Investigator Q&A: Dr. Shannon Orr

Published on Tuesday, July 19, 2022

Dr. Shannon Orr, associate professor of surgery and head of the CCRI Interdisciplinary Gastrointestinal Cancer Care team, is among physicians nationally who support starting colorectal cancer screening at 45 instead of 50. A recent study published in Gastroenterology reviewed records in a large U.S. endoscopy registry to study results of colonoscopies in the 45-49 age group. It found enough cases with abnormal cell growth to support starting screening at 45. Orr discusses why this is important and how Mississippi residents in this age group can take this step to help avoid seeing him and his colleagues. More on the study: Age-Stratified Prevalence and Predictors of Neoplasia Among U.S. Adults Undergoing Screening Colonoscopy in a National Endoscopy Registry.

Questions:

Q: Why does finding abnormal growth earlier matter?
A: The earlier an abnormal growth can be found the better it is for the patient.  The process from a polyp to cancer can take years to happen.  If a polyp can be found early, it can be removed endoscopically and avoid surgery.

Q: What happens if abnormal tissue is found?
A: At the time of colonoscopy, any polyp or mass is biopsied and sent to pathology for evaluation.  For benign lesions, a follow up colonoscopy in several years is often recommended.  If the pathology returns as cancer, the patient will often be referred to a surgeon.

Q: Are you seeing CRC in those in the 45-49 age range?
A: Over the past several years, we have seen an increased incidence of younger patients being diagnosed with colon cancer. 

Q: What if your immediate family has had colorectal cancer? Should you start earlier?
A: If a family member developed colorectal cancer, the patient should be screened 10 years younger than the family member with cancer.

Many people have misconceptions about colonoscopies.  Colonoscopy is an excellent screening tool to diagnose polyps and colorectal cancers.  Following the guidelines, will help catch polyps early before they become cancerous.