“The important thing is to start the conversation
with your physician. Take an active role and
bring up the subject if your doctor does not.”
—Andrejs Avots-Avotins, MD
Avotins. A polyp is an abnormal growth,
which can eventually become cancerous if
not removed.
The gold standard for screening is a
colonoscopy, which is an internal
examination of the entire colon (large
intestine), under sedation using an
instrument called a colonoscope. Most
exams take 30 minutes or less and patients
may experience some mild discomfort.
Patients receive their screening exam results
immediately along with information about
any recommended follow-up measures.
Alternative screening exams include
fecal occult blood testing (FOBT), flexible
sigmoidoscopy which examines the lower
portion of the colon (large intestine),
barium enema (BE), X-ray of the colon
(large intestine) and a virtual colonoscopy
(CT scan of the colon). These are
alternatives to a colonoscopy, but each
individual should talk to his or her
physician about the right test, based on the
patient’s need.
“The screening guidelines can be
complicated, and the effectiveness varies
among the tests. But any screening is
better than no screening,” says Dr. AvotsAvotins. “The important thing is to start
the conversation with your physician. Take
an active role and bring up the subject if
your doctor does not.”
Barriers to screening
Screening makes the difference. “Ageadjusted cancer death rates are decreasing,
and have been since the late 1980s due to
better treatment, better surgeries, and in
part because we’re finding earlier-stage
cancers, which are more treatable,” says
Dr. Avots-Avotins. “But because screening
rates are still lower than what is
recommended, less than 40 percent of
colorectal cancers are found early. “
Besides lack of information or
squeamishness, one obstacle to screening
can be the time required to prepare for a
colonoscopy. One day is spent on
preparation by clearing the colon with
liquids and laxatives, and the second day
requires sedation and a safe ride home.
One way Scott & White helps make it
convenient for patients is by offering a
Saturday clinic twice a month in Temple
and once a month at the Fishpond Clinic
in Waco, to better serve the community.
An auto-reminder program for
patients to schedule colonoscopies has
increased compliance for follow-up
screenings after the initial exam. However,
its technology desperately needs to be
updated and Dr. Avots-Avotins hopes that
philanthropy can fill that gap.
“We want to make it easier for people
to have access to this potentially lifesaving
screening. We want to remove any
obstacles we can. If we could get the vast
majority of people screened and then
enrolled in a follow-up program to keep
them on schedule for future screenings,
that would do a great deal of good.” ■
Dr. Avots-Avotins also is an associate professor
of internal medicine, the Texas A&M Health
Science Center College of Medicine.
Colon Cancer
Risk Factors
Age 50 or older
Family history of colon cancer
or polyps
Crohn’s disease or ulcerative
colitis for a decade or more
African American heritage
Breast cancer or any female
reproductive cancer, such as
ovarian cancer
Obesity
sw.org | Spring 10 THE CATALYST
23