Doctor promotes colorectal cancer awareness
By Ashley Shah
Colorectal cancer awareness month is every March. However, even though the month has passed, it does not mean that awareness of the topic should pass, too.
Dr. Walt Coyle, a resident of Scripps Ranch, is a gastroenterologist with Scripps MD Anderson Cancer Center and Scripps Clinic – and he is promoting information about this topic to raise awareness.
Recent studies have changed the way colon cancer, and preventative treatments, are being viewed. A study published last year in the New England Journal of Medicine declared colonoscopies are less effective than previously known. The study included 85,000 patients in Northern Europe over 10-years. Two-thirds of the patients were not invited to receive a colonoscopy. However, of the one-third of patients who were invited to receive a colonoscopy, only 42 percent received one.
“When they published the data, they looked at the entire group together and said that a colonoscopy didn’t improve survival and death rates as much as it used to. But, if you dive deeper, if you were one of the patients that did a colonoscopy, your chance of getting colon cancer dropped by 31 percent, and your chance of dying from it decreased by over 50 percent,” Coyle said. “If you got the colonoscopy, it saved your life. I think it was a provocative study. It was done to get people to talk about colon cancer, and to get screened.”
Another study, published earlier this year by the American Cancer Society (ACS), focused on the data from colon cancer patients. The data suggests that younger people are at a higher risk of getting colon cancer now.
“The study showed two cohorts. If you were born in 1950, and compare those people to those born after 1990, the people born after 1990 have twice the risk of getting colon cancer,” Coyle said. “If you go back, in 1995, 11 percent of people were under 55 who had colon cancer. Now, it’s 20 percent, so it doubled. Moreover, in any other group, over 55, the rate of dying from colon cancer has been plummeting, except in young people; it is rising.”
Based on the recent information about the rise of colon cancer in younger people and other factors, the U.S. Preventive Services Task Force has lowered the starting age for screening for colon cancer from 50 to 45, if there is no family history of cancer.
With this change – and considering colon cancer is the third leading cause of cancer-related deaths in both women and men, according to the ACS – it is imperative that people stay informed about colon cancer.
This year, there are expected to be more than 150,000 cases of colon cancer in the U.S. More than 50,000 deaths this year are expected to be caused by colon cancer in the U.S., according to the ACS.
Warning signs of this form of cancer can include blood in the stool, any change in stool habits, chronic abdominal pain, and weight loss, Coyle said.
“People often ignore the symptoms. I use Chadwick Boseman (actor, director, producer) as an example. He was only 39 – he was having some rectal bleeding. He, unfortunately, died at age 43 of colorectal cancer. You should never ignore the symptoms, even if you are young,” Coyle said.
Risk-factors to keep in mind can vary from genetics to environmental.
“We do know certain risk factors make the risk of getting this cancer worse. In my mind, it’s about half through genetics, and half through your environment,” Coyle said.
The lifetime risk of getting this cancer, without a family history, is 5 percent, according to Coyle. Other factors, such as preexisting cancers, may also play a part in the risk of developing colon cancer.
“Women who get breast cancer are getting tested for colon cancer. We’re finding all these genetic mutations that they have for colon cancer. If you have other cancers, even if you don’t have a family history, you should seek out your doctor to determine if that is putting you at risk,” Coyle said.
Besides genetic factors, there are lifestyle choices that play a role in increasing or decreasing the risk.
“Being obese increases your risk of getting colon cancer by 30 percent. Diet is important. The World Health Organization has said that processed red meats are really an issue. You should decrease those to about once a week. Smoking significantly increases your risk,” Coyle said. “What I really like to stress to my patients is exercise. If you can get your heart rate above 100 bpm three times a week for about half an hour, it decreases your risk by 20 percent. Drinking over two cups of coffee a day, in one study, dropped the risk of getting cancer by 26 percent. Vitamin D seems to protect women in terms of not getting colon cancer.”
Early detection of this form of cancer is crucial in minimizing the risk of getting it.
“There are several modalities to screen for colorectal cancer. The two main ways are stool-based testing, and colonoscopy, which are both recommended by the U.S Preventative Task Force,” Coyle said.
There are two types of stool-based tests.
“There is a fecal immunochemical test (FIT), which tests for a specific part of blood, the globin part. It costs about $25, and it is recommended to do every year. It’s very easy; you just send a sample of your stool on a card to your doctor,” Coyle said. “The other type of test is the ‘Cologuard,’ where you send your entire stool in a box. It costs $600, but fortunately, most insurances cover it. This test should be done every three years.”
If a positive result comes from either test, a colonoscopy should be done.
“In the colonoscopy, you are sedated. We take a fiberoptic tube through your colon. We look for any polyps or cancer. It detects, just like stool tests, but it also prevents. If we see a polyp, we remove it, and that’s how we decrease your chance of ever getting it,” Coyle said.
Unfortunately, most people are avoiding screening tests.
“Despite all of this, with the young people, people are living longer. We’re curing more people of colon cancer. The cure rate now is over 55 percent for on-comers. If it is just a small-early cancer, the cure rate is over 95 percent. This is just like any other cancer, early detection saves lives,” Coyle said.
Coyle urges all people to take charge of their health – and get screened.