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Colon Cancer (cont.)

Prevention

Your best prevention is to detect colon cancer and treat it early in its formation. People who have regular screening for colon cancer, including fecal occult blood tests, sigmoidoscopy or colonoscopy, and polyp removal, greatly reduce their risk of having a colorectal cancer.

Other things you can do to lower your risk include the following:

Quit smoking. Smoking cigarettes has been clearly linked with higher risk of colon cancer (as well as many other conditions).
Take an aspirin or baby aspirin every day. Because of potential side effects, this is not recommended for everyone. Talk to your health care provider first.
Take a safe dose of folic acid (for example, 1 mg) every day.
Engage in physical activity every day.
Eat a variety of fruits and vegetables every day.

The US Agency for Health Care Policy and Research recommends screening for colon cancer in people older than 50 years who have an average risk for the disease and in people aged 40 years and older who have a family history of colorectal cancer. The agency recommends that one of the following screening techniques be used:

Fecal occult blood testing every year combined with flexible sigmoidoscopy every 5 years
Double-contrast barium enema every 5-10 years
Colonoscopy every 10 years: Colonoscopy remains the most sensitive test for detecting colon polyps and tumors.

Once polyps have been identified, they should be removed. After you have had polyps, even one polyp, you should begin to have more frequent colonoscopies.

Appropriate preventive screening for people with ulcerative colitis includes the following:

Colonoscopy every 1-2 years in the following cases:
- If you have known you have the disease for 7-8 years
- If the cancer involves the entire colon
- Beginning 12-15 years after the diagnosis of left-sided colitis
Random colon biopsies taken during colonoscopy

People with ulcerative colitis in whom biopsies show premalignant changes should undergo surgical removal of their colons.