March is the month to step up on awareness of colorectal cancer, the third leading cause of cancer mortality in the US, according to the American Gastroenterological Association (AGA). Approximately 149,000 new cases of colorectal cancer have been predicted for 2008. About 50,000 Americans die this disease every year
The good news is that colorectal cancer is preventable and treatable when detected at an early stage. And early detection is possible through screening.
The bad news is that, “even in the best economic environment, only half of the people who need colorectal cancer screening receive the life-saving test.” The low screening rate maybe due to a lot of causes. Screening is mainly done by colonoscopy, which involves gently inserting an intrument called colonoscope into the rectum and large intestine. The instrument enables the doctor examine the walls of the lower gastrointestinal tract. Unfortunately, many people find this screening method embarrassing and invasive. With the economic recession, it is expected that even more people will forego screening for colorectal cancer due to loss of health insurance and financial difficulties. In addition, there seem to be cultural and ethnic barriers that are also related to health insurance coverage. According to AGA, African Americans and Hispanics are less likely to be screened and are therefore more likely to die from colorectal cancer than other ethnic groups.
A study by the Lewin Group made public early this year predicts that there will be a shortage of actively practicing gastroenterologists in the US in the next ten years. This shortage will further lead to low screening rates.
Hopefully, legislation will help solve the issue. Texas Rep. Kay Granger reintroduced the Colorectal Cancer Early Detection, Prevention and Treatment Act in the US Congress in February, a bill whose aim is
“to amend the Public Health Service Act to establish a national screening program at the Centers for Disease Control and Prevention and to amend title XIX of the Social Security Act to provide States the option to provide medical assistance for men and women screened and found to have colorectal cancer or colorectal polyps.”
The bill can hopefully establish a life-saving program similar to the Breast and Cervical Cancer Screening Program. Screening for colorectal cancer is recommended for people between 50 and 64 years old but also those younger than 50 but have high risks profiles. The bill will also facilitate screening, follow-up, and treatment of those who do not have insurance coverage.
Risk factors for colorectal cancer (source: American Cancer Society) are:
- Age older than 50 years old
- Previous history of polyps and inflammatory bowel disease
- Family history of colorectal cancer
- Other hereditary diseases (Peutz-Jeghers syndrome, familial adenomatous polyposis, and Lynch syndrome).
- Racial and ethnic background
- Lifestyle-related factors including smoking, diet, lack of exercise, obesity, heavy alcohol consumption, and type 2 diabetes.
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