March is National Colon Cancer Awareness Month

By Dr. March Seabrook, Gastroenterologist


The month of March is National Colon Cancer Awareness Month.  It first received this designation in 2000.  Colorectal Cancer (the term used when cancer begins in either the colon or rectum) is the second leading cause of cancer death and it is generally preventable.  In South Carolina, there are over 2,100 new cases and about 750 deaths a year from this disease.  The good news is that the number of deaths is actually decreasing despite the aging population. The major reason for this is thought to be an increase in screening colonoscopy.  Keep in mind that our goal with breast cancer and prostate cancer is to detect them early enough to cure them.  Our goal with colorectal cancer is to PREVENT it.  

Age is the major risk factor for developing colorectal cancer and over 90% of cases are detected after the age of 50.   A family history of colorectal cancer and certain other diseases such as inflammatory bowel disease can increase your risk as well.  Lifestyle can also affect the development colorectal cancer.  There is mounting evidence that factors such as high fat diet, obesity, smoking and lack of exercise can all increase your risk.  The cancer affects both genders and all races (although there is a slightly more frequent diagnosis in males and a higher death rate among African Americans).

The cancer generally begins as a benign growth called a polyp.  There are two common types of polyps: hyperplastic and adenomatous.  The adenomatous polyps (also called adenomas) are the type that is thought to develop into cancer.  You cannot predict which polyps will turn into cancer just by looking at them so it is best to try to remove all of them.

Polyps and even cancers may cause no symptoms at all.  That is why it is recommended that everyone get screened.  Concerning symptoms may include unexplained change in bowel behavior, blood in the stool, weight loss or abdominal pain.  Anemia or low blood counts may indicate a problem as well.

Screening (testing when there are no symptoms) for colorectal cancer is recommended for everyone beginning at the age of 50.  There are some reasons to screen sooner (usually a family history of colorectal cancer).  Some organizations recommend that African Americans should be screened at age 45.  There are a variety of tests that can be used for colorectal screening including:  colonoscopy, flexible sigmoidoscopy, x ray examinations or testing the stool for blood or other potential cancer markers.   Any of these tests may be appropriate for an individual but most experts would recommend a colonoscopy.

Colonoscopy is currently the Preferred Strategy for colorectal cancer screening.  It is the only test that can visualize the entire colon AND remove precancerous polyps at the same time.  It is clearly the best test but it is not a simple test and it is not a perfect test. If you are going to have a colonoscopy make sure it is the right physician in the right place doing the right procedure.  The risks associated with a colonoscopy are very low in experienced hands but they include bleeding, perforation of the bowel, reaction to medications and possibly missed lesions.  The likelihood of any of these is quite low and the benefits of preventing colorectal cancer far outweigh any of these risks. 

I am proud to say that South Carolina has been recognized as a national leader in some of the innovative programs that have been developed regarding colorectal cancer.  There are about 160 gastroenterologists in the state and the South Carolina Gastroenterology Association in collaboration with Blue Cross Blue Shield and The USC Center for Colon Cancer Research under the direction of Frank Berger have been instrumental in developing statewide awareness and screening programs. Most of this effort has been focused on the disparities that exist in health care in our state.  

The South Carolina Colon Cancer Prevention Network (CCPN) began with a grant from the Blue Cross Blue Shield Foundation in 2008.  It started with a clinic in Anderson and Greenwood counties.  In 2011 it expanded to 4 counties and today, thanks to a grant from the Duke Endowment and a state legislature proviso, the program is in 24 of the 46 counties and over half of the states board certified gastroenterologists are donating their time and expertise to this project.  The preliminary results are impressive.  Thanks to navigating support, over 800 individuals, the majority being African- American will be screened through this program this year.

In recognition of National Colorectal Cancer Awareness Month, there will be a number of awareness activities across the state.  The signature event, the Eight Annual Unmasking Colon Cancer Gala will be held on Saturday March 8 in Columbia.  This event will be a celebration of the survivors of this disease.  Our ultimate goal is to make this disease the number three or number four cause of cancer death and one day to just prevent it altogether!!

Stay tuned for the  Colonoscopy Ps and Qs later this month!