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Colon Cancer & Women

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Chesapeake, VA, gastroenterologist Patricia Raymond has a message for women: "Don't assume you can't get colon cancer because you're a woman."

In fact, you're just as likely to develop the disease as any man, disputing the still-held myth that colon cancer is a "man's disease." And you're more likely to develop it as you age, with more than 90 percent of cases diagnosed in those 50 and older.

This year, an estimated 112,340 cases of colon cancer and 41,420 cases of rectal cancer will be diagnosed in the United States, and 52,180 people will die from the disease. That makes colorectal cancer the second leading cause of cancer-related death and third most common cancer type in both men and women, accounting for about 10 percent of all cancer deaths. And yet, in most cases it can be prevented with a simple, 15- to 30-minute test.

That test is a colonoscopy, in which a gastroenterologist inserts a thin, flexible scope with a camera and a light source in the tip through your anus to exam your colon. The American Cancer Society recommends it every 10 years beginning at age 50, earlier and more often if you have a family history of colon cancer, precancerous colon polyps called adenomas or other risk factors. The test, which costs between $500 and $1,000, occurs under sedation in an outpatient setting and is the primary reason for the significant drop in the rate of colon cancer in the United States over the past 20 years.

Yet getting women to schedule their colonoscopies can be more challenging than convincing them to shave their heads. "Women who are so tolerant of so many screening procedures have a meltdown when it comes to colonoscopy," says Dr. Raymond. "They won't do it, and they don't want to hear that they can get colon cancer."

The procedure itself is not nearly as difficult as many women believe. Sure, you have to drink a large amount of special liquid or take over a dozen pills the day before to "clean out" your colon so your doctor can see what's going on in there, but that's typically the worst part. You turn up at the outpatient endoscopy center, receive a sedative through an IV, and before you know it, it's all over. You feel groggy for about an hour after the procedure, but there is no pain or discomfort. And then you're done for 10 years!

Colonoscopy can be a bit more difficult to perform in some women, says Dr. Raymond, particularly those with small pelvises or surgical adhesions, which are scar tissue from past surgeries. Women also tend to have slightly longer colons then men. But that difficulty is on the physician end; you're usually asleep or so groggy you don't know what's happening.

The beauty of a colonoscopy is that if the doctor finds any polyps, small growths that can look like little mushrooms, they can be removed immediately. Left alone, they can grow and turn into colon cancer. That is why having a colonoscopy can prevent you from getting colon cancer—it can identify and allow the gastroenterologist to remove any polyps before they have a chance to turn into cancer.
Polyps differ in size, location and type. The larger the polyp, the greater the likelihood it is cancerous. The type of polyp also plays a role:

• Hyperplastic polyps. These are benign polyps, which do not turn into colon cancer with the rare exception of people who have an uncommon syndrome known as hyperplastic polyposis syndrome.
• Adenomas or adenomatous polyps. Comprising about two-thirds of all colon polyps, these are precancerous polyps, which may grow and turn into cancer if not removed. Not all adenomas turn into cancer. About 30 to 40 percent of adults over 50 have at least one adenoma, but colon cancer occurs in about five percent.

Although the American Cancer Society and other screening guidelines also suggest colon cancer screenings with sigmoidoscopies, fecal occult blood tests or barium enemas, Dr. Raymond recommends sticking with the colonoscopy. Sigmoidoscopies can only find polyps or cancers lower down in the colon, while most cancers today are found higher up. Plus, if any polyps are found, you'll still need a colonoscopy to remove them.

So if you're 50 and older and have never had a colonoscopy, or if it's been more than a decade since your last one, make an appointment today with a gastroenterologist. Doesn't your colon deserve the same care and attention as your breasts and cervix, especially since we can prevent a majority of colon cancers from ever forming by doing a colonoscopy?

References

American Cancer Society. Cancer Facts & Figures 2007 (Atlanta: American Cancer Society; 2007).

Quigley EM, Flourie B. Probiotics and irritable bowel syndrome: a rationale for their use and an assessment of the evidence to date. Neurogastroenterol Motil. 2007 Mar;19(3):166.

© 2007 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (toll-free). On the Web at: www.healthywomen.org.

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