Colorectal polyps : screening to prevent cancer
Palmdoc in the Malaysian Medical Resources reminds us that screeening for colorectal cancer can be detected early through screening procedures in the appropriate group of people. It has been shown that screening saves lives from colorectal cancer.
“Screening” means the use of a test to detect the presence of a disease in an early stage before it shows any signs or symptoms, among the apparently “normal” population. Among the important charateristics of a disease that can be screened for are:
- the disease is common in the population
- the disease has a fairly long “sub-clinical” stage, i.e. before it shows itself
- the disease is treatable or an intervention can be given to prevent a complication of the disease (it would be quite pointless to screen for a disease that you can do nothing about)
- the test to use is sensitive enough to detect most, if not all, of the patients
- the test to use is safe and acceptable to the well person
It is not only in the early detection of cancer that saves lives. Screening is also expected to prevent colorectal cancers. How does that happen?
80% of colorectal cancers arise from a pre-existing polyp. Polyps of the adenoma type are the ones that have the potential to turn malignant (cancerous). The risk of a polyp turning cancerous is about 1% per year for each polyp. That depends on some characteristics as the shape and size of the polyp. This is called the adenoma-carcinoma sequence. Therefore, a colonoscopic examination can detect a polyp and removes it before it becomes a cancer.
Here is how polyps can be removed fromthe colon or rectum via a colonoscope.
A polyp in the colon as viewed from a colonoscope
A “snare” is threaded throught the colonoscope to the polyp. It looks like a wire lasso.
The polyp is snared tight and lifted away from the surface of the colon. An electrical current is passed through the wire to heat up and burn the stalk of the polyp.
The polyp is cut off through the burning action and is ready to be retireved with a grasping instrument.
So that’s how a screening procedure can prevent cancer by detecting a condition that could lead to cancer and removing it before it does. One of these days we’ll talk about screening for other cancers.
routine screening to start at age 50 and above?
Nyonya, in the US, starting at 50 years of age is the American Cancer Society and US Preventive Task Force recommendations.
I’d say for us Malaysians, there are no specific screening recomendations. My own opinion is that average risk individuals may be screened according to American recommendations if they desire.
However, above-average risk individuals should be advised to receive screening:
These individuals should be screened with colonoscopy. The starting age depends on the specific risk factor, e.g. for FAP, screening starts at the age of 13.
[…] Get out of here….. Of course, not. Ok..maybe the sucking in..got la! Once you have kids (under 20s’) and no maid, it would be infinitely impossible to even do 1/300 of what I just wrote. Every day. But after reading Doc’s posts on rectal cancer, it’s hard to ignore the looming troubles if I continued to indulge in my unhealthy lifestyle of not eating enough fibre everyday. So, I really did it. […]
Aiyo…means i gotta get screening! This is a laser treatment issit? sigh..very expense la..but better this financial burden than cancer!!!!!!
Honoured u dropped by my site
shall we link?
if we link i can see a dr without paying consultation fees
mott, I like your post about psyllium. Funny!
It’s called endoscopy. It’s not “laser” although some people do call it that. Actually, mott, you could get it done in the government hospital if it’s a burden… in Malaysia, no one needs to get burdened by medical care since the Ministry of Health provides it at a token fee.
Bengbeng, i like your style of writing la. Got suspense in it. And not too long. My attention span is not that long. Hehe.
At least now can read up a little what polyps are and where they come from. Guess its never too early to arrange for screening. Do they have roots which could potentially resurrect even after its been cut off?
Milo, polyps can recur. It’s due to genetic mutations in the cells lining the bowel. In fact, the entire colon and rectum has a potential to grow polyps if another polyp had been found anywhere in the colon and rectum before. This applies to adenoma-type polyps, not hyperplastic or inflammatory polyps.
That’s why after polypectomy (removal of the polyp), a follow-up colonoscopy is performed a year later. That is, if there’s no cancer or any cell changes that suggest cancer nearby (dysplasia).
Sounded like wild mushroom springing up from everywhere uncontrollably. When I hear early detection of cancer saves lives… I also at the same time hear somewhere in that sentence… it only delays premature death since the rate of recurrence could be slim yet highly probable.
Doing something about it, the first step is always us, the ordinary everyday people. Easier said than done. I found that it really takes a whole lot of discipline to get something done and thereafter stay motivated living a healthy lifestyle.
Thank you for sharing your knowledge and bringing so much awareness on this topic. Before reading this, I didnt know anything about polyps.
Milo, Thanks for reading. Readers like you are the reason I write.
I don’t think that we have to be so fatalistic about colorectal cancer. The outcome from colorectal cancer is actually better than other GI cancers; and recurrence of polyps certainly doesn’t mean a poor prognosis. Polyps take about 5 to 10 years to become malignant, generally, so catching it early can prevent progression.
The studies which led to the recommendation of screening for colorectal cancers show a reduction in mortality from colorectal cancer in the screened population.
Regarding a healthy lifestyle, it depends very much upon the motivating factors in each individual. We can only disseminate information and the action depends on the individual.
Hmmm…. Of course, behaviour can be changed by loading the health insurance premium for people who practice an unhealthy life-style. But that’s another story.
Ermm ..I wonder if the yellowish thingie .. fats or sh@~!#?
hoiling, that’s sh@~!# ! Haha.
I guess so .. ewww ..will you empty the intestines before conduct the colonoscopy procedure? The tube must be smelly! haha