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Testing is key to early detection.

Lack of knowledge, according to the Centers for Disease Control, can kill--especially when it comes to colorectal cancer (CRC). With approximately 160,000 new cases and 60,000 deaths each year, CRC ranks second to lung cancer in causing cancer fatalities. One in every 20 Americans over age 40 will get CRC, with the higher risk groups including people over 50; blacks; those with a personal or family history of cancer, colon or rectal polyps, or chronic, inflammatory bowel disease (such as colitis and Crohn's disease); and those with high-fat, low-fiber diets.

Despite American Cancer Society recommendations for annual stool screening, 60-70% of the population (especially lower socioeconomic groups) do not know about the simple, efficient, low-cost take-home stool tests--fecal occult (unseen) blood tests (FOBT)--physicians can order. By comparison, tests such as blood cholesterol, chest X-rays, and mammograms now are routine annual procedures and part of the public health consciousness and standard care.

One reason for the public's low awareness of CRC might be comparatively heavy media attention to breast, prostate, and other cancers, which may have contributed to the misconception that these other cancers have higher mortality rates. This--combined with the public's avoidance of colon, bowel, and stool issues and fear of cancer and colostomies--may have impeded colorectal cancer awareness and early detection.

Yet, this low-profile, "silent" cancer has an impressive 90% five-year survival rate with early detection, when symptoms have yet to appear, tumors are localized, and no lymph nodes are involved. Through CRC education and increased screening, thousands of lives could be saved every year.

"The best way to improve detection and survival is to screen well people--those who do not yet have colon symptoms," points out David Greegor, a Columbus, Ohio, internist. According to many studies, FOBT is a key screening tool for detecting microscopic bleeding caused by many colorectal conditions, from benign polyps to cancer. For those over 50, the American Cancer Society strongly recommends annual testing, and, with CRC's high incidence, many people in their 40s also are being tested.

A low-cost, easy, take-home test, FOBT requires only that patients follow simple medication and dietary rules, place tiny stool smears" from three different bowel movements on card-like packets, and then mail (or hand) them in for lab testing. If indicated, the next step may be direct bowel examination via sigmoidoscopy or colonoscopy. According to Certified Nurse Practitioner Joyce Abel, president of Colon Cancer Prevention, Inc., Minneapolis, Minn. (herself a CRC survivor), "Together, FOBT and sigmoidoscopy are a best-bet approach. The flexible sigmoidoscope provides a direct view of the lower one-third of the colon while FOBT checks for hidden blood throughout the colon."
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Title Annotation:colorectal cancer
Publication:USA Today (Magazine)
Date:Feb 1, 1993
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