So That No One Dies of Colon Cancer

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So That No One Dies of Colon Cancer

NewsFlash: Comparative effectiveness of screening strategies for colorectal cancer

The American Cancer Society reports in their journal "Cancer" that:

Colonoscopy emerged as the most effective screening strategy with the highest life years gained and CRCs (colorectal cancers) prevented and the lowest total costs.  Conclusion: Improvement in CRC-detection performance is not sufficient to improve screening outcomes. Special attention must be directed to detecting precancerous adenomas. See Cancer 2017;123:1516–1527.

Translation: Colonoscopy, which detects and removes precancerous adenomas (polyps) is better at saving lives from colon cancer than any other option including FOBT, FIT, and stool DNA testing. As an added benefit for the government and the taxpayer, colonoscopy is even the least-costly option when you consider the money saved by not needing to offer people surgery, chemotharapy, radiotherapy and palliative care. Yet, the real value of a life saved from colon cancer is priceless! If you need a colonoscopy, contact us, so that No One Dies of Colon Cancer.


Colonoscopy Clinic in Ottawa-Gatineau

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Why should you share our vision that "No One Dies of Colon Cancer"? In short, because a life lived free of colon cancer is better than aggressive treatment or death. Colon cancer is the third most common cancer in Canada, the second most common cause of cancer-death in men and the third most common cause of cancer-death in women. 25,100 Canadians get colon cancer each year and 9,300 of us die of it each year (2015 statistics from the Canadian Cancer Society).

All people age 50 and older should be screened. Which test is right for you? Read on.

The FOBT is the "three-stool-samples-sent-away-in-the-mail" test. Many family doctors ask patients to do this test at the age of 50 and repeat it every two years. It is 40% to 60% accurate when done each year. This means that if 10 people had colon cancer, this test would show positive in 4 to 6 of the 10. The others would have cancer but it would not be detected. The American College of Surgeons Colonoscopy Patient Education Brochure gives more detail. This test is good for people not willing or able to have a colonsoscopy and who are willing to accept the high rate of missed cancers.

The Ontario Association of Gastroenterology (OAG) believes that “Colonoscopy is probably the best colon cancer screening test", and that "colonoscopy likely will save more lives than the other types of tests available",  to quote the OAG Response to Task Force Recommendations on Colon Cancer Screening":

“As gastroenterologists, we would rather prevent cancer by finding polyps,” says Gould.  Polyps are growths on the lining of the bowel that can eventually deteriorate into cancer. Polyps are found up to 40% of the time and precancerous adenomatous polyps up to 35% of the time. Studies have shown that more than 50% of those high risk polyps are out of the reach of the sigmoidoscope and are unlikely to be picked up by stool testing. Only colonoscopy will detect and remove polyps so that cancer does not develop in the first place. “FOBTs and sigmoidoscopies find some colon cancers, but certainly miss others, especially early ones.  By finding and removing polyps, colonoscopy PREVENTS cancer from developing in the first place,” Murray says. (Read the Association's Full Response).

As a General Surgeon and Medical Director of this Clinic, Dr. Reimer believes that colonoscopy screening is the gold-standard for all people age 50 and over. "With ongoing cuts to health care funding, there is enormous pressure on family doctors to incentivize patients into the FOBT, but that should be done only after a full consent discussion that includes the miss rate -- FOBT misses more cancers and high-risk polyps than it finds. Colonoscopy is and remains the best test to prevent colon cancer" says Dr. Reimer. "It is up to each patient to educate themselves and to make an informed decision to prolong their own life".

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Have your Screening Colonoscopy at The Reimer Clinic

Listen to Dr. Reimer on the AM 570 News program "Ask the Expert". He explains why colonoscopy is the best way to prevent and detect colon cancer and why, starting at age 50, almost everyone should have one.

Everyone is welcome! If you have no family doctor, you can visit us and we will look after you.


Colon Cancer Facts

What is colorectal cancer?

Colon cancer is 90% curable if caught early -- if caught late, it is 90% fatal. Colon cancer is the second leading cause of cancer death in North America. In 2015 the Canadian Cancer Society estimates that 25,100 Canadians will be diagnosed with colorectal cancer and 9,300 of us will die from it. Put another way, 1 in 13 men and 1 in 16 women will be diagnosed with colorectal cancer. Colonoscopy is the best test to prevent colon cancer.

How does colorectal cancer start? cancers develop on the inner lining of the large bowel from gland-type polyps. You can think of polyps as flat lesions, like a pitcher's mound in baseball, or as pedunculated lesions like a mushroom. Some polyps are harmless and others grow to become cancerous. The pathway from normal mucosa, through a polyp stage to a cancer takes about ten years on average. Some cancers are more aggressive and grow more quickly; others more slowly. The photograph shows two polyps and a cancer.


Screening and Prevention Options

How do I keep from getting colon cancer?

Several options exist to reduce your risk of dying from colon cancer. The recommended choices are the fecal occult blood test, flexible sigmoidoscopy and colonoscopy.

Colonoscopy is the best test. It reduces the risk of death from left-sided cancer by 60-70%. It also protects the right side of the colon. It is  the "preferred" screening test for colorectal cancer prevention according to the American College of Gastroenterology Guidelines for Colorectal Cancer Screening 2008. The benefits of colonoscopy are that it is widely available, it examines the entire colon, it allows for single-session diagnosis and treatment, and it need not be uncomfortable when sedation is used.

The stool for blood test (also called the FOBT test) requires that several stool samples be sent for analysis to determine if blood is in the stool. In a study in the New England Journal of Medicine, the FOBT test identified only 23.9% of patients who had an advanced pre-cancerous lesion or cancer as determined by a colonoscopy performed right after the FOBT test. This test needs to be repeated every one or two years. It reduces death from colon cancer by 15-33% and is better than no screening at all. It is cheap and safe and easy to do.  Colonoscopy is better at preventing colon cancer. The Asia Pacific consensus recommendations for colorectal cancer screening suggest that this test is appropriate for use in resource-limited countries.


News Coverage: New colonoscopy options test more people for preventable cancer

The Reimer Clinic is proud to have served patients in Waterloo Region with quality colonoscopy services. Out-of-hospital clinics, together with hospitals have collectively eliminated the waiting lists for endoscopic care in this region. The KW Record detailed the options available for residents of Waterloo Region.