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Why Are Colonoscopies Crucial for You and When?


I would like to introduce you to my son, Dr. Michael Polcino III! He is a board certified colorectal surgeon and surgical oncologist. Today, he is discussing colorectal cancer and indications for a colonoscopy. Colorectal cancer is the third most commonly diagnosed cancer for both men and women and is the second leading cause of cancer deaths in the U.S.

Dr. Michael Polcino, Colorectal Surgeon begins: According to the most recent cancer center network guidelines, there were approximately 100,000 new cases of colon cancer diagnosed in 2013. Additionally, there were 40,000 new cases of rectal cancer in 2013.

Prior to the advent of the widespread use of the colonoscopy, colorectal cancer was diagnosed at a much later stage. Patients would often present with symptoms such as weight loss, increased satiety, and changes in bowel habits, which could include a change in the caliber of the stool and bloody bowl movements. This would often be an indication of a later stage colorectal cancer.

Now that colonoscopies are widely used, colorectal cancer is being diagnosed and treated at a much earlier stage. We are now diagnosing asymptomatic colon and rectal cancers. By diagnosing these in the early stage, we are often times able to treat these patients in a minimal invasive fashion. We can perform either laparoscopic or robotic surgery. Minimally invasive surgery is often associated with improved overall survival and a decreased hospital stay.

I would like to review the indications for a colonoscopy. In the general population, it is recommended that patients receive their first colonoscopy at the age of 50, but if the patient reports symptoms such as a change in bowel habits or bloody bowel movements, it is recommended that the patient has a colonoscopy.

However, and this is very important, if a patient has a strong family history of colorectal cancer, is it recommended that the patient has his or her first colonoscopy 10 years prior to the age of the family member’s diagnosis. For example, if a patient has a sister that developed colorectal cancer at age 48, then the patient should have his or her first colonoscopy at age 38. The reason why we recommend 10 years prior to the age of diagnosis is because it takes approximately 10 years for a polyp to develop into a cancer.

In summary, in the general population, it is recommended that patients undergo their first colonoscopy at age 50. If a patient has a strong family history of colorectal cancer, it is recommended that the patient undergoes his or her first colonoscopy 10 years prior to the family member’s age of diagnosis.

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