An article on the use of MRI to detect breast cancer sparked a change in the American Cancer Society screening guidelines, and this will be a useful test – particularly in younger women where the ability of mammography to detect cancer is limited by the density of the breasts.
We have been using MRI in breast cancer patients for several years now, and these new guidelines will help this use become more appropriate. It is a welcome change.
But the American Cancer Society guidelines reminded me again about another screening test – Colonoscopy. The very word strikes fear in many people; but now is a good time to reiterate what a great and important test a screening colonoscopy is.
Colon cancer is the second most common cancer and the second most common cause of cancer death in women who don’t smoke. And there is very effective screening available for colon cancer. A screening colonoscopy is a potentially embarrassing thing, but getting over that embarrassment and having one is a great thing to do.
Not only can colonoscopy tell you if you are free of colon cancer, or detect colon cancer at an earlier and more curable stage – it can do something even better – it can prevent colon cancer. We estimate it can take 10 years from the start of a polyp in the colon to develop into a cancer – with a colonoscopy polyps can be detected, removed, and in effect cure you of colon cancer without requiring surgery. Thus it is a fabulous screening test.
A little diarrhea the night before with the prep, the test is done under sedation the next day, a little embarrassment, and your fears of developing colon cancer can be allayed.
The American Cancer Society recommends screening starting at age 50 – the American Gastroenterology Society recommends that African Americans start screening at 45. If you have had a relative with colon or rectal cancer you should start screening at roughly 10 years before that relative's cancer was diagnosed.
Sadly, many of my breast cancer patients put off getting a colonoscopy. I can understand why, but if you’ve gone through so much to cure yourself of breast cancer, consider how little you need to go through to prevent yourself from getting colon cancer.