Perhaps you've seen the commercials for a mail order DNA screening test kit for colorectal cancer. There is a reason that these kits are being promoted. Colon and rectal cancers (CRC) are common, particularly among African-Americans. "Unfortunately, African-Americans have an increased incidence of CRC, along with the highest rate of death and shortest survival of all ethnic groups with CRC," says Alexandria Conley Glenn, M.D., a colorectal surgeon with Ascension Michigan. CRC is the third leading cause of cancer related death in men and women in the United States, according to Dr. Glenn, who graduated from Wayne State University Medical School and is a board-certified colon and rectal surgeon.
Whether you have a close relative diagnosed with CRC or know someone suffering with this disease, it's smart to learn about screening. CRC is one of the most preventable and – when detected early – most treatable forms of cancer. "Colonoscopies are considered the cornerstone of screening along with a Fecal Immunochemical Test (FIT), which tests for microscopic blood in the stool," says Dr. Glenn. Other screening methods include CT colonography, flexible sigmoidoscopy and fecal DNA testing. "Keep in mind that if any of these show abnormal results, the person must be further investigated with a colonoscopy," Dr. Glenn says.
During a colonoscopy, the doctor uses a flexible, lighted tube about 1/2-inch in diameter to examine the colon and rectum while a patient is sedated in an outpatient setting. During the exam, doctors can detect and remove polyps, which may turn into cancer. African Americans have greater rates of polyps on the right side of the colon. A sigmoidoscopy would not detect these growths because it only examines the left side of the colon. "I would recommend screening the entire colon in African-Americans, as opposed to just flexible sigmoidoscopy" Dr. Glenn says.
For average risk people, Dr. Glenn suggests having a colonoscopy every 10 years and a FIT every year. Screening for CRC should begin at age 50 in average risk people and age 45 for African-Americans, based on recommendations by the American College of Gastroenterology. Factors such as having a family history of CRC or a personal history of other bowel diseases place people at higher risk for CRC. As for those commercials you may see, Dr. Glenn points out, "These kits are for people of average risk only." Higher risk persons would not benefit. "I am not opposed to these tests, but people should understand again that an abnormal DNA test result must then be investigated with a colonoscopy."
Some symptoms that signal you need to make an appointment with your doctor include: changes in bowel habits lasting more than a few days, noticing dark stools, or obvious blood in the stool. "CRC is on the rise in people younger than age 50 in general," Dr. Glenn says. "Any person having colorectal bleeding should be thoroughly evaluated."
Some suggestions Dr. Glenn offers for reducing the risk of CRC include: maintaining a good weight and eating a healthy diet. "Obesity and poor nutrition have been linked to higher incidence of CRC in African-Americans in some studies. Avoidance of too much processed meats such as lunch meats, hotdogs and smoked meats is also beneficial," she says. "Education is key. Ask questions about CRC and screening." It might save your life or the life of someone you love.
Get more health information and find a doctor near you by visiting ascension.org/Michigan or by calling 866-501-DOCS (3627).