Colorectal Cancer:An Often Preventable Disease

John M. Dalena, MDDirector, Atlantic Gastroenterology

at Summit Medical Group

Chairman, Morristown Medical CenterDepartment of Gastroenterology

Date

About Colorectal Cancer

• Colorectal cancer (CRC) is a common, sometimes deadly disease It is the leading cause of cancer death

• 1 in 3 people who develop colorectal cancer die from the disease

• It accounts for almost 10 percent of all cancer deaths

Who gets CRC?

Colorectal cancer is uncommon in people at average risk who are age ≤50 years

But by age ≥50 years, risk of the disease increases for all people • 90 percent of cases occur in people

age ≥50 years

What are risks for CRC?

• Although risk for CRC is mostly acquired, genetic factors can have a role

• Other risk includes: Age Gender, with more women than men getting CRC Family history Ethnicity and racial background Geographic area Smoking Dietary and exercise habits

More About CRC Risk

• Risk for CRC is greater if you have: History of colorectal cancer or polyps Inflammatory bowel disease, including

• Crohn’s disease• Ulcerative colitis

Familial adenomatous polyposis (FAP) Hereditary nonpolyposis colon cancer

(HNPCC) or Lynch syndrome

Do you solemnly swearto follow my advice?

Screening Matters!

• Having risk for CRC does not ensure you will get the disease

• Having little risk for CRC does not ensure you will not get the disease

The Good News

Colorectal cancer deathsare declining in the United States!

•Screening is key Data show an estimated 53 percent of the

reduction in colorectal cancer deaths likely result from screening and early detection

Between 1987 and 2010, screening is likely to have prevented the disease in ≤500,000 people

Reducing CRC Risk

• Know your risk • Get screened• Eat a diet

Low in saturated fat, cholesterol, and red meat High in fiber and calcium

• Exercise and be active• Don’t smoke• Reduce stress

CRC Screening

• Helps your doctor find precancerous tissues and remove them before they become cancerous

• Helps your doctor find and remove CRC in its early stages before it has spread

Prepping for Screening

• Is not as difficult as you might think! It’s relatively quick It’s worth the trouble because

screening can save your life

Importance of Proper Prepping

Your doctor cannot conduct your colonoscopy unless your colon

is completely clean!

Types of Screening

• Flexible sigmoidoscopy

• Optical colonoscopy

• Double-contrast barium enema

• Computed tomography (CT) colonography (virtual colonoscopy)

Stool-based Tests

• Guaiac-based fecal occult blood test

• Immunochemical-based fecal occult blood test

• Cologuard fecal DNA testing

Which test is best?

Colonoscopy is the gold standardfor early detection of polyps and cancer.

When to Be Screened

• At age ≥50 years and every 10 years thereafter if you are at average risk If you have a adenomatous polyp,

your doctor will likely advise you to be evaluated in less than 10 years

More Frequent Screening

If you have a personal or family history of CRC or adenomatous polyp

If you have a genetic syndrome increasing CRC risk• Hereditary nonpolyposis CRC (HNPCC)

• Familial adenomatous polyposis (FAP)

• One or more first-degree relatives with CRC

• Two or more second-degree relative with CRC• IBD causing pancolitis or long-term (≥8 years) disease• Other health problems that required radiation therapy

The Bottom Line

Know your risk,

live a healthy lifestyle,

and get screened!