By Susan J. White
NorthShore University HealthSystem
Colorectal cancer is the third leading cause of cancer deaths in women, yet it is a largely preventable disease when appropriate screening is performed.
Colonoscopy at age 50 remains the gold standard screening test for colorectal cancer, yet only about 50% of women take advantage of this life-saving test, according to Laura K. Bianchi, MD, Director of the NorthShore University HealthSystem (NorthShore) Women’s Gastroenterology (GI) Cancer Risk and Prevention Program.
A gastroenterologist with expertise in colorectal cancer, Dr. Bianchi is a passionate promoter of screening and colon cancer prevention, particularly for women who are often reluctant to undergo colonoscopy because of concerns about the procedure, sedation or the bowel cleansing preparation.
“Sometimes colon cancer has been thought of as a man’s disease as women have focused more on issues like breast cancer, however men and women have an equal risk of developing colon cancer,” explains Dr. Bianchi. One in 20 women will be diagnosed with colon cancer during their lifetime. Lack of awareness of this risk is another barrier to colon cancer screening.
While the risk for developing the cancer is the same for both sexes, Dr. Bianchi and her colleagues are learning more and more that there are some significant gender-related differences with respect to colon cancer. Women tend to be diagnosed at a slightly older age than men, women are more likely to develop cancer on the right side of their colon and respond differently to some of the chemo-preventive agents, Dr. Bianchi says. And while women have fewer colon polyps—usually a precursor to cancer—they have the same overall presence of colon cancer as men, she adds.
All of these interesting facts point to the need for more research on women and colon cancer, another area of attention for Dr. Bianchi and NorthShore.
There are certain risk factors like age and family history that obviously can not be changed, but the exciting news is that lifestyle changes including diet, exercise and smoking cessation really do play a role in lowering the risk for developing colon cancer, says Dr. Bianchi.
It’s estimated that over one third of colon cancer cases are related to poor eating habits, physical inactivity and obesity, Dr. Bianchi says, so maintaining a healthy weight, getting regular exercise and eating a diet high in fruits and vegetables and limited in red and processed meats can prevent a significant number of cancers. There is currently a rise in rectal cancer cases among younger adults, says Dr. Bianchi, and one of the prevailing theories is that it is related to lifestyle factors and the rise in obesity.
Dr. Bianchi and the team who comprise the women’s GI program at NorthShore counsel patients about their specific risk factors and offer special consultations with female GI physicians designed to remove barriers and improve compliance with colon cancer screening among women. “We have a dedicated nurse advocate who stays with patients throughout the whole colonoscopy process, we provide women with music and aroma therapy to promote relaxation and we are focused on making this a kinder, gentler process for women,” adds Dr. Bianchi. “Most people say ‘it wasn’t as bad as I thought’ after their first screening.”
Women with a strong family history of colorectal cancer are also referred to the multi-disciplinary high-risk cancer clinic at NorthShore.
With the Affordable Care Act now in place, patients with Medicare and many insurance plans now have no co-pay or out of pocket costs for a screening colonoscopy, removing another barrier to this important test, Dr. Bianchi says.
For more information, go to northshore.org/giwomen
NorthShore gastroenterologist Monica S. Borkar, MD, will host a live, online chat to discuss the importance of colon cancer screening and prevention at 1 p.m. Monday, March 23. For details, go to northshore.org/chat.
