Thursday, June 14, 2012

Individual Guidelines Determine Frequency of Colonoscopy

March is Colorectal Cancer Awareness Month - People know to get their cars tuned up every 10,000 miles, change the batteries in the smoke detector once a year and rotate their mattress every month or two. Health screenings, however, are not always on a standard timeline - and when it comes to screenings for colorectal cancer, people should follow individualized guidelines to determine when to be checked.

According to Heinz-Josef Lenz, MD, associate director of the Gastrointestinal Oncology Program at the USC/Norris Comprehensive Cancer Center, the general recommendation for a baseline colonoscopy is beginning at age 50 and thereafter every three to five years.

But factors including a family history of colorectal cancer, the presence of pre-existing gastrointestinal disorders like irritable bowel syndrome or Chron's disease or polyps on a previous colonoscopy, or behaviors including high consumption of red meat, use of alcohol, a low fiber diet or obesity, may warrant a more frequent check.

"If there is any family history of colorectal cancer, we usually recommend a colonoscopy at the age 10 years younger than the youngest family member was diagnosed," says Lenz. "If there is a general disposition to cancer, a shorter interval is recommended, usually every one to two years."

While the colonoscopy remains the standard screening test for colorectal cancer, Lenz says that two new options are being investigated. One is a virtual colonoscopy that is based on a CT scan; the other is a test of a stool sample for abnormal cells.

For now, though, Lenz says the colonoscopy remains the best option - and people should know that the test is now easier on both the patient and the body, specifically with the replacement of Golytely with tablets as a preparation for the test.

"Usually patients get some anesthesia for the colonoscopy," says Lenz. "It is usually done quite quickly and many patients have no symptoms or problems."

In addition to screenings, Lenz advises that for decreased colorectal cancer risk people exercise regularly, limit alcohol consumption and substitute red meat with selections including white meat, fish, soy or tofu. Lenz says that supplementing the diet with calcium, selenium and folic acid can also be a chemopreventive strategy.

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