While a combination of earlier detection and better treatments have yielded a steady decline in the colorectal cancer death rate over the past 20 years, colorectal cancer will kill an estimated 50,310 people in the U.S. in 2014, and 5,150 in California, according to the American Cancer Society.
Colorectal cancer is one of only a handful of cancers for which screening is proven to save lives, both by finding and removing polyps before they turn cancerous and by finding cancers early, when treatment is most likely to be successful.
During March, National Colon Cancer Awareness Month, the American Cancer Society is highlighting the need to do more to save lives from the nation’s third leading cause of cancer death in both men and women by urging patients and their doctors to talk about the importance of colorectal cancer screening, which is recommended for people at average risk beginning at age 50.
“Although screening guidelines differ for some cancers, this is not the case for colorectal cancer,” said Richard C. Wender, M.D., chief cancer control officer for the American Cancer Society and chair of the National Colorectal Cancer Roundtable. “All guidelines recommend screening with either colonoscopy every 10 years or a stool test at home every year, and the benefit of screening is clear. Colon cancer screening accomplishes two things – it prevents colon cancers from developing by removing polyps and it detects cancers early when it is highly curable.”
More than 1 in 3 adults aged 50 and older are not being screened as recommended for colorectal cancer. The American Cancer Society recommends that most people begin regular screening at age 50. People at higher risk, such as those with a family history of colon cancer, may need to start screening earlier.
“A great number of people do not understand that there are choices for being screened,” Wender added. “If patients are offered a choice among several screening options, then we can increase the chance they will get screened. As we like to say: the best test for you is the one you get.”
The Society recommends the following colorectal cancer screening tests:
- Tests that detect precancerous polyps and cancer:
- Flexible sigmoidoscopy every five years; or
- Colonoscopy every 10 years; or
- Double contrast barium enema (DCBE) every five years; or
- CT colonography (CTC) every five years.
- Tests that primarily detect cancer:
- Yearly guaiac-based fecal occult blood test (gFOBT) with high test sensitivity for cancer (older versions of the Fecal Occult Blood Test should not be used to test for colorectal cancer); or
- Yearly fecal immunochemical test (FIT) with high test sensitivity for cancer; or
- Stool DNA test (sDNA).
Tests that detect precancerous polyps allow doctors to remove the polyps and potentially prevent cancer altogether. And while cancers detected at the earliest stage have a five-year survival rate of 90 percent, only 40 percent of colon cancers are currently detected at this stage, partly because too few people are screened.
The Society is increasing efforts during March and beyond to ensure more people are aware of the lifesaving potential of screenings. As co-founders of the National Colorectal Cancer Roundtable, a coalition of 80 member organizations working to improve screening rates in the US, the American Cancer Society and the Centers for Disease Control and Prevention (CDC) are committed to significantly increasing screening rates.
"Public policies such as the Affordable Care Act are improving access to colon cancer screening, but we have a lot of work to do to ensure everyone has the opportunity to be screened," Wender said.
The American Cancer Society Cancer Action Network (ACS CAN), the Society's nonprofit, nonpartisan advocacy affiliate, strongly supported provisions of the Affordable Care Act that reduce or eliminate the cost of colorectal cancer screening and other proven prevention services for patients and require most health plans to cover them.
ACS CAN supports congressional legislation that would lift a financial burden for people living on a fixed income by ensuring men and women on Medicare receive these lifesaving screenings without risking cost sharing. ACS CAN is also working to increase federal funding of the Centers for Disease Control and Prevention’s Colorectal Cancer Control Program , which provides screenings to low-income and uninsured people.
For more information and guidance on colorectal cancer, visit cancer.org/fightcoloncancer or call the American Cancer Society 24 hours a day, seven days a week at 800-227-2345.