Regular screening for colorectal cancer remains effective in preventing and detecting disease early

Mar 2 2009

As the nation marks National Colorectal Cancer Awareness Month this March, the American Cancer Society is encouraging Americans to get lifesaving screening tests that have been proven to reduce the risk of the third leading cause of cancer death in both men and women.

According to the recent Annual Report to the Nation on cancer (sponsored in part by the American Cancer Society), progress continues to be made in the fight against colorectal cancer (commonly referred to as colon cancer), with incidence and mortality rates continuing to experience a steady decline due in part to an increase in screening. From 1998 to 2005, colon cancer incidence dropped by 2.8% per year in men and 2.2% per year in women. Deaths rates have fallen by 4.3% in both men and women from 2002 to 2005. The American Cancer Society recommends routine screening for men and women starting at age 50, and earlier testing for those at higher than average risk. Regularly scheduled screening can not only detect cancer at an early and more treatable stage, but can also prevent cancer from developing by removing precancerous polyps before they become cancerous.

Despite evidence showing colorectal screening can save lives and the availability of several options for patients, only about half of the U.S. population aged 50 and older has been tested recently for colon cancer. Among those who have not been screened for colon cancer, reasons include lack of access to affordable care, and that clinicians are not recommending screening when they should. Other barriers include lack of knowledge of the importance of screening, of the treatability of colon cancer when detected early, and of available testing options. Screening is critical as more than half of all colon cancer deaths could be prevented if everyone who should get screened did so.

"Colon cancer is one of the only cancers that can be prevented through regular testing" said Durado D. Brooks, M.D., director of prostate and colorectal cancer, American Cancer Soci"ty. ?The declines in incidence and mortality from colorectal cancer can be attributed to prevention and early detection of the disease through screening, as well as increasingly effective treat"ent.?

In March 2008, the American Cancer Society, along with the American College of Radiology and the U.S. Multi-Society Task Force on Colorectal Cancer released the first-ever consensus guidelines for colorectal screening. The guidelines now include two new tests - stool DNA and CT colonography, also known as virtual colonoscopy. The guidelines also for the first time indicate a preference for screening tests that can not only detect cancer early but also detect precancerous polyps before they turn cancerous.

One major barrier to colon cancer screening is a lack of health insurance. Many studies show that people who are uninsured are substantially less likely to be screened for colon cancer - while nearly half (48.3 percent) of men and women ages 50 to 64 with private insurance had a recommended colon cancer screening test in the past 10 years, only one in five (18.8 percent) of those who lacked insurance had received recommended screening. In addition, insurance status strongly influences survival among those diagnosed with colon cancer - individuals with private insurance who are diagnosed with Stage II colon cancer have better survival outcomes than individuals who are uninsured or receive Medicaid and are diagnosed with Stage I.

The American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society, is working to pass the Colorectal Cancer Prevention, Early Detection and Treatment Act. This legislation establishes a program administered by the Centers for Disease Control and Prevention (CDC) that would provide vital colon cancer screenings, treatment and follow-up services to low-income, uninsured and underinsured men and women ages 50 to 64. Additionally, this program will support training for health providers based on research that has shown physician recommendation is a critical factor for patients in deciding to get screening tests, and will support public information and education programs for the prevention and detection of colon cancer and promoting the benefits of cancer screenings targeted both at the general public and medically underserved populations.

A number of lifestyle factors impact colon cancer risk. Studies indicate that men and women who are overweight are more likely to develop and die from colon cancer, and a diet high in red or processed meat is known to increase risk of developing the disease. Studies also show that high levels of physical activity may cut the risk of colon cancer in half. The American Cancer Society recommends engaging in moderate activity for at least 30 minutes on five or more days per week and substituting high consumption of red and processed meat with a healthy diet rich in plant sources, whole grains, and five or more servings of fruits and vegetables.

Age remains the most important risk factor for colon cancer. Risk increases with age, with more than 90 percent of cases diagnosed in individuals aged 50 and older. A personal or family history of the disease also increases risk. An estimated 148,810 cases of colorectal cancer were expected to occur in 2008, and 49,960 deaths were also expected.

The American Cancer Society is dedicated to eliminating cancer as a major health problem by saving lives, diminishing suffering and preventing cancer through research, education, advocacy and service. Founded in 1913 and with national headquarters in Atlanta, the Society has 13 regional Divisions and local offices in 3,400 communities, involving millions of volunteers across the United States. For more information anytime, call toll free 1-800-ACS-2345 or visit www.cancer.org.