What is Colon Cancer?
Colon cancer is cancer of the large intestine that forms in the lining of the colon. Most cases of colon cancer begin as small clumps of cells called colon polyps. While these polyps start out as benign, if not discovered and removed, usually during a colonoscopy, they can become cancerous and develop into colon cancer.
In the United States, colon cancer is the second deadliest form of cancer. Each year about 150,000 people will be diagnosed with colon cancer, and 50,000 people will die from the disease, according to the American Cancer Society.
What is Adenoma Detection Rate (ADR)?
Adenoma detection rate (ADR) is the widely accepted national benchmark on quality for screening colonoscopy. A physician’s adenoma detection rate is the proportion of individuals undergoing a complete screening colonoscopy who have one or more adenomas, or polyps, detected.
When interviewing gastroenterologists for a colonoscopy, potential patients should be looking for a physician with an Adenoma Detection Rate of at least 15 percent in women and 25 percent in men. Gastroenterologists take great pride in their ADR because it is a direct measure of the effectiveness of the colonoscopy that they offer.
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Background and Aims: Colorectal cancer (CRC) prevention by colonoscopy has been lower than expected. We studied CRC prevention outcomes of…Read More
keynote speaker for Victory Over Colon Cancer Symposium
February 15-16, 2019
2030 Gregg St.
Piet de Groen
Dr. de Groen is a Professor of Medicine in the Division of Gastroenterology, Hepatology and Nutrition, at University of Minnesota, emeritus staff at Mayo Clinic College of Medicine, adjunct professor at University of Arizona and former Program Director of the Mayo Clinic/IBM Computational Biology Collaboration. He is an NIH-funded clinical investigator and international expert in medical informatics, primary liver cancers and colonoscopy.
His endoscopic research is focused on measuring what happens during colonoscopy. Together with collaborators at Iowa State University and the University of North Texas he has created a first-of-a-kind new software system that automatically captures and analyzes “inside-the-patient” video information of medical procedures performed via endoscopy. At present he is studying patient- and endoscopist-specific features, including quality of the colon preparation and effort of the endoscopist to visualize mucosa, remove remaining fecal material and adequately distend the colon.
To eliminate suffering and deaths from colon cancer
Create a Consensus:
- Acknowledge the variable benefits of the different screening options.
- Colonoscopy, done well, can reduce deaths 90%.
- Colonoscopy, when the physician’s ADR is below 20 gives less than 10% protection.
- Stool based tests evaluating for hidden blood in the stool have not proven to reduce deaths whatsoever.
- Stool based tests for DNA damage are promising but have not been available long enough to demonstrate clear benefit. It is effective in fining cancer, but our goal is to prevent cancer.
- Virtual colonoscopy (a fancy CT scan) misses 90% of the pre-cancerous polyps removed by high ADR colonoscopy.
- Know your colonoscopist's ADR (adenoma detection rate). If you are a physician, do not refer your patient to a colonoscopist that does not have a minimum ADR of 25. Never refer to a group. Chances are more than 50-50 the test will be performed by a doctor with a below-standard ADR.
- For the patient. Do not have a colonoscopy by a colonoscopist that does not display a minimum ADR of 25. Ask before scheduling. The American College of Gastroenterology clearly states disclosure of the ADR is expected of every colonoscopist. If you cannot get a clear answer, or if the answer is “the doctor is board certified and that is sufficient,” find an alternative colonoscopist. It is your life. You have a choice. The choice can mean life or death.
- Know your family history risk factors. If a first-degree relative (parent, brother, sister or child) had evidence of increased risk (colorectal cancer or a pre-cancerous polyp) begin testing at age 40. You are no longer an “average risk” patient. You are at increased risk and are therefore entitled to screening beginning at age 40. More and more patients are diagnosed at younger ages. The first test is the most important. That is when we occasionally encounter surprises. Do your research. If you can find a legitimate reason, begin your screening as young as possible.
- Recognize the symptoms that might prompt earlier screening. Any changes in digestion, bowel movement, bleeding or pain can be “alarm” symptoms requiring screening.
- Do not ignore the opportunity to reduce your risks with:
- Weight management
- Remember, colorectal cancer is the preventable cancer. Still, 50,000 die each year. Colorectal cancer is 10% of all cancer deaths and cancer is one-third of all deaths. You can eliminate your risk for colorectal cancer death with accepting responsibility for life-style adjustments and high-ADR colonoscopy screening.