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Prostate Cancer Test Popular but Not Colonoscopy

Researchers See Prostate Test as Opportunity to Educate Men About Colon Cancer Screening
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WebMD Health News

March 3, 2005 -- When men get screened for prostate cancer, it wouldn't hurt to encourage them to schedule a colon cancer test as well.

That approach could save lives. Despite the controversy surrounding the utility of routine PSA screening for men in reducing prostate cancer death, more men get tested for prostate cancer than for colon cancer.

Abundant evidence exists to show that colon cancer screening saves lives, yet screening in men trails behind that of PSA screening, a new study shows.

Researchers call the PSA test for prostate cancer a "teachable moment." In other words, it's a golden opportunity to remind men to get screened for colon cancer. Why not take advantage of that fact, say the researchers.

Slacking on Screening

Prostate and colorectal cancers are the No. 2 and No. 3 causes of cancer deaths among men, says the American Cancer Society (ACS). Men and women should start getting screened for colon cancer at age 50 (or earlier, if they're at high risk of the disease), says the ACS.

A lot of people don't do that. In 2001, less than half of adults over age 50 had ever been screened for colon cancer, according to the CDC. That's better than before, but far short of what's needed.

Why the hesitation? Some people may be squeamish about colonoscopy, one of the recommended colon cancer screening tests, in which a thin, flexible tube with a tiny camera is guided through the colon. The camera with its tiny surgical instruments looks at the inner lining of the colon and can biopsy any suspicious lesions.

Lack of health insurance may also be a problem.

Countless articles and public service announcements have gotten the word out about colon cancer. NBC's Today show anchor Katie Couric even underwent colonoscopy on live TV to encourage people to do likewise.

Not everyone is convinced, as the new study shows.

Less Than Half of Men Get Colon Cancer Tests

Data came from a 2002 national phone survey of more than 22,000 men aged 50 and older.

About 61% of the men had stayed current with the PSA tests or a digital rectal exam to screen for prostate cancer. But only 48% had followed colorectal cancer screening guidelines for fecal occult blood test, sigmoidoscopy, or colonoscopy.

That means that a third of men who were good about getting PSA tests didn't make the same effort with colon cancer screening, the study explains.

Older men and black men were more likely to follow colon cancer testing guidelines. Health insurance, bigger paychecks, and higher education levels also helped.

Adherence to prostate cancer screening had the biggest influence on whether men underwent colon cancer screening. Men who adhered to prostate cancer screening were two to three times more likely to have had a colon cancer screening.

Hispanic men, smokers, and those who reported general good health were less likely to follow colon cancer screening guidelines, says the study, which appears in February's Journal of the American College of Surgeons.

The study was conducted by the University of Michigan's Ruth Carlos, MD, MS, and colleagues.

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