Teach public to control colorectal cancer

Promote screenings to decrease deaths

The message promoters of National Colorectal Cancer Awareness Month want to get across to the public in March is that this form of cancer is preventable. "Our mission is to explain to people that if they get screened, they can prevent cancer through the removal of polyps or detect it early enough that it is 90% curable. People can take control of this cancer as opposed to just waiting for it to happen," says Sonja Weisel-Jones, assistant director of external affairs at the Cancer Research Foundation of America in Alexandria, VA.

Although widespread screening for colorectal cancer is available and effective, it lags behind screenings for other types of cancer such as mammography, Pap smears, and prostate exams. Physicians detect only 37% of colorectal cancers at an early stage. The foundation estimates that 30,000 lives could be saved annually with colorectal cancer screenings.

People need to learn about the different types of screenings so that they can talk to their physician about which one is right for them, says Weisel-Jones. Screening methods include fecal occult blood testing, flexible sigmoidoscopy, double contrast barium enema (barium X-ray), and colonoscopy. These screening methods can detect precancerous polyps, which are grapelike growths on the lining of the colon, as well as detect the cancer if it has started to develop.

Everyone over the age of 50 should be screened annually, and those people at a higher risk for colorectal cancer should be screened earlier. Those at high risk include people who have a personal or family history of inflammatory bowel disease, colorectal cancer or polyps, and ovarian, endometrial, or breast cancer.

Colorectal cancer is not gender-specific; both men and women are diagnosed with the disease with equal frequency. It is second only to lung cancer in the number of deaths it causes in the United States. The foundation estimates that this year, 56,700 people will die from colorectal cancer and about 135,400 new cases will be diagnosed.

Dispel myths with education

What prevents people from being screened? Colorectal cancer testing is very complicated and there are a lot of mixed messages about it, says Weisel-Jones. People find some of the screenings such as the colonoscopy to be very invasive and they are afraid that it will hurt. Others think that a screening is to detect cancer and they would rather not know, she says.

However, the annual screening would probably be the fecal occult blood test, a simple chemical test that can detect hidden blood in the stool. It can be taken in a person’s home and sent to a laboratory for results. A colonoscopy would be ordered if something was detected, explains Weisel-Jones.

A lack of understanding about the benefits of screening also keeps the numbers low. In about 75% of all new cases of colorectal cancer, the only known risk factor is age, with the person developing the disease at age 50 or older, according to the Cancer Research Foundation of America. Because colorectal cancer develops from polyps, removing them may prevent the cancer from developing.

In addition, early detection can save a person’s life. If the cancer is confined to the colon or rectum when it is diagnosed, patients have a 91% chance of surviving. Yet only 37% of colorectal cancer cases are diagnosed at an early stage. "Colorectal cancer is not a cancer that you always catch right away without screening because there are no signs and symptoms. As with any cancer, when you do have symptoms it is generally when the cancer is further on and less treatable," says Weisel-Jones.

Symptoms for colorectal cancer according to the Cancer Research Foundation of America include:

  • bright red or orange blood in or on the stool;
  • change in bowel habits, such as diarrhea or constipation;
  • stools that are narrower than usual;
  • general stomach discomfort such as bloating, fullness, or cramps;
  • feeling that the bowel does not empty completely;
  • frequent gas pains;
  • weight loss for no apparent reason;
  • rectal bleeding;
  • constant tiredness.

During National Colorectal Cancer Awareness Month health care facilities can have a fecal occult blood test drive where free screening kits are passed out to participants who will return to obtain lab test results. It’s helpful to have a health care provider present to answer questions and provide education, says Weisel-Jones.

The target population for the screening would be up to the community base, she says. For example, if there was a large African-American population in the area, it might be a good target because they are at higher risk. The death rates are higher for African-Americans diagnosed with colorectal cancer than other ethnic groups.

There are many free educational materials available from the Cancer Research Foundation of America that are designed to be reproduced and can be ordered on-line or by telephone. There is a brochure and a sheet that explains the myths of colorectal cancer that is available in English and Spanish. There’s also a medical history chart people can fill out and give to their health care provider, a sheet with steps for helping people learn their risk for colorectal cancer, and a list of questions patients can ask their health care provider.

"There needs to be shared decision making between the physicians and the patients," says Weisel-Jones.


For more information about National Colorectal Cancer Awareness Month, contact:

  • Sonja Weisel-Jones, Assistant Director of External Affairs, Cancer Research Foundation of America, 1600 Duke St., Suite 110, Alexandria, VA 22314. Telephone: (703) 519-2104. Fax: (703) 836-4413. E-mail: sweisel@crfa.org. Web site: www.preventcancer.org/colorectal.