Simple procedures that could save your life

Patricia F. will never forget her friend Susan’s lifesaving advice. Several years ago, Susan developed recurring stomachaches she thought were symptoms of menopause. They weren’t. It was colon cancer, and incurable by the time she finally sought care. Shaken by the outcome—and at Susan’s urging—Patricia got screened.

“They found two precancerous polyps and removed them,” the 54-year-old recalls. To her relief, the next round of tests resulted in a clean bill of health.

Colon cancer now kills some 28,400 women in the U.S. each year. To reduce your risk, it’s key to have regular screenings and catch problems early. Options recommended by the American College of Gastroenterology (ACG) include a fecal occult blood test, sigmoidoscopy, or colonscopy, the so-called “gold standard.” All can be useful.

Colon cancer screening: know your options!
All the tests detailed here are recommended by the American College of Gastroenterology:

• Fecal occult blood test. This is done at home. Stool samples are then examined for blood, which may or may not signal the presence of cancer. This “first-step” test is cheap and noninvasive.
• Flexible sigmoidoscopy. This procedure, generally performed every five years, enables the doctor to examine the lower part of the colon.
• Colonoscopy. This more complicated procedure allows a doctor to examine all of the colon using a thin, lighted tube called a colonoscope that is inserted into the rectum. In late 2007, the American College of Obstetricians and Gynecologists (ACOG) said that it considered colonoscopy the “preferred” method for women. This is because colonoscopy allows a doctor to see the entire colon. It also gives the doctor better access to the right-hand side of the colon, often the site of a type of advanced cancer more likely to arise in women.

No excuses
Today, half the women who should be tested are not. The reasons they give, however, often have simple solutions.

Cost. Some avoid testing because they think they can’t afford it. In fact, some insurers will pay for a colonoscopy if it’s done as a preventive measure, others if it is done to diagnose a problem. Medicare may also help pay for colonoscopies.

Self-consciousness. Embarrassment can be a factor. Some women avoid screenings because they don’t want a male doctor to perform them. The website of the American College of Gastroenterology (www.acg.gi.org/patients/phylocator.asp) can help locate women gastroenterologists.

Fear of pain. Whatever your physical issues, pain doesn’t have to be part of the equation. Sedation is often used, ranging from a gentle relaxant to a drug that knocks you out for the whole procedure.

Availability. For colonoscopy or sigmoidoscopy, it may be hard to find an a doctor who performs the procedure. If you don’t have ready access to one, use another form of screening.
 
Guidelines to reduce your risk
Doctors recommend most women have a preventive screening by age 50. If you’ve  had endometrial or ovarian cancer, you are at a greater risk of developing colon cancer, so schedule a colonoscopy before age 50. If they find nothing, you can wait 10 years until the next screening. You may need to follow up sooner if cancer or precancerous polyps are found, or if your family history or genetic makeup put you at a higher risk

The best bet for reducing your risk? Exercise, maintain a healthy weight, get adequate calcium and folate, and don’t smoke, according to Jacqueline Wolf, MD, a gastroenterologist at Beth Israel Deaconess Medical Center in Brookline, Mass. And get your screening!