The purpose of colonoscopy for colon cancer prevention is the removal of precancerous polyps (adenomas) before these polyps had time to acquire new mutations, grow and become cancerous. The progression of polyps to cancer is known as adenoma-carcinoma sequence. While there is evidence that certain drugs can decrease the risk of polyps progressing to cancer, the only reliable method is polyp removal during colonoscopy (polypectomy).

Cancer of the colon does not arise spontaneously in normal tissue. Instead, every cancer was a polyp first. Removing polyps prevents colon cancer.

Are all colonoscopists equally effective at finding polyps and cancers during colonoscopy?

To find out, read the article from Dr. Douglas Rex, the leading expert in colonoscopy, in the New York Times entitled “10 Questions You Need to Ask About Colonoscopy”. The bottom line is, if your doctor spends more time looking he will find more polyps.

Dr. Klaus Gottlieb worked with Dr. Rex while at Indiana University (see publications at the end of this page). Dr. Gottlieb is an experienced and diligent colonoscopist with consistently high adenoma detection rates.

Have we won the war on colon cancer?

Rapid declines in newly diagnosed colorectal cancer in the past decade in age groups older than 55 years are likely the result of increased uptake of screening, which rose from 38% in 2000 to 59% in 2013 in adults age 50 years or older according to data from the Centers for Disease Control and Prevention.

However, recent large scale studies (see below) show an increase in new diagnoses in people in their early 50s, as well as younger age groups. This highlights the need for increased adherence to recommended screening.

What Young People Need to Know About Colon Cancer – New York Times March 16, 2017

“Most cases of colon and rectal cancer are indeed found in people 50 and over. But there has been a sharp increase of colorectal cancer in adults as young as their 20s and 30s, with the proportion of cases found in adults under 50 increasing to 11 percent in 2013, up from 6 percent in 1990, according to the American Cancer Society. A recent study from the group that analyzed colon and rectal cancer incidence by birth year found that rates dropped steadily for people born between 1890 and 1950, but have been increasing for every generation born since 1950.”

Younger people today are at higher risk for colon cancer than their parents when they were the same age. Source: JNCI: Journal of the National Cancer Institute, Volume 109, Issue 8, 1 August 2017

“Warning signs include blood in the stool, rectal bleeding or stools that are dark or black in color. The blood, released from the tumor, may be bright red or “tarry” in appearance, which can result when blood has broken down in the intestine. Unexplained or unintentional weight loss or fatigue can also be symptoms. General digestive complaints can also occur, including persistent abdominal cramps, gas pain or low back pain, feeling bloated, or experiencing a change in bathroom habits that lasts more than a few days, such as diarrhea, constipation, narrower than usual stools or a feeling that your bowel is not emptying completely.”

Read the full article here 

 

 

 

Publications

Ness, Reid M., Klaus Gottlieb, Douglas K. Rex, and Glen A. Lehman. “Difficult sigmoid colon intubation: guide wire exchange technique.” Gastrointestinal endoscopy 44, no. 1 (1996): 99-101.

Rex DK, Cummings OW, Helper DJ, Nowak TV, McGill JM, Chiao GZ, Kwo PY, Gottlieb KT, Ikenberry SO, Gress FG, Lehman GA. ”5-year incidence of adenomas after negative colonoscopy in asymptomatic average-risk persons”. Gastroenterology. 1996 Nov 1;111(5):1178-81.