When many people think about cancer, they think about lung cancer and breast cancer. And many can explain that not smoking generally prevents lung cancer and that regular exams can help catch breast cancer early when it can be treated with a high rate of survival. However, they tend to forget that the second most commonly diagnosed cancer in the United States is colorectal cancer.
Colorectal cancer is cancer of the colon or rectum. Estimates by the U.S. Center for Disease Control suggest that over 56,000 Americans will die from colorectal cancer this year, and that 147,000 Americans will be diagnosed with colorectal cancer. The CDC suggests regular screenings to help reduce that number.
In a 2002 survey of adults more than 50 years old, less than 50 percent of respondents in Utah had been screened over a 10-year period.
There are four tests available which can increase early detection and treatment. The first is the fecal occult blood test or FOBT, which samples three consecutive stool samples.
Two types of FOBTs are available. Most home health professionals use the guaiac smear tests, which are interpreted in a laboratory.
Self-testing kits are available from drug stores or can be obtained for no charge from the health department as part of a campaign by the Utah Cancer Action Network to increase awareness and encourage screening. The self-test kits use flushable reagent pads, where there is no stool handling. The test is performed by a placing a test pad in the toilet after defecation. The pad will show results, which then are noted on a card that can be taken or mailed to a physician for review. Test from the health department are mailed to a laboratory where the results are analyzed.
The second test is a felxible sigmoidoscopy, where physicians examine the interior walls of the rectum and part of the colon using a flexible, lighted tube.
Third, a colonoscopy uses a longer tube that the sigmoidoscope to examine the entire colon. The colonoscope also allows physicians to collect tissue samples and remove polyps. Polyps are usually nonmalignant growths which often obstruct the normal path through the digestive tract. However, polyps can later develop to form cancerous regions.
The fourth test is the double-contrast barium enema, which is a series of X-rays of the colon and rectum.
The CDC does not recommend digital rectal examinations as a screening method for colorectal cancer. The procedure is more effective in detecting problems with the prostate in male patients, but because it only examines a limited region, experts suggest that more intense examinations be made for effective screening.
The CDC recommends that both men and women more than 50 years old receive a FOBT annually, a flexible sigmoidoscopy every five years, a double-contrast barium enema every five years and a colonoscopy every 10 years.
Those at higher risk should begin at a younger age and may require more frequent testing. Higher risk individuals include those with a personal or family history of colorectal cancer or polyps, or a personal or family history of colorectal cancer syndromes or inflammatory bowel disease.