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Ideally, colon cancers identified during screening evaluation that involves colonoscopies. The
recommendations are that all individuals undergo a colonoscopy at the age of 50, dependent
on family history of course. We certainly don't want patients to be diagnosed later
on when they have abdominal pain or they are losing weight or they are becoming jaundiced
and we find it on a CAT scan and by that time unfortunately the cancer has moved to other
organs has metastasize and has become more advanced. The importance of colonoscopies
and screening is that we find cancers at an earlier stage and that's when we have an opportunity
to cure people, literally, if a colonoscopist or gastroenterologist finds an early stage
cancer, he can remove it at that procedure. We also have dedicated surgeons who can take
out parts of the colon, relatively straightforward surgeries, they are excellent in doing that.
The morbidity associated with a colorectal surgery is quite low. So ideally, in terms
of diagnosing colon cancers it's done with a colonoscopy. Now there are other tests that
are being developed. There are CT colonography, this is using CAT scans to look at the colon.
These are certainly more convenient, they are less invasive, they don't require sedation,
but if something is detected then a colonoscopy has to be performed to remove the polyp. Other
issues included it's accuracy. Its sensitivity now is estimated about 90%, that's pretty
good, but says that colonoscopy using an endoscopy is still the standard. Other ways the colon
cancer is diagnosed at screening is the use of stool tests. These certainly are inconvenient,
but they are very informative. They will detect blood for example and more recently invasions
to have been able to detect DNA, so we have been able to find mutated genes in the stool
and this triggers evaluations or further evaluations such as colonoscopy, so those are some of
the ways that we diagnose colon cancer ideally as screening and not related to advanced symptoms.