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Gastrointestinal Cancer Screening in New Jersey

Located in Lawrenceville, New Jersey, the Digestive Health & Nutrition Center, led by gastroenterologist Angela Merlo, M.D., performs cancer screening for residents in and around Trenton and Princeton.

What is Gastrointestinal Cancer?

Gastrointestinal (GI) cancers are a group of diseases that affect the gastrointestinal tract (including the stomach, esophagus, and pancreas). Early diagnosis is essential to the effective treatment of these diseases. Most patients do not show any symptoms of GI cancer when it is in its earliest stages. After age 50, the chances of being diagnosed with GI cancer increase.

The gastrointestinal tract starts at the mouth and ends at the anus. It has several parts that include the esophagus (gullet), small intestine, stomach, colon, and rectum.

Any organ in the gastrointestinal tract can be affected by cancer. However, it is extremely rare for cancer to affect the small intestine (the area where digestion occurs).

Bowel Cancer (Colorectal) is second only to lung cancer as one the most lethal forms of cancer. In Westernized countries, it affects 6 percent of the population and causes death in 3 percent of people diagnosed with it. In industrialized nations, 25 percent of deaths are caused by cancer; bowel cancer makes up about 12.5 percent of those deaths.
Stomach cancer is the seventh most common form of cancer. It is responsible for 8 percent of all cancer deaths. Men are twice as likely as women develop stomach cancer.
Esophageal cancer affects men to women on a 1.8:1 ratio. In addition, an increasing number of men being diagnosed with adenocarcinoma, a glandular form of esophageal cancer.
Overall, three percent of cancer deaths are attributed to esophageal cancer. French men have the highest rate of esophageal cancer in Europe. UK men are second.
Pancreatic cancer accounts for 4 percent of cancer deaths. It affects men and women equally. Patients under the age of 65 account for one-third of all pancreatic cancer cases.
There is a strong link between the viral hepatitis infection and cancer that initially develops in the liver (primary liver cancer). Primary liver cancer is not common in Western countries that have low rates of hepatitis. The death rate in Westernized countries is only about 0.7 percent. However, liver cancer is one of the common causes of cancer-related deaths in developing countries with a high frequency of hepatitis. The liver is a popular place for gastrointestinal cancers (like colorectal cancer) to spread, creating metastatic cancer.

How do I Reduce my Risk of These Cancers?

By making lifestyle changes, you can reduce your chances of being diagnosed with gastrointestinal cancer.

Avoid Excessive Drinking

Consuming high amounts of alcohol is associated with the increase in cancers of the:

Esophagus– Alcohol and smoking have additive effects on squamous cancer.
Pancreas – The overconsumption of alcohol causes pancreatitis (chronic inflammation), a condition that leads to an increased risk of pancreatic cancer.
Liver – Drinking too much alcohol causes liver cirrhosis. Cirrhosis of the liver is another risk factor for primary liver cancer.
Bowel

Avoid Smoking

Smoking doubles a person’s chances of developing pancreatic cancer. This is especially true when alcoholic beverages are consumed. Consuming high amounts of alcohol will also increase your risk of esophageal cancer.

Eat Plenty of Green Vegetables

A diet rich in Vitamin C (found in green vegetables and fruit) decreases your chances of developing stomach cancer. A diet that includes green vegetables also reduces the risks of developing bowel cancer.

Avoid Preserved or Burnt Meats

There is a link between the nitrates in smoked and salted meat and stomach cancer. The high amounts of nitrates are the reason for the cancer link. When digested, the nitrates produce nitrosamine, a highly carcinogenic substance.

Eating high amounts of processed and burnt meats are associated with an increased risk of developing bowel cancer. The high amount of carcinogenic cyclic amines in burnt meats is the reason for the link.

Keep to a Normal Weight

For men, obesity increases the chances of developing bowel cancer. Obesity is also linked to an increase in the risk of developing diabetes. Diabetes slightly increases the likelihood of developing pancreatic cancer.

Exercise Regularly

Your chances of developing bowel cancer decrease when you engage in physical activity regularly. The risk decreases, even if obesity is not a factor.

Who Should be Screened for Cancer?

The genetic make-up of some people may cause them to have a hereditary predisposition to GI cancer. For others, an increase in risk is due to lifestyle choices like diet and exercise. Instead of waiting to develop symptoms of GI cancer, it is important to have an early diagnosis. Effective diagnosis includes an awareness of:

The genetic factors that put patients at an increased risk of developing cancer.
Lifestyle choices such as smoking and obesity

Patients should discuss their risk factors with a physician and undergo any necessary testing.

Despite the medical research that has helped doctors gain an understanding of gastrointestinal cancers, early diagnosis still has its issues. First, there are no blood tumor markers that make screening the population easy. Over the past few decades, advances in genetics have allowed us to find mutations in tissues. This discovery allows for the diagnosis of cancer in patients with a hereditary risk of GI cancers. Unfortunately, most people have sporadic onset of GI cancers. The onset of cancer is often influenced by age, lifestyle and dietary habits. These traits are hard to change, but it is important to find them. Understanding these traits will decide a patient’s level of risk.

Can Screening Tests Detect Gastrointestinal Cancer Before they Cause Symptoms?

Screening is a method used to check people that do not have symptoms of a disease. This process helps to treat diseases before any symptoms present themselves.

Currently, screening programs exist to detect cervical and breast cancer in women. There are screening programs available for gastrointestinal cancers, and programs to detect bowel cancer (rectum and colon) are in place nationwide.

While each cancer should be considered individually, the screening programs need to have uniform aspects to them. The properties necessary for success include:

The diagnostic test to detect cancer needs to be reliable and inexpensive.
The disease needs to affect a significant portion of the population who needs the screening. If the test only benefits one person, it will not be enough to justify the risks and inconvenience of widespread screening.
There needs to be a treatment for the disease detected by the screening. When caught early, surgery is an effective treatment method for GI cancers.

Screening for Bowel (Colorectal) Cancer

Screening programs for colorectal cancer have a high chance of success for the following reasons: this cancer is very common and has a greater than 90% cure rate when caught early. In most cases, this disease is treated in its pre-cancerous stage when a polyp is found and removed to prevent the development of cancer.

Population Screening Tests

Identifying a test for the general population is not that straightforward. The simplest one is the fecal occult blood screening. This test detects blood in the feces that would otherwise go unnoticed with a visual check. This test is problematic because of its inaccuracy and the fact that collecting feces is not something most people want to do.

Screening for High-Risk Individuals

Screening tests for high-risk individuals are more likely to detect the disease. These tests may not be as effective for the rest of the population. Having those people who are at the greatest risk screened will improve the benefits of using screening tests. Here are two groups who need to be tested:

People with three first-degree relatives (child, parent, brother or sister) who developed colorectal cancer before they were 50 years old, with a risk factor of 1-in-6 to 1-in-10 of developing the disease.
Individuals with two first-degree relatives (a child, parent, sister or brother) who developed colorectal cancer before age 60, with a 1-in-6 to 1-in-10 chance in their lifetime to develop this disease.

If you live in or around Trenton or Princeton, New Jersey and are looking for a specialist in Gastroenterology to perform a cancer screening, contact the Digestive Health & Nutrition Center in Lawrenceville today to set up an appointment.