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Colon Cancer – What is it? How do you detect it? . William Dailey, MD, MS GVMH - Windsor. Colon cancer is:. Cancer of the colon or rectum Your colon: is another name for your large intestine. is about 6 feet long.

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Colon cancer what is it how do you detect it l.jpg

Colon Cancer – What is it? How do you detect it?

William Dailey, MD, MS

GVMH - Windsor


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Colon cancer is:

  • Cancer of the colon or rectum

  • Your colon:

    • is another name for your large intestine.

    • is about 6 feet long.

    • turns food you eat into waste matter or a bowel movement as it passes through the colon.

  • Your rectum:

    • is the last 8-10 inches of the large intestine.

    • bowel movements travel through the rectum and pass out of the body through the anus.



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How long does it take cancer to develop, and what are your chances?

  • In most people, colorectal cancers develop slowly over a period of several years.

    • 10 to 20 years

  • Chances of developing colorectal cancer sometime in your life:

    • A man has a 1 in 17 chance.

    • A woman has a 1 in 18 chance.


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Why does it develop? chances?

  • Colorectal cancer usually begins as a non-cancerous (or benign) polyp.

  • A polyp

    • is a growth inside the colon or rectum that is not normal.

    • can be several types.

    • is not always cancerous.


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When Cancer Forms in a Polyp chances?

  • It can eventually grow through the lining and into the wall of the colon or rectum.

  • 95 percent of colorectal cancers grow from cancerous polyps and move into the inside layer of the wall of the colon and rectum.


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Importance of Screening and chances? Early Detection

  • Once a non-cancerous (benign) polyp is removed, it will never have the chance to develop into cancer.

  • Regular screenings for colorectal cancer and removal of polyps

    • Reduce a person’s lifetime risk of dying by 80 percent.

  • When colorectal cancer is detected early

    • It is highly curable!


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Lower Your Risk of Developing Colorectal Cancer by: chances?

  • Increasing physical activity

    • Exercise at least 30 minutes a day on the majority of days.

  • Not smoking

    • In the USA, 1 in 5 colorectal cancers in men and 1 in 8 colorectal cancers in women may be due to cigarette smoking.

  • Improving your diet

    • Limit your alcohol use.

    • Limit high-fat diets.

    • Limit red, charred, or processed meat.


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Age and Race Factors for chances? Colorectal Cancer

  • Age

    • 90 percent of all colorectal diagnoses happen after age 50.

  • Race and Ethnicity

    • Everyone is at risk!

    • Risk Rankings

      • African-Americans

      • Whites

      • Asian Americans/Pacific Islanders

      • Hispanics

      • American Indians


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Personal History Risk Factors for chances? Colorectal Cancer

  • Personal History of Cancer

    • If you’ve already been treated for colorectal cancer, you’re at an increased risk for developing it again.

  • Personal History of Polyps

    • If you have had a polyp removed

      • You are no longer at risk of that particular polyp developing into cancer.

    • If you have had an adenomatous polyp removed, you are more likely to have other polyps in the future.

      • Adenomatous polyps are groups of polyps with abnormal cells that multiply and may eventually become cancerous.


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Having Inflammatory Bowel Disease and Type 2 Diabetes Are Risk Factors

  • Inflammatory bowel disease (IBD) includes:

    • Ulcerative colitis and

    • Crohn’s disease

      • The overall increased risk of colorectal cancer for someone with IBD is estimated to be 4-20 times higher than normal.

  • Personal history of type 2 diabetes

    • Increases your risk of having colorectal cancer and colorectal polyps by 50 percent


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Family History and the Role of Genetics Risk Factors

  • You have a higher risk of developing colorectal cancer if:

    • One or more immediate family members were diagnosed with colorectal, uterine, or stomach cancer

    • Immediate family members include:

      • Parent

      • Sibling

      • Child


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Early Detection Makes a Difference Risk Factors

  • Approximately 56,000 Americans die from colorectal cancer each year.

  • It is the 2nd leading cause of cancer in the nation.

  • The most effective way to reduce your risk of colorectal cancer is to get screened routinely.

    • Start at age 50.

    • Start earlier if you are at higher risk.

      • Personal health history

      • Family health history


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What if something is found? Risk Factors

  • If you have polyps

    • They can be removed before they turn into cancer.

