Aging Begins at 30

Looking Inside Your Gut for Cancer. How Often and How Good?

After three years, 80 percent returned for reexamination, their average age was 66. Fourteen percent had a mass or polyp (pre-cancerous pendulous lump of the gut lining). One percent were advanced and likely to soon become cancerous. Three percent had an early or actual cancer. In at least 80 percent this abnormality was in an area that had been well-seen three years before and had been normal. These were accepted as new growths. It is known that if you have a single sigmoidoscopy you will reduce your chance of death from rectal or colon cancer by two-thirds. This procedure is not without risk as the bowel is perforated about once in every 40,000 procedures. It is also expensive but compares well with the cost of screening mammography. The three-year finding of cancer at the repeat exam was about a quarter of the initial cancer pick-up rate.

So does the procedure do more good than harm? This sigmoidoscope examination only sees about half the colon. The much more expensive colonoscopy sees it all but, all tests have a degree of imperfection. The cancers are evenly distributed. As the editorial writer says, "how effective is effective enough?" Even so, at present only one-third of Americans are screened appropriately. It is difficult to build in sigmoidoscopies to the routine of a busy practice but, town medical centers can be set up to have sigmoidoscopies done by well-trained and supervised PAs or Nurse Specialists.

What is the protection by sigmoidoscopy against death from colon or rectal cancer and do medicare and other insurers cover this office-based screening adequately? It is believed that colonoscopy will find cancers in two percent in the area seen with colonoscope and not sigmoidoscope. But, 80 percent of the cancers are seen by the sigmoidoscope. The investigators believe that most deaths from colon and rectal cancers could be prevented, so another approach is that of prevention with diet choice, physical activity, no smoking and reduction in obesity.

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See related Patient Topics Cancers, Colorectal Cancer or Digestive System.

See related Provider Topics Cancers, Colorectal Cancer or Digestive System.

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