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Cancer experts encouraging colonoscopies after new Iowa report

Dr. Robert Summers (right) performs a colonoscopy procedure on a patient in the Digestive Disease Clinic at the University of Iowa Hospitals and Clinics in Iowa City in 2007. Observing (left) is Dr. Young Choi, who was working on a fellowship at the university. (Gazette file photo)
Dr. Robert Summers (right) performs a colonoscopy procedure on a patient in the Digestive Disease Clinic at the University of Iowa Hospitals and Clinics in Iowa City in 2007. Observing (left) is Dr. Young Choi, who was working on a fellowship at the university. (Gazette file photo)

What if your colonoscopy came with a free chance to win the lottery?

Cancer experts admit that the screening for colon cancer doesn’t have the best reputation – high cost, time-consuming, that nasty “prep” liquid – but Iowans shouldn’t need a jackpot as incentive to get one.

Just look at the statistics.

In Iowa, the average annual number of deaths due to colorectal cancer declined from 875 per year in the 1980s to 790 in the 1990s and 685 in the 2000s.

That decline is due to increased screening, said Dr. Charles Lynch, medical director for the State Health Registry of Iowa.

When diagnosed at an early stage, the five-year survival rate for colorectal cancer is more than 95 percent, he said.

The registry, based at the University of Iowa College of Public Health, released its annual Cancer in Iowa report on Monday, March 14.

Lynch said colorectal cancer will continue to be among the four most common cancers diagnosed in Iowa this year, as well as one of the top causes of cancer deaths.

Others are breast, lung and prostate cancer. Those four account for half of all cancer deaths in Iowa.

The report predicts 6,300 Iowans will die from cancer this year, down from last year’s estimate of 6,400; and 16,500 new cancers will be diagnosed, up from 16,400 last year.

Dr. George Weiner, director of the UI-based Holden Comprehensive Cancer Center, said a stool sample test to detect genes that put a person at risk for colon cancer is still at least 10 years away from being perfected.

In the meantime, he said, colonoscopies remain the “gold standard” to screen for colorectal cancer and at the same time, remove polyps – or growths – detected during the test.

Those polyps can become cancerous as they grow.

UI gastroenterologist Dr. Adrian Holm said colonoscopies detect pre-cancerous polyps about 20 to 40 percent of the time. An additional percentage of patients have non-cancerous polyps.

Virtual colonoscopies that use a CT scan to look for polyps are less invasive than colonoscopies, Holm said, but don’t allow for polyp removal, so a patient would have to undergo the same “prep” again if a polyp was detected.

Sigmoidoscopies are another screening method involving a similar prep in which doctors can only see the lower portion of the colon. Those are recommended every five years.

Recommendations for colonoscopies call for one test every 10 years starting at age 50, up to age 75. People at higher risk should have screenings sooner.

Annual blood stool tests are another option, but Lynch noted that blood in stools could indicate a number of conditions, including ulcers or hemorrhoids.

Obesity, smoking and eating red meat are among factors thought to contribute to the risk of colon cancer.

Despite the benefits of early detection, only about half of Iowans ages 50 to 59 have ever had a sigmoidoscopy or colonoscopy.

Like other Iowans, LouAnnda Larson had excuses. Chief among those was being uninsured, with the screening cost quoted to her at $2,000.

But, in a sense, the Clinton woman won a jackpot when she finally had a colonoscopy last year at age 55.

A polyp removed during the screening was cancerous, but doctors believe they caught the cancer before it spread, giving Larson a new lease on life.

“You think getting a colonoscopy is hard. That’s nothing (compared) to telling your family you have cancer,” said Larson, a mother of three and grandmother of six. “Some things are necessary. A colonoscopy is one of them.”For more information, see: http://cph.uiowa.edu/shri/

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