few weeks after she turned 17, Danielle Burgess was diagnosed
with colon cancer.
had been noticing blood in her stool for several years, but
she shrugged it off after consulting Dr. Google and
time she went to the doctor to have a colonoscopy, she was
diagnosed with Stage 3 colon cancer.
wasnít great but they gave me a lot of treatment
options," said Burgess of Kansas City, Mo.
months later she was cancer-free. Doctors continued to monitor
her colon (large intestine) every three years. In 2009, when
she was 25, a growth on her colon once again tested positive
they caught it early," said Burgess, now 32.
cancer, a malignancy that occurs in the colon or rectum, is a
leading cause of cancer deaths. This year, itís expected to
claim the lives of nearly 50,000 people in the United States.
also largely preventable. Screening tests can detect and
remove abnormalities before they have a chance to turn
cancerous ó or spot problems in the early stages, when the
disease is more responsive to treatment.
American Cancer Society and other groups say that screening
for most men and women should begin at age 50. Even so, many
choose to ignore this advice. Roughly one-third of the countryís
eligible adults havenít been screened for colorectal cancer
as recommended by the U.S. Preventive Services Task Force,
according to the Centers for Disease Control and Prevention.
estimates that if everyone age 50 and up had regular testing,
at least 60 percent of deaths from this cancer could be
nearly every case, colon cancer begins with a small growth
called a polyp, which over time turns into a large polyp, and
eventually turns into cancer," said Dr. David Greenwald,
director of clinical gastroenterology and endoscopy at Mount
Sinai Hospital in New York. "This process takes many
years to occur; if polyps are removed when they are small or
even when they are big, but before they turn into cancer,
colon cancer is prevented."
in its earliest stages and if the cancer hasnít spread, the
survival rate beyond 5 years is 90 percent, said Durado
Brooks, managing director of cancer control intervention for
the American Cancer Society. If it has already spread, the
survival rate drops to 12 percent beyond 5 years.
treatments are much, much more effective at the early
stage," Brooks said.
are numerous ways to screen for colorectal cancer, and several
organizations have issued their own guidelines.
Preventive Services Task Force recommends screening using
high-sensitivity fecal occult blood testing, sigmoidoscopy or
colonoscopy beginning at age 50 and continuing until age 75,
at which point the decision to continue screening should be
made on an individual basis depending on the personís
overall health and screening history.
tests the task force recommends:
High-sensitivity fecal occult blood test (FOBT) or fecal
immunochemical test (FIT) to detect blood in the stool, a
possible sign of cancer. People get a kit and collect small
samples of stool that are sent to a lab. This test should be
Flexible sigmoidoscopy, where doctors use a thin, flexible,
lighted tube called a sigmoidoscope to examine the interior
walls of the rectum and the lower third of the colon. Should
be done every five years in conjunction with FOBT/FIT every
Colonoscopy, similar to a sigmoidoscopy but uses a longer
colonoscope tube to look at the inside walls of the rectum and
the entire colon. Should be done every 10 years. During the
procedure, tissue samples may be collected for further testing
or polyps may be removed. Colonoscopies are often performed as
a follow-up if abnormalities are picked up by other screening
say theyíve heard a plethora of excuses from patients whoíve
put off screening.
excuses for not undergoing screening include a fear of being
diagnosed with cancer," said Dr. Andrew Chan, associate
professor of medicine at Harvard Medical School and
gastroenterologist at Massachusetts General Hospital.
"Other patients do not want to undergo endoscopic
screening tests because they are afraid of pain or discomfort.
For these patients, I explain that the vast majority of
patients do not experience discomfort since they are given
sedatives and pain medicines during the procedures."
American Cancer Societyís recommendations include additional
screening options, such as an X-ray of the colon and rectum
called a double-contrast barium enema, and a CT colonography
(virtual colonoscopy), where X-rays and computers create
images of the entire colon. Both require that the colon is
completely empty before testing, so patients need to do a
colon-cleansing prep, same as they would with a standard
society also recommends a stool DNA test every three years
that entails sending a bowel movement to a lab to be checked
for cancer cells.
(stool tests) may not be as sensitive as colonoscopy, and some
patients also worry about having to manipulate fecal
matter," Chan said. "However, any screening is
better than no screening exam."
most adults can wait until 50 to start routine screening,
tests should begin earlier and be done more frequently for
those at higher risk, such as people with inflammatory bowel
disease or a strong family history of colorectal cancer or
also need to be vigilant about symptoms ó no matter what
before Susan Cohanís 40th birthday in 2002, Cohan
experienced stomach pain and rectal bleeding. She saw several
doctors who prescribed laxatives rather than referring her to
ended up in the emergency room in incredible pain. She was
diagnosed with advanced stage colon cancer and told she had a
couple of months to live, said her father, David Cohan,
president of the Baltimore-based Susan Cohan Colon Cancer
died two years later after a heroic battle," her father
said. "We urge anyone regardless of age with symptoms
such as abdominal pain, bleeding or continuous constipation to
get screened for colon cancer."