A Cancer That's Entirely Preventable: Early Screening for Colon Polyps Dramatically Raises Survival

Mar 27, 06:38 AM

Current Headlines: By Cathleen F. Crowley, Albany Times Union, N.Y.

Mar. 27--Thousands of New Yorkers die each year from a cancer that could easily be avoided by taking a medical test.

But a new study shows that more than half of all colon cancers in New York are detected in the late stages, when treatment options are limited and survival rates drop dramatically.

"People are not getting screened the way they should, and that's a wake-up call for everyone," said Dr. Ira Zackon, a medical oncologist with New York Oncology Hematology in Latham.

The American Cancer Society studied New York colon cancer detection rates between 1999 and 2003 and found that most cases had advanced to later stages before being discovered. Fulton County had the highest rate, with 74.6 percent of colon cancer cases in the late stages when first detected. Albany County's rate was 62.3 percent, Schenectady's 53.8 percent and Rensselaer had 63.6 percent. The statewide rate was 60.4 percent.

When colon cancer is detected early, the five-year survival rate is 90 percent. After the cancer has spread to nearby organs and lymph nodes, the survival rate drops to 68 percent. Survival drops to 10 percent when the cancer spreads to distant tissue. The American Cancer Society study gauged colon cancers in these two later stages.

"Colon cancer is the only cancer that is completely preventable by screening," said Sherry Tomasky, interim regional vice president of the American Cancer Society. "Every colon cancer begins as a polyp. When you remove a polyp during a colonoscopy, you remove your chances of developing cancer."

A colonoscopy is an examination of the inside of the colon with a camera attached to the tip of a long, flexible tube. It is the gold standard of colon cancer detection.

Colon cancer tends to strike people over 50, so medical guidelines advise men and women to get a colonoscopy when they turn 50 and repeat it every 10 years thereafter. People who have a family history of colon cancer should have the procedure 10 years before the age their family member was diagnosed.

Some doctors also recommend that African-Americans begin screening earlier because evidence suggests they are at risk at younger ages.

Colon cancer is the third-leading cause of cancer deaths in the nation, according to the American Cancer Society. This year, 10,710 new cases of colon cancer will be diagnosed in New York state. About 3,350 New Yorkers will die of colon cancer in 2007, according to the cancer society.

The study didn't investigate why New Yorkers aren't getting colonoscopies, but Tomasky and Zackon have theories.

They said some people don't have insurance to pay for the $2,200 procedure, others don't have access, and some physicians don't tell their patients to get the colonoscopy. And, of course, many people don't want to undergo the examination.

"Some people will put it off and shy away from doing it," Zackon said. "I think it's because it's an invasive procedure, and they are a bit fearful. ... Most of the time, the fear is out of proportion."

Zackon said that, with the help of sedatives, he slept through his colonoscopy.

Lack of medical insurance is no longer a barrier, Tomasky said. Beginning in April, every county will have a free colon cancer screening program, and if cancer is detected, uninsured residents are automatically eligible for Medicaid for treatment. The policy is part of the Colon and Prostate Treatment Act, which the state Legislature approved last year.

Many people complain that the preparation for a colonoscopy is worse than the procedure. Before the colonoscopy, patients must purge their digestive system with preparations that can cause hours of diarrhea.

"The truth is that a diagnosis of colon cancer is far worse than what anyone has to go through to prepare for a colonoscopy," Tomasky said.

Cathleen F. Crowley can be reached at 454-5348, or by e-mail at ccrowley@timesunion.com.

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