Colon cancer screening. Which test is most effective? Part 1 of 2. Colonoscopy. 1-1

How to choose best colon cancer screening test? There are 1.4 million new colorectal cancer diagnosis every year. All colon cancer cases are preventable. Is colonoscopy the best cancer screening method? What are risks of colonoscopy? Leading colorectal cancer oncologist and research expert discusses colon cancer treatment options.

Colorectal cancer is number one or number two cancer in the United States and Western Europe. But deaths from colon cancer are uniquely preventable. Because effective screening is available for precancerous lesions in the large bowel. Dr. Anton Titov, MD. Screening is available also for early stage colorectal cancer. But there are some controversies about the best method of screening for colorectal cancer. Is it fecal occult blood test, colonoscopy, or flexible sigmoidoscopy? Dr. Anton Titov, MD. Could you please discuss colorectal cancer screening options? What colon cancer screening works better for this situations? Prof. Dr. Hans-Joachim Schmoll, MD. Yes, indeed. Colorectal cancer is the most frequent cancer type in the western world. If you put female and male patients together. We can separate cancer patients by sex. Then colorectal cancer is the second frequent cancer. But for men and women together colon cancer is the most frequent one. But colon cancer develops in a hidden region in the colon or rectum. Prof. Dr. Hans-Joachim Schmoll, MD. We are not able to see into bowel from outside the body. Therefore, we do need do early detection program for colon cancer. When the colon cancer arises with blood in feces or with symptoms, normally it is too late. Cancer with symptoms is always in advanced stage. Cancer is locally advanced. Colon cancer is already at metastatic stage. Prof. Dr. Hans-Joachim Schmoll, MD. The chance of a cancer cure is limited. Then many patients die. It is a high mortality at these advanced stages of colon cancer. But on the other hand, the colorectal cancer is a visible tumor in the colon or in the rectum. You can see cancer by colonoscopy. Sometimes you look on a skin cancer. Most skin cancer could be detected at an early stage. Specialists look on the skin. Also cancer at the neck region could be detected earlier. Dr. Anton Titov, MD. An expert would inspect this region. Most cancers cannot be seen because they develop inside the body. Because there is no access from the outer part. Colorectal cancer is the most frequent cancer in the western world. But this cancer is accessible for inspection by endoscopy inside intestines. This gives us a chance in most patients, about 80% of the patients to detects colon cancer tumor early. Prof. Dr. Hans-Joachim Schmoll, MD. Detection of “early cancer” means detection before cancer metastasized. Before colon cancer reached the stage when the patient has to die from colon cancer. This is an excellent model to detect this tumor early and to eliminate this tumor early. The most effective method is clearly the objective measurement by looking by endoscopy. However there is clearly other risks of colonoscopy. Because colonoscopy procedure depends on the quality of the doctor who performs the procedure. Prof. Dr. Hans-Joachim Schmoll, MD. Colonoscopy can have real and dangerous side effects. One of them is bowel perforation. Bowel perforation will require a secondary surgery. Dr. Anton Titov, MD. Ultimately there is some real risk associated with colonoscopy.