Summit Medical Group gastroenterologist John M. Dalena, MD, discusses the benefits and risks of the procedure as well as when and how often you should be screened.

1. Colorectal Cancer:
An Often Preventable Disease
John M. Dalena, MD
Director, Atlantic Gastroenterology
at Summit Medical Group
Chairman, Morristown Medical Center
Department of Gastroenterology

2. About Colorectal Cancer
• Colorectal cancer (CRC)
is a common, sometimes deadly disease

It is the leading cause of cancer death
• 1 in 3 people who develop colorectal
cancer die from the disease
• It accounts for almost 10 percent of all
cancer deaths

3. Who gets CRC?

Colorectal cancer is uncommon in people
at average risk who are age ≤50 years

But by age ≥50 years, risk of the disease
increases for all people
• 90 percent of cases occur in people
age ≥50 years

4. What are risks for CRC?
• Although risk for CRC is mostly acquired, genetic
factors can have a role
• Other risk includes:

Age

Gender, with more women than men getting CRC

Family history

Ethnicity and racial background

Geographic area

Smoking

Dietary and exercise habits

5. More About CRC Risk
• Risk for CRC is greater if you have:

History of colorectal cancer or polyps

Inflammatory bowel disease, including
• Crohn’s disease
• Ulcerative colitis

Familial adenomatous polyposis (FAP)

Hereditary nonpolyposis colon cancer
(HNPCC) or Lynch syndrome

6. Do you solemnly swear
to follow my advice?

7. Screening Matters!
• Having risk for CRC does not ensure
you will get the disease
• Having little risk for CRC does not
ensure you will not get the disease

8. The Good News
Colorectal cancer deaths
are declining in the United States!
•Screening is key

Data show an estimated 53 percent of the
reduction in colorectal cancer deaths
likely result from screening and early detection

Between 1987 and 2010, screening is likely to
have prevented the disease in ≤500,000 people

9. Reducing CRC Risk
• Know your risk
• Get screened
• Eat a diet

Low in saturated fat, cholesterol, and red meat

High in fiber and calcium
• Exercise and be active
• Don’t smoke
• Reduce stress

10. CRC Screening
• Helps your doctor find precancerous
tissues and remove them before they
become cancerous
• Helps your doctor find and remove CRC
in its early stages before it has spread

11. Prepping for Screening
• Is not as difficult as you might think!

It’s relatively quick

It’s worth the trouble because
screening can save your life

12. Importance of Proper Prepping
Your doctor cannot conduct your
colonoscopy unless your colon
is completely clean!

13. Types of Screening
• Flexible sigmoidoscopy
• Optical colonoscopy
• Double-contrast barium enema
• Computed tomography (CT)
colonography (virtual colonoscopy)

14. Stool-based Tests
• Guaiac-based fecal occult blood test
• Immunochemical-based fecal occult
blood test
• Cologuard fecal DNA testing

15. Which test is best?
Colonoscopy is the gold standard
for early detection of polyps and cancer.

16. When to Be Screened
• At age ≥50 years and every 10 years
thereafter if you are at average risk

If you have a adenomatous polyp,
your doctor will likely advise you
to be evaluated in less than 10 years

17. More Frequent Screening

If you have a personal or family history
of CRC or adenomatous polyp

If you have a genetic syndrome increasing CRC risk
• Hereditary nonpolyposis CRC (HNPCC)
• Familial adenomatous polyposis (FAP)
• One or more first-degree relatives with CRC
• Two or more second-degree relative with CRC
• IBD causing pancolitis or long-term (≥8 years) disease
• Other health problems that required radiation therapy

18. The Bottom Line
Know your risk,
live a healthy lifestyle,
and get screened!