If you’re a woman ignoring the benefits of colonoscopy screening, you are not alone.

“Women are less likely then men to be screened with colonoscopy,” said Dr. Shauna Lorenzo-Rivero, a colorectal surgeon on the campus of Mercy Health Center. “They’re less likely to follow up their endoscopy, which is not what you’d expect. They’re usually very good about their medical care, but they’re more likely to be embarrassed about their medical procedure.”

Women are more likely to undergo a colonoscopy if they have a female physician, Lorenzo-Rivero said. Nationwide, 11 percent of colorectal surgeons are female, the smallest percentage in a surgical subspecialty, Lorenzo-Rivero added. She is one of only two female colorectal surgeons in Oklahoma. The other surgeon is Dr. Jennifer McNeil, also in practice at Mercy.

Men and women without a family history of colorectal cancer should have a baseline colonoscopy at age 50, Lorenzo-Rivero said. Patients with a strong family history of colorectal cancer should be screened earlier. Theoretically, persons should be screened 10 years prior to the age their relative had colon cancer, she said. And genetic testing for colon cancer is also available at Mercy.

“We can test them for the genetic defect,” Lorenzo-Rivero said. “And then any of their children can be tested. And what that means is it may not change the outcome for the person with the cancer.

“But it changes the outcome for the family because instead of being screened at 50, those people can be told, ‘You probably have this gene. You should be tested.’ If they’re positive, they can start undergoing colonoscopy at the age of 20.”

Only 25 percent of men and women in Oklahoma receive colonoscopy screening, she added.

Second only to lung cancer, colon cancer is the leading cause of death among cancers. The American Cancer Society expects 145,000 people in the United States will be diagnosed with colorectal cancer by the end of 2005. And more than 57,000 colorectal cancer patients will die this year.

Patients should ask their primary care physicians about the benefits of colonoscopy screening, she said.

As a colorectal surgeon, Lorenzo-Rivero’s specialties include:

n Laproscopic surgery for colon cancer and benign disease.

n PPH stapling of hemorrhoids for less pain and quick recovery.

n Transrectal and transanal ultrasound for cancer staging and sphincter reconstruction.

n Genetic testing for colon cancer syndromes.

n Pelvic floor and sphincter reconstruction for incontinence.

“Women tend to have a problem with fecal incontinence, which is very embarrassing,” Lorenzo-Rivero said. “They don’t tell their partner, their spouse, their family and friends. And they certainly don’t tell their doctor that they’re incontinent with stool.”

Fecal incontinence is more common in women because women have babies, Lorenzo-Rivero continued. The sphincter muscle can be stretched during childbirth.

Fiber supplements are inexpensive ways to treat fecal incontinence, she said. But many women choose to have surgery instead of drinking gritty fiber drinks. Surgery can repair breaks in the sphincter muscle, and women have a 90 percent satisfaction rate in the procedure, Lorenzo-Rivero said.

While the transanal ultrasound examines the sphincter muscle, the transrectal ultrasound is used for determining the stages of colon cancer.

“The reason you would do that is to see if the person can be cured with surgery, (or) if they need any chemotherapy or radiation,” Lorenzo-Rivero explained.

Colon cancer is curable when people undergo early colonoscopy screening. Screenings should continue every five years or at the recommendation of a physician, she said.

A diet of high fat and low fiber is the major factor for the 6 percent of Americans who will be diagnosed with colorectal cancer, said Dr. Ronald Janzen, Mercy Health Center gasteroenterologist.

Warning signs of colorectal cancer might include rectal bleeding, lumps, changes in bowel habits, constipation or diarrhea, unexplained weight loss or gain, abdominal pain or rectal pain and changes in the caliber of one’s stool. A normal stool should be shaped like a banana, Lorenzo-Rivero said. Stools appearing like rabbit pellets or pencil-thin stools should be reported immediately to one’s physician.

“You can be without pain, without any change in your stool, without blood,” Lorenzo-Rivero said. “That’s why screening colonoscopy is so important because you may have no idea, and you may have a polyp or a cancer waiting.”

(Features Editor James Coburn may be reached via e-mail at jcoburn@edmondsun.com.)


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