Colon Cancer Prevention

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.

We often ask you to mail guaiac cards to us with a thin smear of stool from the toilet tissue (as opposed to the Popsicle stick in the toilet bowl routine), in an attempt to identify microscopic unexplained blood.  Do not provide a smear with obvious hemorrhoidal bleeding. This will mislead us into thinking you are bleeding from higher up in the colon.  We will call you if we identify unexplained blood on the cards.

If there are risk factors for colon cancer, the colonoscopy should be performed, looking at the entire colon.

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.

 Colonoscopy preparation

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