Colon Cancer: Get The Test

Colorectal cancer is the second leading cause of cancer-related deaths in the United States with an estimated 148,300 new cases and 56,600 deaths expected this year. According to the American Cancer Society, many of these deaths could be avoided if people over the age of 50 had regular screening tests.

Colorectal cancer is usually curable when discovered early. Diagnosis is possible with regular screenings. When colorectal cancer is detected in its earliest stage, Stage 1, the survival rate is 96 percent.

Most colorectal cases begin as polyps, which are growths on the inner wall of the colon or rectum. People who have polyps or colorectal cancer do not always have symptoms, especially at first. Screening tests can help prevent colorectal cancer by finding precancerous polyps so they can be removed before they turn into cancer. Eating a low-fat diet, including lots of fruits and vegetables, may also lower risk.

Risk for the disease increases with age. Most cases, 92 percent, occur in people age 50 and older. Colorectal cancer strikes men and women with almost equal frequency and often progresses without symptoms.

A personal or family history of colon cancer or polyps increases the risk of cancer. People with a history of inflammatory bowel disease also may be at greater risk. There also are a number of hereditary conditions that increase the risk of colon cancer, including familial adenomatous polyposis (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), Gardner’s syndrome, and Ashkenazi Jewish heritage.

The use of cigarettes and other tobacco products also are believed to increase risk as does physical inactivity and eating a diet high in animal fats.

Symptoms

Early colon cancer usually has no symptoms. People with the following symptoms should see their doctor, particularly if they are over 40 years old or have a personal or family history of the disease:

*A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days

*A feeling that you need to have a bowel movement that does not go away after you do.

*Bleeding from the rectum or blood in the stool.

*Cramping or gnawing stomach pain

*Decreased appetite

*Weakness and fatigue

*Jaundice (yellow-green color of the skin and white part of the eye).

Testing And Detection

According to the American Cancer Society, starting at age 50, both men and women should have one of the following testing options:

*Yearly fecal occult blood test (FOBT)

*Flexible sigmoidoscopy every five years

* FOBT and flexible sigmoidoscopy every five years (preferred)

*Double-contrast barium enema every five years

*Colonoscopy every 10 years

Because the risk increases with age, Medicare covers the following tests for persons who are on Medicare:

*A yearly take-home fecal blood test with no co-pays or deductible

*A flexible sigmoidoscopy every five years. Beneficiaries pay 20 percent of the Medicare-approved amount after the annual Part B deductible.

*A colonoscopy for high-risk individuals every two years. Beneficiaries pay about 20 percent of the Medicare-approved among after the annual Part B deductible.

*A barium enema as an alternative to either the sigmoidoscopy or the colonoscopy.

Medicare also covers a screening colonoscopy every 10 years for people not at high risk for colorectal cancer. To find a doctor or health care professional who can give a Medicare-paid screening test, call 800-MEDICARE or visit the Medicare website at www.medicare.gov for a list of all participating Medicare physicians.

Common Treatments

*Surgery is the most common form of treatment for colon cancer. For cancers that have not spread, it frequently stops the disease.

*Chemotherapy, or chemotherapy with radiation treatment, is given before or after surgery to most patients whose cancer has spread extensively into the bowel wall or to the lymph nodes.

*A permanent colostomy (creation of an abdominal opening for the elimination of body wastes) is very seldom needed for colon cancer and not often required for rectal cancer.

For more information on cancers of the colon or rectum or to order a fact sheet called Colorectal Cancer: Basic Facts on Screening (#99-6949) and other materials on colorectal cancer, call the Centers for Disease Control and Prevention toll-free line at 888-842-6355. Information also is available by calling the American Cancer Society at 800-ACS-2345 or by visiting the website at www.cancer.org.