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Colon cancer is often a preventable disease.
Only a small percentage of the population is screened with endoscopic procedures, in spite
of widespread availability.
At age forty, in both men and women, stools should be checked for microscopic blood. Admittedly, this is a very inaccurate and unproductive test. People are reluctant to
smear stool on the guaiac cards. Theoretically, one has to stop vitamin c, iron, and aspirin, as well as avoid rare meats in order to improve accuracy. Most cases of positive stool turn out to be due to
superficial bleeding from hemorrhoids or fissures. Nonetheless, on those occasions where we do find unexplained blood in the stool, which is resulting from leakage from a pre-malignant
polyp, or an early colon cancer, early intervention can be life saving.
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If there are risk factors for colon cancer, the colonoscopy should be performed, looking at the entire colon. |
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The colonoscopy evaluates the entire five feet of the large bowel. When an
individual has a family history of a first-degree relative with colon polyps or colon cancer, full colonoscopy is warranted. In other conditions such as ulcerative colitis, breast or ovarian
cancers, familial polyp syndromes, etc., early colonoscopy is urged. It should be appreciated that in most cases a colon cancer must first start as a benign polyp. Since it takes between five and ten years
to go from normal to polyp to cancer, there is a large window of opportunity for intervention.We generally advocate full colonoscopy starting between age thirty and thirty-five in individuals who have first degree
relatives with polyps or colon or rectal cancer. |
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