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Medical Director's Notes: An Ounce of Prevention Is Worth a Pound of Cure

by Bernard M. Bettencourt, Jr.   DO, MPH, FACEP, CPE
Medical Director, Alicare Medical Management
Bernard M. Bettencourt

Colorectal cancer remains the second leading cause of cancer deaths in the United States. This year an estimated 147,000 Americans will be diagnosed with colorectal cancer and an estimated 56,500 will die from this disease. The larger tragedy is that colorectal cancer is one of the most treatable and preventable cancers if detected early. Colorectal cancer screening with colonoscopy, the gold standard, is an effective tool in the fight against this deadly disease.

Despite our efforts to promote quality patient care in cancer prevention and screening, colorectal cancer screening rates remain poor. Only 25-40% of adults over age 50 report receiving screening tests. Numbers may vary on age and gender, yet only 37% of cases are diagnosed when the disease is still localized. Diagnosis at later disease stages results in substantially lower survival rates.

Getting the word out on colonoscopy screenings is as important as ever. A colonoscopy is recommended for most individuals starting at age 50 and earlier for high-risk groups (e.g., starting at age 40 for African Americans and individuals who have a family history of colon cancer).

New procedures and innovations are also making the process easier. Much like sedation dentistry, many Americans are now choosing to be sedated during their colonoscopy with propofol, a drug administered by a licensed anesthesiologist or certified registered nurse anesthetist. The endoscopic procedure is carried out by a licensed gastroenterologist. Interestingly, several recent studies indicate that when patients undergoing a colonoscopy are placed under monitored anesthesia care, the procedure generates a higher number of polyps that are detected and then removed.

Even though colonoscopies are the current gold standard in colorectal cancer screening, several other screening options are available.

Patients should check with their physician to identify the best approach for each individual. Clearly, patient safety should be everyone's top priority. In this case, "an ounce of prevention" is clearly "worth a pound of cure."

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