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  • "An ounce of prevention is worth a pound of cure." -Benjamin Franklin

  • If you were to lay your digestive tract out in a straight line,

  • it would form a tube spanning nearly ten meters.

  • The last 1.5 meters of that are called the colon, or large intestine.

  • Cells in this organ's lining constantly renew themselves,

  • but the genes that moderate this process occasionally go awry,

  • leading to the excessive growth of new cells.

  • That results in small growths or abnormal clumps of cells called polyps.

  • The majority of these polyps won't do any harm,

  • but some can become cancerous when their cells begin to grow and divide rapidly,

  • projecting further into the colon.

  • At that point, they can transform into colon cancer,

  • one of the most prevalent and preventable forms of cancer in the world.

  • That's a slow process:

  • though growth times vary,

  • it often takes around ten years for a small polyp to grow and develop into a cancerous one.

  • We don't know exactly what causes the majority of colon polyps and colon cancers.

  • We do know in general that colon cancer involves the activation of what's called oncogenes in the polyp,

  • and/or the loss of tumor-suppressor genes that usually keep cancer cells in check.

  • Most cells have proto-oncogenes that help them grow.

  • When a proto-oncogene mutates, or there are two many copies of it,

  • it can become a permanently active oncogene with cells that grow out of control.

  • While we don't yet know exactly what underlying factors cause these changes,

  • experts suspect a combination of both environmental and inherited genetic factors.

  • In the worst cases, when cells within polyps divide and spread unchecked,

  • they eventually break through the lining of the colon.

  • Lymph and blood vessels carry those cells all over the body, and they can go on to form tumors.

  • Despite these challenges, there's a solution.

  • We've become extremely good at detecting and removing offending polyps before they can cause cancer.

  • This happens through a process called screening,

  • and when we do it regularly, we can prevent many cases of colon cancer.

  • So, who's at risk?

  • Most cases occur in people aged 50 years or older.

  • This group is considered at average risk for colon cancer or colon polyps.

  • There's also a higher risk group that includes people with personal or family histories of colon polyps or cancer,

  • and those who suffer from inherited genetic syndromes, or inflammatory diseases,

  • like Crohn's disease and ulcerative colitis.

  • So the best age to initiate screening varies from person to person.

  • If you have access to healthcare,

  • it's best to consult a doctor to find out when you should begin.

  • Screening can be done with various tests.

  • Colonoscopy involves a long, thin, flexible tube that's fitted with a video camera and light at the end

  • and placed internally to examine the colon for polyps.

  • If polyps are found, a doctor can do a polypectomy,

  • a procedure that removes polyps from the colonic wall.

  • Doctors can also then test the polyp for cancerous cells.

  • Colonoscopy is the only test that can be used to both find and remove polyps.

  • There are, however, other useful screening tests,

  • including imaging and at-home tests that can allow patients to examine their stool for small amounts of blood.

  • Occasionally, polyps are too large to be removed during a colonoscopy,

  • in which case, the next step is surgery.

  • If blood and imaging tests then reveal that cancerous cells have spread outside the colon,

  • then a special treatment, like chemotherapy, may also be required to stop the cancer from escalating.

  • We can also take on certain habits to reduce our likelihood of developing colon cancer in the first place.

  • There's evidence that maintaining a healthy weight, not smoking, and being physically active can help.

  • But most importantly,

  • access to healthcare and regular screenings at crucial times in life are the best ways to prevent colon cancer.

"An ounce of prevention is worth a pound of cure." -Benjamin Franklin

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