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How Knowing Your Family History Can Help Prevent Colon Cancer

When found and treated early, colon cancer is often curable

While nobody likes to talk about their backside, I’ve got good news in honor of National Colorectal Cancer Awareness month. When found and treated early, colon cancer is often curable. And a colonoscopy, the main colon cancer screening method, is one of the few cancer screening tests that can potentially rid a patient of cancer.

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As a colon and rectal surgeon, it is my job to treat patients after they have been diagnosed with colon and rectal cancer during a colonoscopy or other exam, typically by their gastroenterologist. I can attest to the importance of early colonoscopies and family history awareness because I see so many difficult cases of advanced colon and rectal disease. While minimally-invasive surgery has helped me better treat these difficult cases, prevention, via colonoscopy, really is still the best option. 

How Colon Cancer Develops

There are two known ways that colon cancer develops, sporadic or familial. Sporadic cancer is the result of a polyp within the colon that becomes cancerous over time. Familial colon cancer is passed down within the family, making it more likely for close relatives to develop cancer. Some examples of familial colon cancer types include familial adenomatous polyposis (FAP) and hereditary non-polyposis colon cancer (HNPCC), otherwise known as Lynch Syndrome. Sporadic colon cancer is by far the most common type of colon cancer, but it’s important to be aware of your family history to allow for earlier screenings and be mindful of symptoms.

Colonoscopies were developed to help screen for both types of colon cancer. They are not just diagnostic, they are also therapeutic. During a colonoscopy, your gastroenterologist can see inside the colon, or large intestine, by using a flexible camera called a colonoscope, which can both detect and remove potentially cancerous polyps. In use for more than 40 years, the device allows doctors to look inside the large intestine. It may sound a bit scary, but with proper overnight preparation and anesthesia, most patients report that the test is quick and painless.

Screening Best Practices

For the general population, my gastroenterology colleagues and I agree with the American Cancer Society guidelines for colonoscopy screenings. If you are at no increased risk of colorectal cancer, screening colonoscopies should begin at age 45*. If you have a family history of colon cancer or colon polyps, colonoscopies should begin 10 years before any first-degree relative was diagnosed, or at age 40, whichever is earlier. Of course, if you have symptoms such as bleeding or stool changes, you should be referred to a gastroenterologist, who may order an earlier test. It is vital to be aware of symptoms and open about your family history of colon and rectal cancer so your physician can make an informed decision about your screening plan. If you are truly fearful of colonoscopies, there are other options such as yearly fecal occult blood testing or diagnostic computed tomography scans (CT). However, the colonoscopy is still the gold standard.

It’s easy to avoid this embarrassing topic, but there is no escaping the fact that preventive measures are necessary for everyone, no matter your gender or race. You can only prevent colon cancer by visiting a gastroenterologist for a colonoscopy at the recommended time for your unique risk factors.  If you heed my advice, chances are you’ll never have to make an appointment with me for more invasive treatment.

*This article was updated February 2019 to represent the American Cancer Society's revised colon screening guidelines that lower the recommended screening age from 50 to 45.

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Dr. Tahilramani is a board-certified colorectal surgeon. She received her medical degree from Virginia Commonwealth University in Richmond, Va. and completed her general surgery residency at INOVA Fairfax Hospital in Falls Church, Va. Dr. Tahilramani was a research fellow at the University of Texas Medical School at Houston, in Houston, TX. She also completed both an advanced minimally invasive colon and rectal surgery fellowship and a colon and rectal surgery fellowship at the Colon and Rectal Clinic of Orlando in Orlando, Fl.

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