Screening Critical to Detect Colorectal Cancer
May 18, 2000 -- Katie Couric's been saying it for months, and now a new article reinforces the Today show host's message: Safe and effective tests for colorectal cancer can catch the disease early and save lives.
Experts recommend screening for everyone over 50. If the disease runs in your family, or if you have one of several bowel disorders, they recommend that screening begin at 40.
"People don't like to talk about their colon, but the fact of the matter is that the tests are not really that bad," says Scott Gazelle, MD, MPH, PhD, co-author of the review article published in the journal Radiology. "The real message should be to go out and talk to your doctor and get screened." Gazelle is an associate professor of radiology at Harvard Medical School and associate professor of health policy and management at Harvard School of Public Health.
Colorectal cancer was newly diagnosed in 130,000 Americans and killed 57,000 people in the U.S. in 1999, according to the American Cancer Society (ACS), making it the second leading cause of deaths from cancer. But it is one of the most survivable of all cancers, experts say -- if it is caught early. The Radiology article notes that although both the number of colon cancer cases and the number of deaths from colon cancer have declined during the past two years, due in part to improved screening efforts, too few people are getting the tests.
Several screening methods are available, and they all work, says Robert Smith, PhD, director of cancer screening for the American Cancer Society. The ACS recommended in 1997 that people over 50 be screened using one of the following techniques:
- A yearly fecal occult blood test , which detects blood from bleeding cancers in the stool, and a flexible sigmoidoscopy, which lets the doctor see the lower part of the colon, every five years
- A colonoscopy, in which the doctor scans the interior of the colon for tumors or precancerous growths called polyps, every 10 years
- A double-contrast barium enema, which uses a liquid containing a radioactive isotope to detect colon abnormalities, every five or 10 years
"I think that the ACS ... guidelines are very logical and should be followed," Gazelle says.
Those who are at high risk for colorectal cancer and should therefore get screened beginning at age 40 include people with a family history of colorectal cancer and people with inflammatory bowel disease. People should also be screened if they have one of two hereditary disorders that increase the cancer risk: familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer syndrome.
Colorectal cancer is preventable in part because -- unlike some other cancers -- it is slow to develop. Often, noncancerous polyps, similar to warts, form on the inside of the colon. Over a period of years, a few of these may go on to become cancerous. As a result, doctors screen for the presence of both polyps and actual tumors, Smith says.