Fighting Colorectal Cancer on Many Fronts

Posted by Carlea Bauman on May 4th, 2012

Dr. Indran Krishnan and Georgia Governor Nathan Deal

Indran Krishnan, MD, FRCP (London), FRCP(C), FACP, FACG is fighting colorectal cancer on many fronts. As a gastroenterologist, he personally screens people every week. As an associate professor at Emory University, he trains the next generation of physicians. As an advocate, he serves on Fight Colorectal Cancer’s Board of Directors, and was a founding member of the Georgia Colon Cancer Coalition. In the first 4 months of 2012, Indran stepped up his efforts by:

  • Meeting with Georgia Governor Nathan Deal and members of the Georgia legislature to introduce them to Fight Colorectal Cancer and spread the word about screening;
  • Attending this year’s Call-on Congress, our annual advocacy training and lobby day; Read the rest of this entry »
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Cutting Out Polyps Cuts Colorectal Cancer Deaths in Half

Posted by Kate Murphy on March 9th, 2012
A Colon Polyp Snared and Removed

A Colon Polyp Snared and Gone

We thought it was true . . . and now research comes along with evidence.

Colonoscopy reduces death from colorectal cancer.

In a follow-up analysis from the National Polyp Study, people who had adenomas — the risky kind of polyps — removed during the study were much less likely to die from colon or rectal cancer than  the general US population.  In fact, removing adenomas cut the death rate from colorectal cancer in half.

We knew that colonoscopies find and remove precancerous polyps and reduce the number of new colorectal cancers, but this is the first study to actually link colonoscopy to cutting back death from colorectal cancer.

There was good news in the study for people who didn’t have adenomas too. They had a very low risk of colorectal cancer death. Only one person out of nearly 800 with no adenomas found at the initial exam  died of colorectal cancer. Read the rest of this entry »

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Colorectal Cancer News in Brief: August 7

Posted by Kate Murphy on August 7th, 2009

Research has found aspirin or resistant starch doesn’t help people with Lynch syndrome avoid new polyps.  While almost all people had seen a cancer-related ad, very few actually got a prescription for the advertised drug. People who followed a low-fat, high-fiber diet most carefully had fewer new polyps.

A Johns Hopkins team has developed SUDS — a device for cleaning ER equipment that wipes out dangerous bacteria and keeps it from returning for several days.  The Caring Connection will help you find advance directive forms and instructions for your state. Read the rest of this entry »

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Screening Methods

Posted by Kate Murphy on February 29th, 2008

Comparing Screening Methods for Average Risk Patients

Tests that Detect Adenomatous Polyps and Cancer

Colonoscopy

   Every 10 years  

Most sensitive test for small and large polyps and cancers. Examines the entire colon, polyps can be removed and biopsied during the procedure.

  

Expensive, requires complete bowel cleansing. Normally uses sedation and requires someone to accompany patient, Rare instances of bowel perforation and bleeding. May not be covered by insurance.

Double-contrast barium enema

  

Every 5 years

  

Visualizes the entire colon, can detect most cancers, and the majority of large polyps. Helps patients who cannot complete a colonoscopy or where colonoscopy is not medically appropriate. Less expensive.

  

Requires complete bowel preparation. May be uncomfortable. An experienced radiologist is critical to quality exam. Colonoscopy is still required to biopsy lesions or removed polyps.

CT-colonography (virtual colonoscopy)

  

Every 5 years

  

Does not require sedation. No recovery time, patients can drive home or return to work. Finds cancer and large polyps at the same rate as colonoscopy. May find problems outside the colon as well.

  

Requires complete bowel preparation. Colonoscopy is required to biopsy and remove polyps. Technology and radiologist training are growing but not complete. May not detect non-polypoid colorectal neoplasms. May not be covered by insurance. False-positive problems identified outside the colon may require unnecessary follow-up tests.

Flexible sigmoidoscopy

  

Every 5 years

  

Can be done by primary care physician or trained nurse practitioner. Does not require sedation

  

Will miss polyps or cancers in the right colon beyond the reach of the scope. If polyps are found, colonoscopy and addition bowel preparation are required. Can be uncomfortable.

Tests that Primarily Detect Cancer

gFOBT: Guaiac-based stool test

  

Every year

   Inexpensive, is done privately at home, can be offered to many people through community programs, including those without primary care or insurance.  

Not very sensitive to polyps, will miss some cancers. Needs to be done correctly over three days. Requires diet and drug restrictions. Patients must handle stool. Has a high false positive rate that requires follow-up colonoscopy for about 1 in 3 tests.

FIT: Immunochemical stool test

   Every year   Has no diet or drug restrictions prior to the test. Limits blood detected to the colon and rectum . Is more sensitive than  guaiac-based tests for cancer. May be simpler for patients to do.

 

Will miss some cancers and most advanced polyps. More expensive than gFOBT. All positive tests require colonoscopy follow-up.
Stool DNA test   Not yet known  

Done at home privately. Not necessary to handle stool. Collection kit shipped directly to patient. No special diet prep required.

  

May not find all cancers or large polyps. Requires prompt, ice-pack shipment to special labs. Significantly more expensive than gFOBT or FIT. Colonoscopy follow-up necessary for positive test.
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