Pill provides tasteless alternative

With ABC movie critic Joel Siegel's passing from colorectal cancer, Americans are reminded once again to undergo a routine colonoscopy starting at the age of 50 to screen for this disease. Timely screenings can detect the majority of colorectal cancers at an early stage while they still are curable, but the disease becomes deadly once it has spread beyond the colon.

Many adults skip the recommended colonoscopy screening because they must drink up to four liters of a bad-tasting laxative to cleanse their colon before the procedure. The liquid's bitter, salty taste can cause nausea, vomiting, and abdominal cramping, and patients routinely fail to finish the cleansing regimen at all. As a result, less than half of Americans get the recommended screenings for colon cancer, according to a National Health Interview Survey.

Colon cancer ranks as the second leading cause of cancer death in the U.S., indicate statistics from the American Cancer Society. Early screening can detect 95% of colon cancers, and the cure rate is extremely high if the cancer has not spread beyond the bowel. Waiting even a few years past the recommended screening age can allow precancerous polyps to grow and spread outside the colon, where the cancer is difficult to cure. With tumors that spread to the liver, the five-year survival rate is less than five percent.

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"Colon cancer remains a tragic disease, not because we can't do anything about it--we can cure the disease if it is caught early," says David Rubin, a gastroenterologist at the University of Chicago Medical Center. "The vast majority of colon cancers are actually due to screening failures because patients are not getting the recommended tests to screen for the disease."

A virtually tasteless pill provides an alternative to the liquid colon-cleansing preparations that deter many patients from getting screened. Approved by the Food and Drug Administration in 2006, the tablets can be taken with any clear beverage of the patient's choice, such as ginger ale, water, or dye-free sports drinks. With each eight-ounce glass of fluid, four tablets are taken. The total amount of liquid consumed is about two or three liters of their preferred beverage.

Patients report that the pills cause less nausea, abdominal pain, and bloating than some of the liquid preparations, points out Douglas K. Rex, of Indiana University Medical Center, Bloomington. "The tableted purgative is equally effective, safe, and greatly preferred over the existing aqueous preparations," concludes a study in the journal Gastrointestinal Endoscopy. "This may improve patient compliance with recommendations for screening colonoscopy."

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