The rates of colorectal cancer cases and deaths in the US have fallen thanks to more widespread screening, but one in three adults who should be receiving screening is still missing out, according to a new report from the US Centers for Disease Control and Prevention (CDC).
The CDC Vital Signs report for July 2011 shows that between 2003 and 2007:
- New cases of colorectal cancer fell from 52.3 to 45.4 per 100,000.
- Deaths fell from 19.0 to 16.7 per 100,000.
- This translates to 66,000 cases of cancer prevented and 32,000 lives saved compared to 2002.
The report also says half of the prevented cases and deaths were due to screening.
However, it emphasizes that 1 in 3 adults is still not getting screened as recommended.
Of cancers that affect both men and women, colorectal cancer (a disease that occurs in the colon or rectum) is the number 2 cancer killer in the US, the number 1 being lung cancer. In 2007 more than 142,000 Americans found out they had colorectal cancer, and more than 52,000 died of the disease.
However, the CDC say these numbers could be reduced even further if screening reached everyone who should have it. This is because screening helps find precancerous growths or polyps that can be safely removed before they turn into tumors.
The other advantage of screening is that it helps find cancer before it has started spreading, making it much easier to treat and increasing people’s chances of survival and returning to normal life.
If the US government’s Healthy People 2020 target of 70.5% for colorectal cancer screening is met, nearly 1,000 more lives will be saved every year, they said.
The latest available figures on screening coverage shows that in 2010, one in three adults aged between 50 and 75 is not up to date with their colorectal cancer screening.
People without health insurance, or who are on low income or who have a low level of education are the ones most likely to not have received any screening or who don’t receive it as often as recommended, say the CDC.
A common reason for why men and women fail to get the screening they need is that their healthcare provider doesn’t suggest it to them. Other reasons include: some people don’t realize the risk goes up as you get older, or they fear the test and/or the result says the report.
American adults should have one of the following screening tests for colorectal cancer:
- Every year: a fecal occult blood test (FOBT): this looks for hidden traces of blood in the stool.
- Every five years: a flexible sigmoidoscopy, where a healthcare provider uses a flexible tube with a camera to look for polyps (and safely removes them if necessary) in the rectum and the lower part of the colon.
- Every 10 years: a colonoscopy, which is like a sigmoidoscopy except that the doctor examines both the upper and lower sections of the colon.
People who should be screened more often include all adults from 50 to 75 years old, and anyone at risk of developing colorectal cancer, such as people with inflammatory bowel disease, Crohn’s disease, who have an inherited predisposition, a personal history of polyps or close family members with a history of polyps or colorectal cancer.
The CDC says various provisions in the Affordable Care Act should increase access to colorectal cancer screening, but federal, state and local health departments can also help by establishing their own screening targets and working with state Medicaid programs to identify people who should get screened and make sure they do, plus ensure abnormal results are dealt with quickly.
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Written by: Catharine Paddock, PhD