Questions with Gastroenterologist Dr. Steven Finkelstein

March 18, 2019

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Colon cancer is the third leading cause of cancer-related deaths in the United States. In includes cancers found in the large intestine (colon) and rectum (the lower part of the large bowel). Colon cancer often starts as a small polyp, a growth of extra tissue. Some polyps can become cancer if not removed. It's important to get screened, which is testing before there are any symptoms, to help find polyps before they turn into cancer. If colon cancer is found early, treatment may work better. 

For Colorectal Cancer Awareness Month, we asked our Gastroenterologist, Dr. Steven Finkelstein, some questions about the risks and facts of colorectal cancer: 

1) What are some signs and symptoms of a colorectal issue?
 
Although the signs and symptoms of colorectal disease are broad and often times subtle, the most common symptoms include a change in bowel habits, rectal bleeding, anemia, abdominal pain and unexplained weight loss.
 
2) What is the recommended age for someone to get their first colonoscopy?
 
It depends on one’s ethnicity and risk factors. Average-risk African Americans should get their first colonoscopy at the age of 45, while people of other races may begin at the age of 50. If someone has a family history of colon cancer or colon polyps, we typically recommend getting a colonoscopy at the age of 40 or at least 10 years prior to that relative’s diagnosis. There are certain cancer syndromes that would warrant even earlier screening.

3) Should people with prior cancer diagnoses get a colonoscopy before the recommended age?
 
Those patients with a prior cancer diagnosis do not typically need to begin their colorectal cancer screening early, unless they have been tested and are positive for one of the colon cancer syndromes.
 
4) How often do you need to get a colonoscopy?
 
This depends on one’s risk factors, the findings on one’s prior colonoscopy, the quality of the prior colonoscopy prep and the development of any interval symptoms. If the patient had an excellent prep, is considered average-risk and remains asymptomatic, the cancer guidelines advise 10-year intervals.

5) If a family member is diagnosed with colon cancer, how often should other members of the same family have a screening such as a colonoscopy?
 
It depends at what age that family member developed their colon cancer. If the family member was age 60 or less, every five years is the appropriate interval. If that family member was over the age of 60, we would recommend getting screened every 10 years.
 
6) Is there another test to detect colon cancer that is less invasive?
 
There are other tests approved for the detection of colon cancer, including Cologuard stool testing and Virtual Colography. But these are tests to detect possible colon cancer, while a traditional colonoscopy would still be needed for verification. What colonoscopy offers that the other tests don’t is that it is also a colon cancer prevention test. By performing a colonoscopy, the goal is to prevent colon cancer from growing in the first place. This is done by finding and removing any pre-cancerous polyps. These polyps exist in nearly 25 percent of the population, while colon cancer occurs in nearly 5 percent of the population.


LEGAL DISCLAIMER: The information provided in responses is for general information purposes only and does not address individual circumstances. It may not be right for you and should not be relied upon in making decisions about your health. Always consult your doctor for medical advice.

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