Colorectal Cancer

Prevention

The best defense against colorectal cancer is regular screening. Screening tests are designed to find benign polyps (precancerous growths) that can be removed before they become cancerous (malignant) and catch cancer at an early stage when it is easier to cure. The American Cancer Society recommends that all adults begin screening for colorectal cancer at age 50. People at higher risk should begin screening earlier. Recommended screening methods include:

• Digital rectal examination - Beginning at age 40, then yearly after 50; should not be used as the only screening method

• Fecal occult blood test - Yearly beginning at age 50

• Sigmoidoscopy - Every five years beginning at age 50, unless you have a colonoscopy

• Colonoscopy - As a routine screening test every 10 years, beginning at age 50, unless you have a screening sigmoidoscopy every five years

• Double-contrast barium enema - Not the preferred method of routine screening, but can be performed instead of colonoscopy or in addition to sigmoidoscopy every five years

• Virtual colonoscopy – More accurate x-ray pictures of the colon using CT technology without insertion of a scope. Possible alternative to other methods of screening.

In addition to these screening tests, other methods can reduce a person's risk of developing colon cancer. Daily exercise and a diet low in fats, especially saturated fats, and high in fruits, vegetables and whole-grain foods may lower your risk of colorectal cancer. Also, some scientific studies have suggested that taking aspirin or folate every day may reduce a person's risk of colon cancer. These should be discussed with your doctor to see if they are appropriate for you.

Treatment

Surgery is the primary method of treating colorectal cancer. Surgery sometimes is followed with chemotherapy or radiation. The extent of surgery and whether you need treatment after surgery depends on the stage of the disease and whether it is in the colon or rectum.

There are three slightly different systems for staging colon cancer: Dukes, Astler-Coller and AJC/TNM. Following are the stages in the AJC/TNM system and recommendations for treatment in addition to surgery.