Simple Screening Cuts Deaths from Colon Cancer

The Center for Disease Control and Prevention reports the following: "Of cancers affecting both men and women, colorectal cancer (cancer of the colon and rectum) is the second leading cancer killer in the United States." According to the United States Cancer Studies reports that In the United States in 2007, 142,672 people were diagnosed with colorectal cancer, and 53,219 people died from it " between 2003 and 2007.

Good News:

In contrast to a 2003 study, the rate of colorectal cancer screening is up and the rate of death has gone down. That is a success in anyone's book, and, perhaps more importantly, it means that colorectal cancer can be managed.

The CDC says that reports of new cases of this devastating cancer fell almost 9% (per 100,000 people). In short, 66,000 fewer people suffered from this cancer. In fact, the rate dropped in 35 states - with the lowest rate in Utah.

Moreover, deaths from colon cancer dropped by almost 3%; that is, 32,000 fewer people died. These deaths declined in 49 states and The District of Columbia (although D.C. still claims the highest death rate). Most significantly, the number of deaths was lowest in the states with the highest rates of colorectal screening.

Bad News:

While screening for colon cancer has increased, it is still only pursued by two-thirds of the American populace. When you consider that one third of those who do not screen WILL test positive, you see the problem - in terms of unnecessary pain, suffering, death, and expense.

The CDC is making outreach efforts through television and other media to get the attention of those who, for one reason or another, do not screen.

• o Men and women aged 50+ - of all racial and ethnic backgrounds
• o African Americans, the group with the highest death rate
• o Hispanics, a group for whom language may be a barrier
• o People with low income/education profiles
• o People without medical insurance
• o People with colon cancer in the family, a group with a one-in-five chance of carrying the disease.
• o Patients who already suffer from problems, such as inflammatory bowel disease, Crohn's disease, ulcerative colitis, and some genetic disorders.

Warning Signs.

You can wait for symptoms that should drive you to the doctor. If the signs or symptoms appear, see your doctor immediately.

• o Noticeable bleeding from rectum
• o Blood in your stool or in the toilet
• o Diarrhea or constipation lasting several weeks
• o Cramps in your lower stomach/bowel area
• o Bowel discomfort or urge
• o General weakness
• o Unexpected sudden weight loss

Now, these symptoms could be signs of some other problem, and the doctor will consider them in combination with each other. But, you need to begin by seeing the doctor.

What to expect?

The colorectal cancer screening can take a series of test, each increasing in complexity. However, if the cancer can be ruled out with a simpler test, it is still the best route to follow:

• o Digital rectal Exam is part of most thorough physicals, so it should be no surprise. The doctor inserts a gloved finger into the rectum to search for growths or polyps. (This is also preliminary prostate screening in male patients.) It may be uncomfortable, but it is brief and pain-free.
• o Barium Enema injects a barium fluid into colon so that x-ray can follow barium to detect abnormalities.
• o Fecal Occult Blood Test detects blood in your stool. Blood, if discovered, may lead to additional tests. (You will be instructed to avoid certain foods before providing the sample.)
• o Stool DNA Test identifies cells that are produced by colon cancers or precancerous polyps. (You will be instructed to avoid a list of foods before testing.)
• o Virtual Colonoscopy goes high-tech with acomputerized tomography (CT) machine. It takes pictures of your colon, not unlike an MRI or CAT Scan.
• o Flexible Sigmoidoscopy inserts a thin tube with a light through the rectum into the bowel. A tiny video camera explores the rectum and lower colon. It can identify small polyps, but it does not reach the upper colon area.
• o Colonoscopy can be a psychological deterrent from some people. But, patents are given something to relax them before testing. Then, a miniature camera is inserted through the rectum to explore the colon. This apparatus can also be used to eliminate polyps or cancerous lesions.

Discuss your concerns openly with your doctor. All tests have some expense in cost, time, and physical discomfort. Hopefully, your doctor is not "test happy" and will advise a comfortable course of action.

Your main concern should not be the discomfort as much as the risk. From the age of 50, at least until age 75, all men and women should test regularly. The maximum benefit appears to arise when people in their 50s start to test regularly. That is, their regimen should be a Stool Test every year, a Flexible Sigmoidoscopy every 5 years, and a full Colonoscopy once every 10 years. Medicare covers these tests with reasonable regularity. (Those people or groups with a family history or a combination of indicative symptoms should test regularly at a younger age.)

So concerned is the CDC with the value of early and regular screening and with the need to reach those who remain uniformed or ill financed, it has created the CDC Colorectal Cancer Control Program (CRCCP). This is an outreach program now operating among targeted needs groups in 25 states and 4 tribes. The CDC wants to increase the screening of men and women in the funded areas to 80% before 2014, convinced that the increased screening will reduce the illness and deaths from colon cancer. You can find more information about this task force at http://www.cdc.gov/cancer/crccp/

If you still do not see this as your problem, hopefully because you test regularly, spread the word that some conscientious effort can save lives. Print out this Fact Sheet or email it to a friend.