 Dr. Kleiman, why is colonoscopy screening important? Colon cancer screening is important because it reduces colon cancer. We find polyps early before they've become tumors and remove them, so they never have a chance to grow into tumors. And who should be screened? So the National Guidelines state that every person should be screened without symptoms starting at the age of 50 or 45 if you're African-American. And then if you have a negative colonoscopy, the screening should be repeated every 10 years until age 80 when screening should be stopped for people who have no symptoms. What are some of the risk factors of colon cancer? So by far the most common risk factor is the presence of polyps or prior colon cancer. Family history is important, especially if you have a first-degree relative under the age of 60 with colon cancer. There's also new data that people who eat a lot of red meat are at increased risk of developing colon polyps and cancer. What about age and that sort of thing? Yeah, age is also important. People who are over the age of 50 have an increased risk of colon cancer and the risk goes up as you get older. If people have a family history, should they consider genetic testing? So people who have a family history really depends on the age that their family member had it, whether they're a first-degree relative, like a mother, father, or sister, or brother, or son or daughter. If they're under the age of 60, screening should start at age 40 and then be repeated every five years. If they have a second-degree relative, like a grandparent or an aunt or uncle, they should tell their doctor, but it may not lead to an early screening. I've heard people say that the first symptom of colon cancer is no symptom at all. Is that right? That's true. Oftentimes, colon cancer presents with no symptoms. Some people do experience bleeding, weight loss, abdominal pain, or a change in the stool, for example, smaller, more narrow stools, or any disruption in their bowel habits. March is colon cancer awareness month. Why is it important to educate people about colon cancer? Well, it's important to educate people about colon cancer because this is a preventable disease and people have to be aware that there is an excellent test for screening and that if we find people early, we can prevent colon cancer from ever happening and we can prevent it from spreading if it does occur. Catching it early makes a big, big difference because it can be removed. Dr. McCran, what can a patient expect during a screening? So, during a screening colonoscopy, the patients are sedated with medications and then a flexible fiber optic scope is inserted into the rectum and the entire colon is examined. And there's anesthesia for this process? Yes, yes. So there are different types of anesthesia depending on underlying medical conditions or the patient preference. But in general, we aim to have the experience be painless and overall a positive experience. One of the things that people sort of fear most about a colonoscopy is the prep. Has the prep gotten any better over the years? So at Mercy Gastroenterology, we have a unique preparation using a combination of dolcolax and milk of magnesia. We also use the standard preparations, but if we have found at Mercy Gastroenterology that our patients are better able to tolerate the preparation with less side effects. During a test, what are you looking for? During a screening colonoscopy, I'm looking for polyps. Polyps are pre-cancerous growths that can over time turn into cancer. The key is to remove those polyps before they have the opportunity to turn into cancer. And are they removed during the screening? Yes, they are. And what happens if you find something that can't be removed during the screening? So if a lesion or a very large polyp or heaven forbid, a cancer is found during the screening colonoscopy, we typically take biopsies that are then analyzed to confirm our suspicion. Sometimes then we'll inject some tattoo dye, so if that patient needs to have surgery to have that lesion removed, the surgeon is able to find it. And what are the side effects, if any, for a screening test? The most common side effects that patients experience are some crampy gas pains. Typically those are relieved after simply passing gas. Air is put into the colon during the screening test. They may be tired for the rest of the day, but typically people go back to work the following day. And what should they do after the test? Anything special they need to do? The major thing they need to do is just pass the gas that was put in during their screening test. And we typically advise patients just to go home and relax, they can start eating normally. And if somebody has a clean reading, what do they do then? How long do they wait until their next screening test? So the national guidelines are to wait 10 years in between screening colonoscopies as long as you don't have risk factors for colon cancer. So in a patient who has a family history of colon cancer, they're screening maybe every 5 years instead of 10 years. If polyps are found on your first screening exam, again, that might be a time when we shorten the interval in between tests. Are there different screening guidelines for women and men? No, the screening guidelines for colon cancer are the same for both men and women. It's very important for women to undergo screening colonoscopies starting at age 50, just like men. Sometimes the age at which screening begins can be lowered if there is a family history of colon cancer. And it's important to tell your physician about a family history of colon cancer. What are some of the features here at Mercy Gastroenterology at Casco Bay that you feel are important for patients to know about? At Mercy Gastroenterology, we have a very personalized setting. There's only one physician working at a time. Thus, the number of patients are low. You get a lot of personalized attention. And it's less of a sterile hospital-like feeling, which patients really seem to appreciate. What's the biggest misconception people have about colon cancer? The biggest misconception about colon cancer is that it's not anything that they can do anything about. People feel like it is either going to happen or not happen, and that's a terrible misconception. If you follow the guidelines, which is having a colonoscopy starting at age 50, earlier if you have a family history, or any time if you have symptoms like bleeding or change in your bowel habits or anemia, you can prevent colon cancer. Early detection equals the best outcome. Yes. And what sort of lifestyle changes can people make to help them perhaps prevent colon cancer? Things like reducing the intake of red meat is important, or cutting it out altogether, having a healthy diet with lots of whole grains, root vegetables, and avoiding anything that might increase the risk of all cancers like smoking cigarettes. If people want more information about the Mercy Hospital gastroenterology program and the screening, where can they go for more information? Visit our website at mercy.org or they can call us directly at 207-535-1100 and we'd be happy to talk to them formally or informally about screening and when they should have it and whether they need to see us in the office first.