- Email: [email protected]
Colorectal Cancer Awareness Month
Editorial Edward Chu, MD Professor of Medicine and Pharmacology Chief, Section of Medical Oncology Deputy Director of Clinical Research, Yale Cancer Center Yale University School of Medicine New Haven, CT
Colorectal Cancer Awareness Month Colorectal cancer (CRC) is a major public health problem in the United States. Each year, this disease affects nearly 150,000 new patients, and it is the second leading cause of mortality, accounting for almost 60,000 deaths. On a worldwide level, CRC remains a significant health issue, afflicting nearly 800,000 individuals and resulting in 500,000 deaths. Because March is Colorectal Cancer Awareness Month, it is an opportune time for all of us health-care providers involved with the disease to increase awareness that this disease is largely preventable, treatable, and curable through regular screenings, a healthy lifestyle and proper nutrition, and expert clinical care. Screening and early detection must be viewed as absolutely critical in our approach to preventing and/or curing this disease. Several screening methods have been approved by the American Cancer Society and the Centers for Disease Control and Prevention, and they include fecal occult blood testing, sigmoidoscopy, colonoscopy, and barium enema. Colonoscopy is the gold standard screening method because it can visualize the presence of polyps; remove polyps when detected, thereby removing the main risk factor for cancerous growth; and potentially identify the presence of early-stage colon cancers. When colon cancer is diagnosed in its earliest stages, nearly 90% of patients can be cured. However, once the disease presents in an advanced stage with widespread involvement of visceral organs such as the liver and lungs, the prognosis remains dismal, with the vast majority of our patients being deemed incurable. What is of major concern and why increasing awareness of colon cancer screening is so vitally important is that, at present, only approximately 40% of all individuals in the United States aged > 50 years undergo any type of screening. Perhaps even more surprising is the fact that women undergo screening at nearly half the rate of men. Apparently, there is the grossly incorrect perception that
women are at reduced risk for developing CRC than men. To compound matters, the majority of the primary care physicians who take care of women do not believe that colon cancer is as much of a concern relative to breast cancer and cervical cancer, for which effective screening methods are available. Minority and underserved populations also seek colon cancer screening at a much lower rate than the general population. Although economic issues can help explain at least partly why these groups of individuals do not undergo colon cancer screening, it is imperative that we as a community develop creative outreach and awareness programs that will lead to increased screening numbers. As one example, at the Yale Cancer Center, we are working closely with the State of Connecticut to provide funding for minority and underserved groups that will allow them to undergo colonoscopy screening for colon cancer. For patients who are survivors of colon cancer, March represents a time to rejoice and celebrate. For individuals who are aged > 50 years, including many of the key experts in the field of colon cancer, this month is an appropriate reminder to undergo screening, because screening does save lives. Certainly for individuals at increased risk because of family history, screening should occur at an earlier age and perhaps more frequently. On a personal note, yours truly has already undergone 3 colonoscopies since the age of 30 because of a strong family history of colon cancer. Finally, for all healthcare professionals, it is imperative that we emphasize the importance of colon cancer screening and continue to develop innovative outreach screening and education programs that serve our respective communities.
Edward Chu, MD Editor-in-Chief
Clinical Colorectal Cancer March 2006
• 389
Colorectal Cancer Awareness Month Colorectal cancer (CRC) is a major public health problem in the United States. Each year, this disease affects nearly 150,000 new patients, and it is the second leading cause of mortality, accounting for almost 60,000 deaths. On a worldwide level, CRC remains a significant health issue, afflicting nearly 800,000 individuals and resulting in 500,000 deaths. Because March is Colorectal Cancer Awareness Month, it is an opportune time for all of us health-care providers involved with the disease to increase awareness that this disease is largely preventable, treatable, and curable through regular screenings, a healthy lifestyle and proper nutrition, and expert clinical care. Screening and early detection must be viewed as absolutely critical in our approach to preventing and/or curing this disease. Several screening methods have been approved by the American Cancer Society and the Centers for Disease Control and Prevention, and they include fecal occult blood testing, sigmoidoscopy, colonoscopy, and barium enema. Colonoscopy is the gold standard screening method because it can visualize the presence of polyps; remove polyps when detected, thereby removing the main risk factor for cancerous growth; and potentially identify the presence of early-stage colon cancers. When colon cancer is diagnosed in its earliest stages, nearly 90% of patients can be cured. However, once the disease presents in an advanced stage with widespread involvement of visceral organs such as the liver and lungs, the prognosis remains dismal, with the vast majority of our patients being deemed incurable. What is of major concern and why increasing awareness of colon cancer screening is so vitally important is that, at present, only approximately 40% of all individuals in the United States aged > 50 years undergo any type of screening. Perhaps even more surprising is the fact that women undergo screening at nearly half the rate of men. Apparently, there is the grossly incorrect perception that
women are at reduced risk for developing CRC than men. To compound matters, the majority of the primary care physicians who take care of women do not believe that colon cancer is as much of a concern relative to breast cancer and cervical cancer, for which effective screening methods are available. Minority and underserved populations also seek colon cancer screening at a much lower rate than the general population. Although economic issues can help explain at least partly why these groups of individuals do not undergo colon cancer screening, it is imperative that we as a community develop creative outreach and awareness programs that will lead to increased screening numbers. As one example, at the Yale Cancer Center, we are working closely with the State of Connecticut to provide funding for minority and underserved groups that will allow them to undergo colonoscopy screening for colon cancer. For patients who are survivors of colon cancer, March represents a time to rejoice and celebrate. For individuals who are aged > 50 years, including many of the key experts in the field of colon cancer, this month is an appropriate reminder to undergo screening, because screening does save lives. Certainly for individuals at increased risk because of family history, screening should occur at an earlier age and perhaps more frequently. On a personal note, yours truly has already undergone 3 colonoscopies since the age of 30 because of a strong family history of colon cancer. Finally, for all healthcare professionals, it is imperative that we emphasize the importance of colon cancer screening and continue to develop innovative outreach screening and education programs that serve our respective communities.
Edward Chu, MD Editor-in-Chief
Clinical Colorectal Cancer March 2006
• 389