Stopping Colorectal Cancer Begins With a Quality Colonoscopy Exam

OAK BROOK, IL--(Marketwire - Feb 28, 2012) - One in three adults between the ages of 50 and 75 who should be screened for colorectal cancer have not gotten screened for this largely preventable disease. March is National Colorectal Cancer Awareness Month and the American Society for Gastrointestinal Endoscopy (ASGE) recommends that, starting at age 50, everyone should have a colonoscopy to screen for colorectal cancer, even if they have no symptoms and lead a healthy lifestyle. Screening should begin sooner if there is a family history of colorectal cancer or polyps or if other risk factors are present. This year, the ASGE is offering helpful tips for patients on what they can do to receive a quality colonoscopy exam.

"Colorectal cancer is one of the most preventable cancers because the majority of colorectal cancers arise from precancerous growths in the colon called polyps, which can be found during a colonoscopy screening exam and removed before they turn into cancer," said Gregory G. Ginsberg, MD, FASGE, president, American Society for Gastrointestinal Endoscopy. "ASGE represents the doctors who specialize in colorectal cancer screening and we encourage patients to get screened at recommended intervals as directed by their doctor, to find a qualified doctor for their colonoscopy who has had specialized training in the procedure and to carefully follow exam preparation instructions to ensure that the colon is thoroughly cleaned so that no polyps or cancers are missed during the procedure. A quality preparation for colonoscopy and appropriate follow-up exams save lives."

Colonoscopy is a common and very safe procedure that examines the lining of the lower intestinal tract called the colon or large intestine or bowel. A doctor specially trained in the procedure uses a flexible tube that has a light and miniature TV camera on the tip. This instrument, often referred to as the "scope," is placed in the rectum and advanced through the colon. It is connected to a television monitor that the doctor watches while performing the test. Various miniaturized tools can be inserted through the scope to help the doctor obtain biopsies (samples) of the colon and to perform a wide range of maneuvers to help diagnose or treat a condition. When used as a colon cancer prevention method, colonoscopy can find potentially precancerous polyps and remove them before they turn into cancer.

Quality colonoscopy: Tips for patients

• Follow screening recommendations - Age is the single most important risk factor for colorectal cancer. For individuals at average risk, the ASGE recommends colonoscopy screening beginning at age 50 and repeating the procedure every ten years after a normal exam. For individuals with a family history, screening should begin at age 40, or at an age as recommended by their doctor. Some experts suggest that African-Americans should begin screening at age 45. Individuals with other risk factors such as inflammatory bowel disease may also require earlier screening. Patients should speak with their doctor about when to begin screening.
  
  
• Find a qualified doctor - It is important to find a doctor who has had highly specialized training in colonoscopy. ASGE is the only medical society that requires documentation of specific training in gastrointestinal endoscopic procedures such as colonoscopy. To find an ASGE doctor in your area, log on to ASGE's "find a doctor" web page.
  
  
• Ask questions - Ask questions; confirm that the doctor has had specialized training in colonoscopy. ASGE provides a list of "Ten Questions to Ask Your GI Endoscopist."
  
  
• Follow instructions about exam preparation - One of the most important steps in colonoscopy is patient bowel preparation to ensure that the colon is thoroughly cleaned before the exam so that the doctor can clearly see the entire colon to look for abnormalities, such as polyps and cancer. Cleansing the colon before a colonoscopy is called bowel preparation, or "prep." It involves taking medication that causes diarrhea, emptying the colon. The medication is taken by mouth, and comes in liquid or tablet form. Patients will also need to change what they eat during the day or two before the colonoscopy. It is vital to follow prep instructions as directed. Learn more about prep in ASGE's Understanding Bowel Preparation patient education brochure.
  
  
  • A recent study from ASGE's scientific journal, GIE: Gastrointestinal Endoscopy, reported that colonoscopies done with suboptimal bowel preparation are associated with relatively high adenoma (precancerous polyp) miss rates, suggesting that poor bowel preparation substantially decreases colonoscopy effectiveness and may mandate an early follow-up examination.
    
    
• Return for follow-up exams as recommended - Individuals at average risk screened at age 50 with normal exam results will not have to return for another exam for ten years. Removal of an adenomatous (precancerous) polyp prevents that polyp from becoming cancerous, but the patient is still at risk to develop new polyps in the colon and will require more frequent follow-up exams. If the patient has a family history of colorectal cancer, the interval for their follow-up exam may be shortened. After a colonoscopy, the doctor will recommend when the patient should return for another colonoscopy.
  
  
• Talk to family - People who have been diagnosed with polyps or colorectal cancer should notify their family members of the type of polyp or cancer found and their age at diagnosis. Both factors are important in assessing family members' risk and will help their doctor determine when the family members should begin screening for colorectal cancer.
  
  
• Learn more - See ASGE's video: What to expect before, during and after a colonoscopy.
  
  

About Colorectal Cancer and Prevention
The majority of colorectal cancers, also referred to as colon cancer, arise from precancerous growths in the colon called polyps. Colorectal cancer is considered a silent killer because often there are no symptoms until it is too late to treat. Age is the single most important risk factor for the disease, so even people who lead a healthy lifestyle can still develop polyps and cancer. Both men and women are affected by colorectal cancer equally. The ASGE recommends screening begin at age 50; sooner if there is a family history of polyps, colorectal cancer or other risk factors. Some experts suggest that African-Americans should begin screening at age 45.

A 2011 CDC report says that rates of new cases and deaths of colorectal cancer are decreasing and more adults are being screened, however, one in three adults of screening age is not being screened. Colorectal cancer still takes the lives of more than 50,000 people a year in the United States. Colonoscopy is considered the preferred screening test because it is a preventive exam: it is the only test that both finds and removes precancerous polyps during the same exam. With other screening methods, if a polyp is found, that test must then be followed by a colonoscopy to remove the polyp. Patients should speak with their doctor about the screening option that is best for them and at what age to begin screening.

Colorectal Cancer Symptoms
Colorectal cancer is often present in people without symptoms, but the following signs or symptoms, might indicate colorectal cancer: blood in stools, narrower than normal stools, unexplained abdominal pain, unexplained change in bowel habits, unexplained anemia, and unexplained weight loss. These symptoms may be caused by other benign diseases such as hemorrhoids, inflammation in the colon or irritable bowel syndrome. The presence of these symptoms for more than a few days is an indication to talk with a gastrointestinal specialist about these symptoms and the patient's family history.

ASGE and Quality
ASGE is the profession's leader in setting standards of excellence in endoscopy through its safety guidelines and the training of its members so that patients receive the best and safest care possible. The Society constantly reinforces the importance of quality among its members through member communications, such as emails and newsletters, the GIQuIC quality benchmarking tool, a joint initiative with the American College of Gastroenterology, and its courses, including "Improving Quality and Safety in Your Endoscopy Unit." This course is a requirement for ASGE's Endoscopy Unit Recognition Program, which honors endoscopy units that follow the ASGE guidelines on privileging, quality assurance, endoscope reprocessing and CDC infection control guidelines.

For more information on colorectal cancer prevention and to find a doctor, log on to ASGE's colorectal cancer awareness website www.screen4coloncancer.org.

About the American Society for Gastrointestinal Endoscopy
Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. ASGE, with nearly 12,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asge.org and www.screen4coloncancer.org for more information and to find a qualified doctor in your area.

To view a media-rich version of this release, go to: http://www.pwrnewmedia.com/2012/asge/colon_cancer/