Colonoscopy
Over 50? Go get’m
ACOG NEWS RELEASE
| For Release: | October 26, 2007 |
| Contact: | ACOG Office of Communications |
| (202) 484-3321 | |
| communications@acog.org |
Washington, DC — At a news briefing today, The American College of Obstetricians and Gynecologists (ACOG) announced new recommendations emphasizing colonoscopy as the preferred method for colorectal cancer screening for both average-risk and high-risk women. ACOG is the first and only primary care organization to recommend colonoscopy as the preferred screening method for colorectal cancer. ACOG’s new recommendations will be published in the November issue of Obstetrics & Gynecology.
ACOG changed its colorectal cancer screening recommendations because colonoscopy allows for direct visualization of the entire colon surface, and it allows for removal of any precancerous polyps at the same time. Additionally, colonoscopy allows access to right-sided lesions—the main type of advanced colorectal cancer occurring in women—which are more likely to be missed by other screening methods. Previously, ACOG recommended that all women age 50 and older be screened for colorectal cancer by one of several methods, with no single method being preferred over another.
“Our message today is that colonoscopy is the gold standard when it comes to colorectal cancer screening. While we want ob-gyns to encourage this method, they should still discuss the advantages and limitations of the other screening options with their patients,” said Carol L. Brown, MD, immediate past vice chair of ACOG’s Committee on Gynecologic Practice, which developed the recommendations. “The bottom line is we want women to get tested by whichever method they are most likely to accept and follow through with.”
The most recent national statistics show that the death rate from most types of cancer is falling in the US. Between 2002 and 2004, the incidence of colorectal cancer (often referred to as colon cancer) decreased by more than 2% a year for men and women. Experts believe that the decrease is most likely due to more people being screened and having precancerous polyps in the colon removed before they turn into deadly cancer. Colon cancer remains the third leading cause of death from cancer among women.
“As the primary care physicians for many women, we are encouraged by the latest statistics showing a decline in deaths from cancer, especially colorectal cancer since it truly is a preventable cancer,” said Douglas W. Laube, MD, MEd, immediate past president of ACOG. “But we’ve got a long way to go: Only about 50% of women undergo the recommended screening for colon cancer.”
“Far too many women are not getting colon cancer screening. They may be squeamish, embarrassed, or anxious about getting a colonoscopy,” said Dr. Brown. “We need women to move past their fears and take a positive step to prevent cancer by having a colonoscopy. And, most women only have to do colonoscopy screening once every 10 years.”
In 2007, an estimated 154,000 Americans—about the same number of women as men—will be diagnosed with colorectal cancer. Despite recent data showing a decline in colorectal cancer deaths, the disease will still claim the lives of more than 52,000 Americans this year alone, half of which will be women.
Women should be screened before age 50, or more often, if they have any of the following: family history of colorectal cancer or adenomatous polyps (a first-degree relative age 60 or younger at diagnosis or two or more first-degree relatives of any age); personal history of colorectal cancer, adenomatous polyps, or inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease; or family history of colorectal cancer syndromes, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC). ACOG’s new recommendations note that the American College of Gastroenterology advises African Americans, both men and women, to begin screening at age 45 due to increased incidence and earlier age of the onset of colorectal cancer.
Colorectal cancer is a slow-growing cancer that affects the cells in the colon and rectum and can spread to other parts of the body; its exact causes are unknown. The risk of developing colorectal cancer increases with age. About 90% of people with colorectal cancer are older than 50.
“Women shouldn’t wait until they have symptoms before they are screened,” said Dr. Laube. “By then, it may be too late. Colorectal cancer doesn’t always have symptoms, and those women who do have symptoms typically have more advanced cancer.”
As colorectal cancer progresses, the disease may cause the following symptoms: a persistent change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days; bleeding from the rectum or blood in the stool; cramping pain in the abdomen; unexplained weight loss; and weakness and fatigue.
Also, according to the Committee Opinion, ACOG does not recommend fecal DNA testing or computed tomography colonography—also known as “virtual colonoscopy”—for screening outside the research setting, pending further data on their effectiveness.
Committee Opinion #384, “‘Colonoscopy and Colorectal Cancer Screening and Prevention,” is published in the November 2007 issue of Obstetrics & Gynecology.
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The American College of Obstetricians and Gynecologists is the national medical organization representing over 51,000 members who provide health care for women.