    • Finding and removing adenomatous polyps can decrease colorectal cancers by 60-90 percent.

  • If cancer is found

    • It is often curable in its early stages.


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Don’t want to get screened? Risk Factors

  • Embarrassed?

    • Doctors need to know about changes in your bowel habits or rectal bleeding.

    • Everyone has “private parts,” and it’s important to keep them healthy!

  • Don’t want bad news?

    • Getting screened can find bad things early, which increases the amount of time you can spend with your family. They need you!

  • Doctor didn’t say you need to get tested?

    • Bring it up with him or her – it’s important!


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What test do I take to get screened? Risk Factors

  • There are several tests to screen for colorectal cancer.

  • Some tests are used alone, while others are used in combination with other tests.

  • Talk to your doctor about which type of test is best for you!


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Fecal Occult Blood Test (FOBT) Risk Factors

  • Recommended to be done yearly

  • Checks for hidden blood in the stool

  • Your doctor gives you a test kit

    • At home, you place a small amount of your stool from 3 bowel movements on test cards.

    • You then return the cards to your doctor’s office or a lab where the stool samples are tested for hidden blood.

    • If blood is found, a colonoscopy will be needed.

  • A disadvantage of this test

    • The test is often negative in people who have adenomatous polyps and colorectal cancer.


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Flexible Sigmoidoscopy (Flex Sig) Risk Factors

  • Recommended every 5 years

  • Examines the lining of your rectum and lower part of your colon

  • Uses a thin, flexible, lighted tube called a sigmoidoscope

    • It is inserted into your rectum and lower part of your colon.

    • If polyps or lesions are found, a follow-up test is needed.

  • Disadvantages:

    • Patient discomfort – but not painful

    • Only looks at lower part of colon, therefore polyps in the upper colon can go undetected.

    • If a polyp is found, it needs to be followed by a colonoscopy to remove the polyp.


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Combination FOBT and Flex Sig Risk Factors

  • Some experts recommend using both of these tests to increase the chance of finding polyps and cancers.

  • It is recommended every 5 years.


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Colonoscopy Risk Factors

  • Similar to the Flexible Sigmoidoscopy except:

    • It allows the doctor to look at the lining of your rectum and entire colon.

    • Done as an outpatient procedure

    • Done with “conscious sedation”

      • An IV line is inserted to help you remain calm and comfortable. Some patients sleep though the procedure.

      • Not everyone needs sedation.

    • Uses a thin, flexible, lighted tube called a colonoscope

    • It is inserted into your rectum and colon.

    • The doctor can also find and remove polyps and some cancers using the colonoscope.

    • It is recommended every 10 years for:

      • Individuals with no family or personal history of colon cancer and no symptoms.


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Colonoscopy (continued) … Risk Factors

  • Procedure takes 15–30 minutes.

  • May take longer if polyps are removed.

    • Called a polypectomy

    • A wire loop is passed through the scope to cut the polyp from the lining of the colon using an electrical current.

    • Polyps are collected and sent to the lab for evaluation.


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Double Contrast Barium Enema (DCBE) Risk Factors

  • This test allows the doctor to see an x-ray image of the rectum and entire colon.

  • First you are given an enema with a liquid called barium that flows from a tube into your colon, followed by an air enema.

  • The barium and air create an outline around your colon, allowing the doctor to see if anything is wrong.

  • Recommended every 10 years.

  • Many disadvantages:

    • Detects only 50 percent of adenomatous polyps greater than 1 cm in size and only 33 percent of polyps .5 cm in size

    • May miss up to 15 percent of colorectal cancers

    • Does not allow removal of polyps


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Worried about How Much It Will Cost? Risk Factors

  • If you are 50 years old or older and have Medicare

    • You are eligible for colorectal screenings!

    • For more information, call or visit:

      • 1-800-MEDICARE (1-800-633-4277)

      • http://medicare.gov/Health/ColonCancer.asp

  • If you have private insurance

    • Most insurers are now paying for some form of colorectal screening

    • Often including screening colonoscopy


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Think about the future Risk Factors

  • Your family needs you.

  • If you’re 50 years old or older

    • Get screened!

    • You have the power to determine your future!

  • Any questions?


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