This year has been dominated by the COVID-19 pandemic.
Although we’ve had a lot to worry about, and many of us have put our lives on hold this past year because of it, I wanted to discuss the importance of cancer screening.
Cancer screening is done to identify disease at an early stage in patients who do not have symptoms. The basic premise is that early detection of cancer can lead to eventual cure and improved outcomes.
There is data emerging about the effects of delaying routine medical care because of the COVID-19 pandemic. The worry is that delays in cancer screening specifically, will mean diagnosis of cancers at later stages.
Cancer is a broad term for a group of diseases caused by transformation of normal cells into abnormal cells. These abnormal cells grow uncontrollably, and have the potential to spread throughout the body. This can be caused by both environmental and hereditary (genetic) factors.
Environmental factors can be preventable and include tobacco, excess alcohol, dietary factors, obesity, and a sedentary lifestyle. The single most preventable cause of cancer is tobacco.
Cancer is the second leading cause of death in the United States, with heart disease the first. Cancer can develop at any age however most often occurs in middle age.
The risk of cancer also increases as we age. The lifetime risk for developing cancer is nearly one half in men, and one third in woman. The top four causes of cancer death the U.S. are lung, colon, breast, and prostate.
As a gastroenterologist, I am going to focus on the importance of colon cancer screening; however, age appropriate screening for common cancers is a discussion to have with your primary care physician.
Colon cancer is the second most common cancer in the U.S. Risk factors include age (about 90% diagnosed in patients over age 50), tobacco, family history, obesity, heavy alcohol, colon polyps, and a diet high in red meat.
Certain colon polyps are precursors to colon cancer, and are considered precancerous.
Signs of colon cancer can include blood in stool, change in stool caliber or bowel habits, and abdominal pain. Over the last two decades, as a result of improvements in early detection and treatment, colon cancer cases and deaths have been decreasing. However, when we look at the numbers closer, the improvements have occurred in the 50 and older age group.
A particular concern has been an increase in cases of colon cancer in a younger population. In 2020, it is estimated that about 12% of colon cancer cases will be in patients less than 50 — about 18,000 cases. The reason for this is not known, but likely related to lifestyle and dietary factors.
Currently only about 70% of the population aged 50 to 75 are up to date on colon cancer screening. The age at which screening for colon cancer begins depends on one’s risk. In patients at higher risk, which are those with a family history of colon cancer or polyps, generally screening starts at age 40 or earlier.
Average risk patients are those without a family history. The starting age is 45 for average risk African Americans, and 50 for others. However, recent recommendations from the American Cancer Society and United States Preventative Services Task Force (USPSTF) are to consider starting screening at age 45 because of increasing incidences of colon cancer in a younger population.
Screening is to be individualized in those between age 75 and 85 years old based on functional status and life expectancy.
There are several screening options to consider. The only screening test in those with a family history of colon cancer or polyps is a colonoscopy.
Screening options in average risk patients include a colonoscopy every 10 years, stool fecal immunochemical test (FIT) every 1 to 3 years based in which type of test is taken, sigmoidoscopy every 5 years, or CT colonography every 5 years.
An important distinction to remember is that colonoscopy is the only test that can both detect, and prevent colon cancer by removing colon polyps during the procedure. Additionally, if any of the other screening modalities are positive, a colonoscopy must be performed.
You should talk to your gastroenterologist or health care provider about the differences in screening options. A screening test for colon cancer is generally mandated to be covered by your insurance company. You can compute the amount of insurance using an Instant Insurance Cost Calculator. In depth information regarding colon cancer screening is also available at www.arizonadigestivehealth.com.
For the most part, I believe many diseases can be prevented with a well-balanced diet, exercise, avoiding tobacco and excess alcohol, and maintaining a normal body weight. Unfortunately, even by doing everything right, we can develop cancer.
Earlier detection of cancer leads to earlier treatment and the potential for a cure. We should also be serious about any symptoms we encounter. Any symptoms of blood in the stool, change in bowel movements, and abdominal pain; however minor one may consider them, should be investigated further.
