ANN ARBOR, MI -While many people mark their 50 th birthday with a big celebration or a special trip, Sheila Ricketts instead decided to do something that would give her the comfort of knowing that she has many more healthy and happy birthdays to look forward to – she got a colonoscopy.

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“The big 5-0 means it's time to get a colonoscopy,” says Ricketts, who found that she is healthy and free of cancer following a recent colonoscopy. “I think it's important to have the screening because early prevention does make a big difference. If you can catch cancer in the early stages, you can prevent having to go though a lot of treatment at a later date.”

While it may seem like an unusual birthday present, Kim Turgeon, M.D., a gastroenterologist at the University of Michigan Health System, says routine colonoscopies every 10 years after the age of 50 are the best way to prevent colorectal cancer and increase survival rate following a diagnosis, especially since many people often do not show any symptoms until it's too late.

Colon cancer, a cancer of the large intestine, is the second leading cause of cancer death in the United States. It's also the leading cause of cancer death among non-smokers. The American Cancer Society estimated that in 2004, there were about 145,400 cases of colon cancer diagnosed, and approximately 56,300 colon cancer deaths in the U.S.

Often called the silent killer, colon cancer is believed to begin when polyps or small benign growths evolve into cancer. However, its symptoms – changes in bowel habits or appetite, rectal bleeding, bloody stool, weight loss or anemia – often don't manifest until very late in the course of the disease.

Although 50 is the golden age to begin routine colonoscopies, people at an increased risk for colon cancer, especially those with a family history of the disease, are often encouraged to begin screening earlier and more often.

Other factors that put people at an increased risk include obesity, a sedentary lifestyle, smoking, heavy alcohol use, high-fat diets, and a diagnosis of ulcerative colitis or Crohn's disease.

Regardless of symptoms, lifestyle or family history, everyone is at risk for colorectal cancer and should be regularly screened after the age of 50, warns Turgeon. Colon cancer can be preventable with the early detection and removal of polyps before they become cancerous.

In fact, patients have a 95 percent chance of survival if colon cancer is caught in its initial stage, compared to a 5 percent survival rate if the disease is detected in its final stage.

“Half of the patients who are diagnosed after symptoms have developed will die from cancer,” says Turgeon. “Studies have shown that colonoscopy has the ability to prevent up to 80 percent of colorectal cancers through screening.”

That's why it's so important not to put off screening tests, even if you don't have any symptoms. Fortunately, awareness for the need for colon cancer screening is increasing, although Turgeon says that routine colon cancer screening is still greatly lagging behind screenings for breast, cervical and prostate cancers.

Fear and embarrassment often factor into lower screening rates for colon cancer. But colonoscopies, Turgeon says, are nothing to be ashamed or afraid of.

Undergoing a colonoscopy involves a patient taking laxatives to clean out his bowels the day before the procedure, and then coming into an outpatient facility where he will be given medications to put him into a conscious sedation or “twilight sleep.”

After sedation, the patient is placed on his side so that a flexible tube about the thickness of a finger can be inserted through the rectum and then up through the colon to check for abnormalities. Colonoscopies can also help diagnose other problems in the intestines such as inflammatory bowel disease or infection.

“Colonoscopy is the most powerful prevention tool in clinical medicine,” stresses Turgeon. “Screenings really can save lives, so don't wait until it's too late.”

Facts about colorectal cancer and colonoscopies:

• Colorectal cancer is the second leading cause of cancer deaths in the United States , and the leading cause of cancer deaths among non-smokers.
• Because individuals may not demonstrate any symptoms until late in the course of the disease, colorectal cancer can be a silent killer.
• Colorectal cancer can be prevented through regular screenings, typically starting at the age of 50, with colonoscopy examination.
• Patients have a 95 percent chance of survival if colon cancer is caught in its initial stage, compared to a 5 percent survival rate if the disease is detected in its final stage.
• Symptoms often do not appear until late in the disease, and may include changes in bowel habits or appetite, rectal bleeding, bloody stool, weight loss or anemia.
• Everyone is at risk for colorectal cancer. Several factors that increase risk include a family history of the disease, obesity, a sedentary lifestyle, smoking, heavy alcohol use, high-fat diets, and a diagnosis of ulcerative colitis or Crohn's disease.

For more information, visit these web sites:

UMHS Health Topics A-Z: Colonoscopy
www.med.umich.edu/1libr/aha/umcolon.htm

U-M Comprehensive Cancer Center : Colon or Rectal Cancer Information
www.cancer.med.umich.edu/learn/coloninfo.htm

Colorectal Cancer Screening Saves Lives!!
http://www.mcancer.org/polyp_pest/

National Cancer Institute: Colon and Rectal Cancer
http://www.nci.nih.gov/cancertopics/types/colon-and-rectal

National Human Genome Research Institute: Learning About Colon Cancer
http://www.genome.gov/10000466

Written by Krista Hopson

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