Dr. Mohamed Erfani, with Denise Mananas
By Dan Murphy
March is National Colon Cancer Awareness Month, and St. John’s Riverside Hospital is committed to providing the Yonkers community with valuable information on the prevention and treatment of colon cancer.
On March 13th, SJRH VP Denise Mananas hosted a webinar in which Dr. Mohamed Erfani, a board-certified gastroenterologist with nearly twenty years of experience, helped the public understand the risk factors for colon cancer and the current screening recommendations. Dr. Erfani has taught at Mercy College and New York Medical College and received several honors, including the Peer-to-Peer Excellence in Medicine Award. His research and publications have contributed significantly to the field of gastroenterology.
Dr. Erfani began by discussing that while everyone is at risk of colon cancer, age is the biggest factor. Despite the general recommendation to get screenings starting at age 50, Dr. Erfani states, “I know that people who are younger are being diagnosed with colon cancer…the new recommendation is to start screening for colon cancer at age 45, not age 50.” If patients have other risk factors, screenings should begin even earlier.
When asked if medical practitioners understand what is causing people to develop colon cancer at an earlier age, Dr. Erfani comments that while the exact reason is unknown, it is likely due to several factors, including a sedentary lifestyle, urban living, obesity, and dietary considerations. Limiting the consumption of red meat and processed meat, limiting alcohol consumption, and quitting smoking can lower the potential risk.
“The incidences of colon cancer in the last decade or so has gone up by 2.4%,” Erfani continues, “as well as the cancer mortality, which is almost 1% in younger individuals.” Because of its increasing prevalence, regular screenings are important.
Mananas mentions the fear that many people have surrounding colon cancer screenings and asks Dr. Erfani about the different options patients have for completing them. “In general, we divide them into two categories,” he explains. “There is a stool-based test called Cologuard, which comes as a kit that patients can use at home. Alternatively, a colonoscopy visually looks at the colon’s health.”
Fortunately, Dr. Erfani mentions improvements in the colonoscopy process, giving patients hope that the procedure might be less formidable in the future. For example, the colon-cleansing drinks that are required the day before the procedure taste better than they used to and are often smaller in volume. “At the end of the day,” Erfani says, “the issue is that really we have to clean the intestine.” Despite these improvements, many people choose to complete the at-home stool tests as they are less invasive and can be completed without significantly disrupting the day. However, a colonoscopy will be required if a patient receives an abnormal result on their stool sample.
While the general recommendation is a screening every 3 years for patients with average risk, Dr. Erfani says that patients with high risk for colon cancer should be screened more often. If there is a family history of colon cancer or polyps or if the patient suffers from gastrointestinal problems such as Crohn’s Disease or irritable bowel syndrome, the patient would be considered high risk. “Even if you are in your 20s and 30s,” Erfani states, “this is a conversation you should be having with your primary care physician…and that conversation needs to be repeated every couple of years.” Though a colonoscopy only last 20-40 minutes, around 40% of Americans are not up-to-date on their colon cancer screenings.
If a patient has an abnormal colonoscopy, a biopsy will be performed, and those results will determine the best course of treatment. According to Dr. Erfani, “If it’s in early stage, it’s very curable…the five-year survival rate for stage one colon cancer is north of 90%.” Surgery, endoscopy, chemotherapies, and new immunotherapies are currently being utilized to treat colon cancer.
Dr. Erfani concludes by emphasizing the importance of regular screening. Early detection can make the difference between a very curable disease and a devastating diagnosis. To learn more about colon cancer screening, St. John’s webinar can be viewed in its entirety at https://www.youtube.com/watch?v=nAHFDT_RrI0 .
