Wednesday, May 9, 2012

Preventing colon cancer is more fun than having colon cancer

                           Colorectal cancer 
                  early detection is the key to survival that many of us overlook

Recommended screening for early cancer detection 2012
American Cancer Society


           Beginning at age 50, both men and women should follow one of these testing schedules

Test to find polyps and cancer
                     * flexible sigmoidoscopy every 5 years , or
                     * colonoscopy every 10 years ,or
                     * double - contrast barium enema every 5 years , or
                     * CT colonography ( virtual colonoscopy ) every 5 years

Test that primarily find cancer
                    * yearly 3 card fecal occult blood test( FOBT) , or
                    *yearly fecal immunochemcal test ( FIT ) every year, or
                    * stool DNA test (sDNA) , interval uncertain

 Colonoscopy and fecal blood test are probable the most common test done.


 Comment and selection of the most user friendly look at a colon
After years of medical practice , with analysis of my patients experience and my own personal experience with these test,  I have selected the "most beneficial " and  "user friendly " of the above test.

Colonoscopy is the winner based on my experience
   The prep was a small very effective vial of liquid the evening before. My visit to the colonoscopy center at our hospital was a very pleasant experience . I exchanged my cloths for theirs and was ask to lie down on a gurney. The gastroenterologist walked by and said , without  breaking his stride , Dave , I will do a good job. Another doctor walked by and said , I am your bartender.
 My next awareness was a nurse telling me the test was ok and that I could get dressed. She made sure that I had a ride home

Reality
A study published in the Archives of Internal Medicine 2012;172 (7) : 575 - 582  reported on 997 patients; 58% agreed to have colorectal cancer screening  .They could chose between colonoscopy or fecal blood test to be completed within 12 months.

 38% of those selected to have colonoscopy actually completed the test within 12 months
 67% of those selected to do a fecal blood test actually completed the test within 12 months


Why not do both .
  A study , published in the " The Journal of Family Practice Nov. 2005. vol. 54 #11 compared  studies using 3 card fecal blood test  and colonoscopy , found no specific comparison .  They did find that the odds of dying from colorectal cancer were lower for patients who had had a colonoscopy compared to people who did not have a colonscopy.They also found in multiple trials that people with a positive 3-card test for blood followed by a colonoscopy had a significant reduction in mortality from colon cancer.


Who is ultimately responsible for maintaining your good health ?
 Don't look around , it is you.  Ask your doctor about doing yearly 3 card occult blood test and a colonoscopy every 10 years.


Have fun , Be Smart and take care of your body
David Calder,MD



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Your comments and questions are appreciated. David Calder,MD