VIDEO: ‘Never been more important’ to discuss value of CRC screening, early detection
In a Healio video exclusive, David M. Poppers, MD, PhD, explains why “now is the most important time” for colorectal cancer screening and how physicians can help make patients more comfortable with colonoscopy.
Patients, and even some physicians, often prefer to avoid discussion of anything “below the belts,” but overcoming the stigma is critical, Poppers, professor of medicine and director of GI quality and strategic initiatives at NYU Langone Health, said.
“Screening is important because patients have no symptoms, and we need to stay on top and be focused on preventative care,” he said. “Colorectal cancer discovered early generally has an excellent prognosis.”
Poppers noted it is “very helpful” for patients to know that there are “a lot of options” available for the pre-colonoscopy bowel cleanse that are optimized for comfort and efficacy, lowering the chance that a repeat procedure will be necessary.
“We have so many good options now for enhancing a very straightforward procedure that really indeed saves lives,” he said.
Poppers made the case for why it is more important than ever to screen for malignancies even in the absence of symptoms.
“It’s never been more important to have this discussion with patients, especially as we have been actually detecting colorectal cancer and some of the precursor lesions, colon polyps, at younger ages,” he said.
Perspective
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When performing a colonoscopy, medical professionals are not only looking for cancer; we are also looking for changes in the colon that might suggest early precancer.
A polyp can be detected during colonoscopy and, if removed early enough, the lesion never has the chance to turn into cancer. Most stool-based tests cannot detect these polyps and the longer they progress, the higher the likelihood of needing surgery for treatment.
Think of colonoscopy screening both as a therapeutic and preventative measure: When talking to patients about early detection and early intervention, the need for a colonoscopy cannot be stressed enough. In some cases, cancer is caught so early that there are no symptoms to set off alarm bells that would make one seek medical treatment.
Colon cancers and rectal cancers caught in the early stages are very treatable and curable. If caught early enough, it is even possible to treat the cancer by using advanced endoscopic procedures. Doctors at Cleveland Clinic have a lot of expertise in a treatment called endoscopic submucosal dissection, or ESD, and this can help avoid colon resection altogether.
Undergoing a colonoscopy and catching cancer in its early stage significantly improves patient outcomes. It can decrease the complexity of what we have to do to treat the disease, and potentially avoids treatments like chemotherapy or radiation. Early detection also improves long-term survival.
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