer survivors in the United States today.”

Colorectal cancer screening, the process of looking for cancer in people who have no symptoms of the disease, is a powerful weapon for preventing colorectal cancer deaths. Dr. Elfant recommends that all patients understand their personal risk and follow screening guidelines recommended by their physicians. “Because most early colorectal cancers produce no symptoms, it’s only through screening that many cases of the disease are caught in early stages,” he says. “And we know that catching and treating colorectal cancers early significantly improves recovery and survival.”

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For many of us, spring is the time of year we take on many of those household fix-it and clean-up projects that we’ve been putting off for too long. Why not make it the time of year to get your annual medical check-ups and cancer-screening tests, too? What better way to greet this glorious change of season than to start with a clean bill of health?

“We sometimes take better care of our houses than we do our own bodies,” said medical oncologist Robert A. Somer, MD, of the Cooper Cancer Institute.

“Keeping up with regular medical check-ups and cancer screenings is an important part of our health. Talk to your doctor about what tests and services might be right for you, because if problems are found early, they will be easier to treat,” Dr. Somer said.

The American Cancer Society recommends these screening guidelines for most adults:

Breast Cancer

• Yearly mammograms are recommended starting at age 40.
• Clinical breast exam (physical exam by a healthcare professional) about every three years for women in their 20s and 30s and every year for women 40 and over.
• Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam is an option for women starting in their 20s.

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Colorectal cancer is the number two cancer killer in the United States, yet it is one of the most preventable types of cancer. Colorectal cancer – also called colon cancer – can be curable when detected early. In fact, when colon cancer is diagnosed at an early stage, the five-year survival rate is 90 percent. When the disease isn’t diagnosed until it has spread to distant organs (metastasized), the five-year survival rate drops significantly.

“Most early colorectal cancers produce no symptoms; that’s why screening for colorectal cancer is so important for early detection of the disease,” said Cooper University Hospital’s Thomas A. Judge, MD, Division of Gastroenterology.

Colon Polyps and Cancer

Most colorectal cancers develop from polyps, which are abnormal growths in the colon. Colon polyps are common; about 30 percent to 50 percent of adults have them. Their occurrence typically increases with age and they usually cause no symptoms. The majority of polyps aren’t cancerous (malignant). Yet like most cancers, polyps are the result of abnormal cell growth. In the colon and rectum, this unregulated growth can cause polyps to form. If polyps grow unnoticed and are not removed, they can become cancerous. Screening tests can find pre-cancerous polyps so they can be removed before they turn into cancer. In fact, studies suggest that the development of more than 75 percent to 90 percent of colorectal cancer can be avoided through early detection and removal of pre-cancerous polyps.

Screening Colonoscopy

“The preferred method of screening for colorectal cancer prevention is colonoscopy,” Dr. Judge said.

Performed while the patient is sedated, colonoscopy is a painless, out-patient procedure that allows the physician, using a colonoscope, to view the entire length of the large intestine, and identify abnormal growths, inflamed tissue, ulcers, and bleeding. The colonoscope allows the physician to see the lining of the colon, remove tissue for further examination if necessary, and possibly treat some problems that are discovered. Polyps can be completely and safely removed using a device inserted through the colonoscope at the time of the screening.

Colorectal Cancer Screening Guidelines

For average-risk individuals, a screening colonoscopy for colorectal cancer prevention is recommended every 10 years, beginning at age 50.

African Americans, who typically are diagnosed with colon cancer at a younger age than other ethnic groups and experience lower survival rates, are advised to begin screenings at age 45.

People at higher risk for developing colorectal cancer – those with a personal or family history of the disease or colorectal polyps; inherited forms of colorectal polyps or cancer; predisposing chronic digestive conditions, such as Crohn’s disease or ulcerative colitis – are recommended to get screenings at any age and interval that their physician recommends.

“Remember, colorectal cancer is most common after age 50, and the risk of developing it increases with age. Regular screenings can help protect you. Colon cancer is preventable and curable when found in its early stages,” Dr. Judge said.

The board-certified gastroenterologists of the Cooper Digestive Institute in Mount Laurel have state-of-the-art outpatient facilities dedicated to a full range of diagnostic testing, including colonoscopy screening.

Related Links:

• Thomas A. Judge, MD
• Cooper Digestive Health Institute

With the National Cancer Institute estimating nearly 135,000 new colon cancer cases diagnosed each year, it is surprising that recent figures show that only half of all Americans age 50 and above have had a screening colonoscopy.  The good news is that when caught early, colorectal cancer is among the most treatable of all types of cancer.

Unlike other cancers that can appear suddenly and grow quickly, most colon cancers have a long “precancerous” phase, known as colon polyps, and can exist for several years before becoming cancerous. “If these polyps are discovered early and removed promptly, the colon cancer can be prevented. Unfortunately, many otherwise health-conscious people have a ‘don’t-want-to-know’ approach when it comes to protecting themselves against colorectal cancer,” said Cooper University Hospital Gastroenterologist Thomas A. Judge, M.D.

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The National Cancer Institute offers the following information about cancer of the colon and rectum:

Risk Factors

Age over 50: Colorectal cancer is more likely to occur as people get older. More than 90 percent of people with this disease are diagnosed after age 50. The average age of diagnosis is 72.

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