Colon cancer has claimed another life. Emmy Award and Golden Globe winner Kirstie Alley, best known for her roles in the television sitcoms Cheers and Veronica's Closet, died Monday at age 71 after battling cancer that was "recently discovered," according to a family statement.
A representative for Alley confirmed to CNN via email on Tuesday that she had been diagnosed with colon cancer prior to her death.
Colorectal cancer, which includes colon and rectal cancers, is the second most common cause of death from cancer in 2022, outranked only by lung and bronchus cancer, according to the National Cancer Institute Surveillance, Epidemiology and End Results Program.
Regular checkups are the best way to keep colon cancer at bay, according to the US Preventive Services Task Force. In the United States, the task force lowered the age to begin screening for colon and rectal cancer to 45 last year after a worrisome spike in cases of colorectal cancer in people younger than 50.
In the US, the new recommendations apply to everyone ages 45 to 75, including people with no symptoms, no prior diagnosis, no family history of colon or rectal disease, and no personal history of polyps, which are all key risk factors. Polyps are bumps or tiny mushroom-like stalks that grow inside the colon or rectum.
If these growths are not found and removed, they can turn cancerous.
Adults ages 76 to 85 years can also be screened, depending on their overall health, prior screening history and personal preferences, the task force said.
In New Zealand, the free National Bowel Screening Programme (NBSP) is offered to people aged 60 to 74. The programme invites about 835,000 people for screening every two years.
In some parts of New Zealand, free bowel screening is available to Māori and Pacific people aged 50 to 74 due to a higher proportion of cases before the age of 60, compared with others. In time, Māori and Pacific people throughout the country will have the lower starting age.
Bowel cancer, also called colon, rectal or colorectal cancer, is the second most common cause of death from cancer in New Zealand. Around 3000 New Zealanders are diagnosed with bowel cancer every year and more than 1200 die from it. For every 1000 people who complete a bowel screening test, about 50 will be positive. Of those, about 35 will be found to have polyps and on average, three or four will have bowel cancer.
People eligible to participate in the bowel screening programme are invited to complete a faecal immunochemical test (FIT).The test kit arrives in the mail and is easy to do at home. It can can detect tiny traces of blood in bowel motions that may be an early sign of pre-cancerous polyps - growths - or bowel cancer.
What type of non-invasive tests are available?
Colorectal cancer screening can occur in several ways, including simple mail-in tests that look for blood or cancer cells in a sample of stool collected by the patient. However, all stool tests can have false-positive test results, which would likely require a more invasive test to rule out cancer, according to the American Cancer Society.
Stool tests: While a stool test is the least invasive option, it does have to be done at least once a year, the society said. No anti-inflammatory pain relievers can be taken for seven days prior to a stool test, while red meats such as beef, lamb or liver and any citrus or vitamin C supplements should be avoided for at least three days.
If the test finds something of concern, "you will still need a colonoscopy to see if you have cancer," according to ACS. However, hidden bleeding in the stool does not automatically signal cancer, as ulcers, haemorrhoids and other conditions can also cause rectal bleeding.
DNA stool test: A DNA stool test is another option, the society said. Because colorectal cancer cells can have DNA mutations, the test can screen for those genetic abnormalities. This test only needs to be done once every three years, but an entire stool sample must be collected and mailed.
Patients may have insurance coverage issues because the test is fairly new, ACS said. Again, if anything suspicious is found, a colonoscopy will still be required.
Visual, more invasive tests
For all of the following tests, the colon must be clean and free of stool matter, which requires at-home bowel prep. Ways to empty the bowels include pills, drinking a laxative solution or the use of an enema the night before the procedure.
This process has become much easier over the years with the advent of new kits that don't require as much liquid laxative, so talk to your doctor about your options, ACS suggested.
Colonoscopy: One of the most widely used tests, this procedure allows a doctor access to the entire length of the colon and rectum with a colonoscope, a "flexible, lighted tube about the thickness of a finger with a small video camera on the end," ACS said.
Typically, the patient is under light sedation during the whole procedure, waking up with no knowledge of the process. Watching on video in real time as the scope moves through the intestine, the doctor can stop and insert small instruments into the scope to take a sample or even remove any suspicious polyps.
Virtual colonoscopy: This test uses computer programs that take X-rays and a computed tomography (CT) scan to make three-dimensional pictures of the inside of the colon and rectum.
The test does not require sedation. However, it does require the same bowel prep as a regular colonoscopy. After the patient drinks a contrast dye, a small, flexible tube will be inserted into the rectum, followed by pumped air to expand the rectum and colon for better pictures.
As with all CT scans, this procedure exposes the patient to a small amount of radiation and can cause cramping until the air exits the body, the society said. If a suspicious mass is detected, a colonoscopy will still be needed to remove the mass.
Flexible sigmoidoscopy: This test inserts the same flexible camera tube into the lower part of the colon. However, because the tube is only 2 feet (60 centimetres) long, this test only allows the doctor to examine the entire rectum and less than half of the colon - any polyps in the upper colon will be missed. This test is not often used in the United States, the society said.
It's not that bad
Many people avoid a colonoscopy, partly due to the preparation, so as a way of encouraging people to get screened, former Today host Katie Couric broadcast her entire procedure in 2000 - from prep the night before to a mildly sedated Couric watching the procedure as it unfolded.
"I have a pretty little colon," Couric said with a sleepy chuckle as she watched the video projection from the scope inside her colon. "You didn't put the scope in yet, did you?" asked Couric, whose husband, Jay Monahan, had died from colon cancer at age 42 in 1998.
"Yes! We're doing the examination. We're almost done," said her physician, the late Dr Kenneth Forde, who taught for nearly 40 years at Vagelos College of Physicians and Surgeons at Columbia University in New York City.
More recently, actors Ryan Reynolds and Rob McElhenney videotaped parts of their colonoscopies to raise public awareness after Reynolds lost a bet.
"Rob and I both, we turned 45 this year," Reynolds said in the video. "And you know, part of being this age is getting a colonoscopy. It's a simple step that could literally - and I mean, literally - save your life."
Doctors found both actors had polyps that were removed during the screening.
"It's not every day that you can raise awareness about something that will most definitely save lives. That's enough motivation for me to let you in on a camera being shoved up my ass," Reynolds said.
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