This year has felt like a marathon, and we are getting closer to the finish line, but I fear that missed opportunities with cancer screening will lead to further suffering.
I would encourage every reader to discuss cancer screening with their healthcare professional or specialist.
Arizona Digestive Health would like to welcome our two new doctors, Dr. Anil Seetharam and Dr. Nayan Patel! These Board-Certified Gastroenterologists begin on November 1st at our 9767 N 91st St and 9755 N 90th St Scottsdale locations. Please learn a bit about our new doctors below and request appointments today!
Dr. Seetharam is a Board Certified Gastroenterologist and Transplant Hepatologist with Arizona Digestive Health in Scottsdale. In a distinguished academic career, he rose to UNOS Medical Director of liver transplantation at one of the highest volume centers in the country. He has performed extensive clinical research with over 100 published peer reviewed studies, national abstracts and book chapters. Driven by a desire to prevent most GI/liver disorders before they create serious problems and promote wellness, Dr. Seetharam is thrilled to offer office consultations on all GI/liver issues and performs GI procedures (EGD, colonoscopy, enteroscopy) at Scottsdale Endoscopy Center. Dr. Seetharam serves as chair of the Medical Advisory Board of the American Liver Foundation in the Southwest and is a Clinical Associate Professor of Medicine at the University of Arizona.
Dr. Nayan Patel is a Board-Certified Gastroenterologist and Transplant Hepatologist with Arizona Digestive Health in Scottsdale AZ. He performs routine GI procedures such as upper endoscopy and colonoscopy in the diagnosis, screening and surveillance of gastrointestinal diseases and cancers. In addition, he also specializes in advanced liver disease, and cirrhosis and formerly was co-director of a liver transplant program. He also specializes in general gastroenterology conditions and colon cancer prevention. He is a member of the American Association for the Study of Liver Disease and holds a national position as a member of the Training and Workforce committee. He is also a member of the American College of Gastroenterology and American Gastroenterological Association.
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Tips for successfully surviving Thanksgiving Day
- Start with a balanced breakfast including fiber and protein – a bowl of oatmeal with a hardboiled egg is a great example, if you struggle to find good sources of protein, then consider going to the deli for some various options.
- Limit snacking throughout the day and do not skip meals
- Go for a walk after dinner with family
- Stay hydrated by drinking half your body weight in ounces of water
- Eat your vegetables first
- Eat slowly and savor every bite
- Plan to have only one plate of food – prioritize your favorites and have just a small portion of each food item – if there’s something you don’t care much about, skip it
- Remember what the holiday is all about, giving thanks for all that you have & all that you are. Take a look to the latest biofit reviews.
Tips to surviving holiday parties from now through Christmas
- Follow the 3 bite rule from. If there is a holiday food or treat you just can’t resist then take a bite – enjoy it and savor it. Take two more (really enjoy them) then toss it.
- Be diligent about your exercise routine – make a plan and stick to it! Consider purchasing equipment to make your workouts easier, like Pure Canned Oxygen. With these you won’t only have a more comfortable workout, but you will also be making sure you don’t hurt your back while you’re at the gym and also combining the routine with the supplement of your choosing, read the meticore supplement reviews to know about the best one.
- TRY going to the gym or even working out at home two times a week. This ACE Certified trainer is reviewing fitness workouts that only require dumbbells. You could buy some for home.
- Place tempting treats at home or in the office in an inconvenient place and in a non-see through container
- Think of calories as dollars – how much can you afford in your budget and what would you most like to spend those calories on?
- Eat balanced snacks between meals to prevent intense hunger – some nuts and a fruit juice which you can make with an small blender made will do.
- Serve yourself on a small plate and limit yourself to one plateful
- Do not attend a party hungry. Bring a healthier food item so you have something lower calorie to eat
- Chew sugar free gum to prevent mindless snacking
- Avoid sugary cocktails – go for light beer, wine, champagne, or liquor mixed with Zevia or lemon juice and sparkling water