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Colonoscopy important part of screening by Brenda Hoffman, M.D., Department of Gastroenterology, and Peggy LeVeen, R.N.,  GI Cancer Nurse Coordinator What do Audrey Hepburn, Ronald Reagan, Ruth Bader-Ginsberg, and Darryl Strawberry all have in common? They were all diagnosed with colorectal cancer.     This year, approximately 150,000 Americans will develop colorectal cancer.  More than 55,000 will die of the disease. A married couple faces a 1- in-10 chance that either the husband or wife will ultimately develop colorectal cancer.      Colorectal cancer is the second leading cause of cancer death in the United States, second only to lung cancer. Yet a simple test could spot the disease early and save countless lives.   Waiting for symptoms to develop won’t work, because by the time they do, there may be advanced disease. Approximately 90 percent of colon cancers begin in benign, asymptomatic growths called polyps. These polyps appear as fleshy growths arising in the lining of the colon. They occur in both men and women with equal frequency. Mutations in DNA caused by a combination of high fat diets, toxic environmental factors, viruses, and hereditary factors result in polyps. Most people do not develop polyps until age 45 to 55, although there are some exceptions.   As we age, these benign growths may have a predilection to malignant transformation. It is thought some polyps will develop into cancer in five to 10 years if left in the colon.   Colon cancer screening can be performed by stool tests for blood, sigmoidoscopy, barium enema, and colonoscopy.   Virtual colonoscopy may soon be reimbursed by Medicare and will be added to these recommendations. For a person without symptoms, the current national preferred screening recommendations suggest a colonoscopy starting at age 50 and continuing at 10 year intervals. African-Americans should begin colonoscopy screenings at age 45. Those with a positive family history of colorectal cancer or polyps should begin screening at age 40 or 10 years younger than the earliest diagnosis in their family, which ever comes first, and repeat screenings every five years.     Colonoscopy is more effective in preventing colon cancer death than mammography is for preventing breast cancer deaths. Unfortunately, few people have undergone endoscopic colorectal cancer screening. It is estimated that less than 45 percent of eligible individuals in the United States have been screened. Increased awareness of the need for and the beneficial effects of colorectal cancer screening is vital.   By an act of Congress, March is Colon Cancer Awareness Month. Ask your doctor about screening for colorectal cancer. Remember, colorectal cancer is preventable, and this is truly a case where an ounce of prevention may save your life, or the life of someone you love. Editor's note: The preceding column was brought to you on behalf of the Employee Wellness Program. Striving to bring various topics and representing numerous employee wellness organizations and committees on campus, this weekly column seeks to provide MUSC, MUHA, and UMA employees with current and helpful information concerning all aspects of health. Colon cancer symptoms While most early cancers produce no symptoms, the American College of Gastroenterology offers these possible symptoms for colorectal cancer: New onset abdominal pain Pain in passing the stool A change in typical bowel habits, diarrhea and constipation A change in the stool caliber or shape   For information, check with your family physician or visit http://www.acg.gi.org. Lifestyle and diet suggestions Eat a diet high in yellow, red and orange fruits and vegetables, low in meats and saturated fats and high in fiber. Discuss with your physician your intake of calcium, folic acid, and whether aspirin might be helpful Keep an active lifestyle, walk and exercise Do not smoke     Friday, March 23, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island papers at 849-1778, ext. 201.