$Unique_ID{BRK01929} $Pretitle{} $Title{Colon Cancer Risk Factors} $Subject{Colon Cancer cancers cancerous Risk risks factor Factors surgery surgeries disease diseases colorectal die died dead death deaths precaution precautions inflammatory bowel adenoma adenomas polyp polyps inherit inherited syndrome syndromes digital rectal examine examination examinations test tests testing stool feces blood sigmoidoscopy barium enema colonoscopy American Society benign nutrition diet diets fiber roughage} $Volume{} $Log{ Colonoscopic View of Colon Conditions*0002803.scf Discussion of Colonoscopy*0002801.scf} Copyright (c) 1993 Tribune Media Services, Inc. Colon Cancer Risk Factors ------------------------------------------------------------------------------ QUESTION: My brother, age 53 and 4 years older than I am, has been found to have colon cancer. He will be having surgery to rid him of this disease. I am now worried about myself and my other younger brother and sister. Are all three of us likely to develop this cancer? What can we do about this? Please tell us what we must do try and avoid the same surgery our brother must now have. ------------------------------------------------------------------------------ ANSWER: Your question reflects the concern of all families faced with this commonly occurring cancer. More than 155,000 new cases of colorectal cancer are diagnosed each year, causing the deaths of more than 66,000 Americans. That means that 1 out of every 20 Americans will develop this disease, a number that has been rising over the last 20 years. The frequency of colorectal cancer rises sharply after the age of 40, and 90 percent of all cases occur in people 50 years of age or older. The presence of this cancer in your brother does increase the possibility that you may also develop the disease about threefold, and that means you must take all possible precautions. Other risk factors that place people at high risk are inflammatory bowel disease, the presence of adenomas (polyps) in the colon, or inherited syndromes that may or may not produce polyps in the colon. Your brother's doctor may be able to help you evaluate your own risk, by informing you of the precise nature or origin of your brother's cancer. When certain inherited conditions are discovered, screening procedures should be started as early as age 25 or 5 years younger than the earliest age at which a family member was diagnosed, whichever is earlier. Several types of screening procedures are currently available, to discover the presence of cancer at the earliest possible moment. They include a digital rectal examination, testing stool for the presence of blood, sigmoidoscopy, barium enema, and colonoscopy of the full colon. For people at average risk, the American Cancer Society recommends an annual digital rectal examination beginning at age 40, and flexible sigmoidoscopic examinations every 3-5 years after two normal annual examinations beginning at age 50. However, when a positive family history exists involving a first degree relative (like a brother) in inherited syndromes, a full colon examination (colonoscopy) is recommended every 5 years beginning at age 40. If polyps are discovered, they should be removed, for it is now generally accepted that most colorectal cancers develop from these benign adenomas. Reexamination in these cases should be performed after the third and fifth year, and colonoscopy may be discontinued after two consecutive examinations where no new polyps are found. Depending upon your brother's history, and the findings in your own case, your physician may modify these recommendations, utilizing a combination of screening procedures that best serve your needs. A double contrast barium enema is a good technique for finding new polyps or growths, but often misses findings in the rectum. However, a flexible sigmoidoscopy can be used to correct this deficiency. Incidentally, home testing for fecal blood is no substitute for the other screening exams, and should not form the first line of defense in your case. Recent advances in nutrition have shown that a diet high in fiber may reduce the possibility of developing these cancers, so consider increasing your consumption of fiber, or "roughage" as it was once called. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.