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Cancer of the Rectum


Colorectal cancer is cancer of the colon or the rectum, and is the second largest cause of cancer deaths in the U.S. It is estimated that 56,730 people will die in the U.S. this year, according to the American cancer Society. 90% of cases happen to those 50 years old or older, so increased age is a risk factor for colorectal cancer. A family history of colorectal cancer, inflammatory bowel disease and some hereditary syndromes are also risk factors. Alcohol consumption, tobacco use, obesity, low-fiber and high-fat diets, and not eating fruits and vegetables are other risk factors for colorectal cancer. Early screening and detection is essential.

Detecting and removing pre-cancerous polyps can reduce the number of colorectal cancer deaths, detect cancer earlier, and allow early treatment. Removing these polyps or growths can prevent this type of cancer, because these pre-cancerous polyps can appear years before the cancer develops.

There are four tests to screen for colorectal cancer. These are the fecal occult blood test, a flexible sigmoidoscopy, colonoscopy, and the double-contrast barium enema.

The fecal occult blood test, or FOBT, finds hidden blood in three consecutive stool samples. In the U.S., a 33% reduction of colorectal cancer deaths and a 20% incidence reduction of colorectal cancer occurred with people that had an annual FOBT. In Europe, a 15% to 18% reduction in colorectal cancer deaths occurred in trials where FOBT's were performed every other year.<

With the flexible sigmoidoscopy exam, a flexible, lighted tube is used to visually inspect the inside walls of the rectum and portions of the colon. In case-control studies, a 59% to 79% reduction of colorectal cancer cases occurred in patients that had a flexible sigmoidoscopy over people that did not have the procedure.

For the colonoscopy exam, a flexible, lighted tube that is longer than the one used for the flexible sigmoidoscopy is used to see and inspect the interior walls of the rectum and the entire colon. Samples of tissues can be collected and polyps can be removed with this procedure. A colonoscopy can screen for colorectal cancer or be used as a follow-up diagnostic tool if another screening test is positive.

The double-contrast barium enema exam involves x-raying the colon and the rectum in a series, after an enema of barium dye is given and an air injection into the lower bowel to facilitate easier viewing.

A digital rectal exam is not recommended as a screening method because the area screened is limited.

For adults over 50 years old, it is recommended that an FOBT be given every year, a flexible sigmoidoscopy be performed every 5 years, a double-contrast barium enema be given every 5 years, and a colonoscopy every 10 years be performed. If you have a higher risk for colorectal cancer, you should start screening at a younger age, and more often than the above guidelines.

The earlier you get screened will greatly reduce your chance of getting colorectal cancer, and can prevent your getting colorectal cancer in the first place, or increase your chances of survival if you already have colorectal cancer.

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