March Is the Month for Colorectal Cancer Awareness and Screening
March is Colorectal Cancer (CRC) Awareness Month, and this issue of Consultant offers a timely article on the screening, staging, and assessment of the condition. According to expert cancer groups,1,2 in 2017, more than 135,000 Americans will receive a CRC diagnosis, and more than 50,200 will die of the condition.
Because of the high incidence and mortality rates of CRC, screening is recommended in US adults with no risk factors via fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy beginning at age 50 until age 75 and on an individual basis thereafter. Adults who have CRC risk factors may begin screening before age 50 and may be screened more frequently. Today, these screening measures offer the best hope for preventing CRC by identifying polyps for removal before they progress to cancer.
But even though colonoscopy, sigmoidoscopy, and FOBT have demonstrated efficacy in screening for CRC, these preventive measures are imperfect. As the authors write in the article, which begins on page 150, “More research is necessary to develop effective screening techniques that are more sensitive and perhaps less invasive than the options available today.”
To illustrate their point, they describe the case of a patient whose colonoscopy revealed a tubulovillous adenoma in the cecum; later, during right hemicolectomy, the tumor was not found in the cecum but rather in the hepatic flexure. Chalking the discrepancy up to poor bowel preparation for the initial colonoscopy, another colonoscopy, performed during the hemicolectomy, showed a second invasive adenocarcinoma in the rectal vault that had been missed on the initial colonoscopy.
We at Consultant and Consultant360.com are committed to bringing you practical peer-reviewed cases and review articles like this one to help you conquer the daily challenges you face in the practice of primary care medicine. For more on CRC, during Colorectal Cancer Awareness Month and throughout the rest of the year, visit the Gastroenterology 360 specialty area at Consultant360.com. And for instant access to the latest clinical news, articles, and more on your Android or iOS phone or tablet, download the Consultant360 app for free from Google Play or the App Store.
We welcome your comments. Contact me at editor@consultant360.com, or call me directly at (800) 237-7285, ext. 4396. Thanks for reading.
Michael Gerchufsky, ELS, CMPP
Managing Editor, Consultant
References:
- American Cancer Society. About colorectal cancer. https://www.cancer.org/content/dam/CRC/PDF/Public/8604.00.pdf. Published 2016. Accessed February 28, 2017.
- Prevent Cancer Foundation. Colorectal cancer: preventable, treatable, beatable. http://preventcancer.org/learn/preventable-cancers/colorectal. Accessed February 28, 2017.