Lynchburg Business

Colon/Rectal Cancer Month

Issue: March 2010 by Lynchburg Business in Healthcare, Inside The Magazine

Colorectal cancer is the third most common cancer and the third leading cause of death in the United States, according to the American Cancer Society, causing approximately 50,000 deaths in 2009. The economic toll from colorectal cancer also looms large. Researchers at the National Institutes of Health project the estimated burden of colorectal cancer care in the U.S. for the initial, continuing and last year of life care will cost more than $6 billion annually by 2020.

Despite such staggering statistics, there is good news. The death rate from colorectal cancer has been dropping for more than 20 years as a result of screenings where pre-cancerous polyps can be removed, early detection when the disease is highly curable and improved treatment. Certainly, the primary way to prevent and cure colorectal cancer at its earliest stages is through screening.

The American Cancer Society, Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality and gastroenterology associations all recommend that men and women at average risk for developing colorectal cancer should begin colonoscopy screenings at age 50, with follow-up screenings at 10-year intervals. Those with colorectal cancer risk factors should begin screening earlier and be screened more often. Colonoscopies should be repeated in five years if an abnormal polyp is found; in three years if multiple polyps are found. Additional screening options include fecal occult blood tests and flexible sigmoidoscopy, though they are not as effective.

A new, non-invasive screening process called a virtual colonography does not require sedation and uses a CT scanner and computer software to produce three-dimensional images of the colon and rectum. However, insurers have not agreed to pay for this yet, and if polyps are seen in the scan, the patient must undergo a regular colonoscopy.

When colorectal cancer is found early, treatment dramatically increases the chances of survival. However, many people put off screening for a variety of reasons, including cost, fear of the test, privacy issues or concerns about sedation.  

Colorectal cancer risk factors include personal history of colorectal cancer or polyps, chronic inflammatory bowel disease (Crohn’s disease or ulcerative colitis) or a strong family history of colorectal cancer or polyps (first degree relative—parent or sibling). The American Cancer Society lists other risk factors that may increase a person’s chance of developing colorectal polyps or colorectal cancer. These include:

• Age: Younger adults may develop colorectal cancer, but the chances of developing the disease increase markedly after age 50.
• Diets high in red and processed meats. Research shows diets high in vegetables and fruits have been linked to a decreased risk of colorectal cancer.
• Physical inactivity
• Smoking
• Heavy alcohol use
• Type 2 Diabetes

Symptoms of colorectal cancer include:

• Rectal bleeding, dark stools or blood in the stool
• Change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days
• Stomach pain

It’s important to note that these symptoms may be caused by conditions other than colorectal cancer, such as hemorrhoids, so see your physician to determine the cause of the symptoms and course of treatment, if necessary.

Surgery is the treatment for colon cancer, and a patient’s prognosis depends on the depth of cancer invasion. The survival rate when a cancerous polyp is removed is 95 percent, but the rate goes down if the cancer has spread. If the cancer has invaded a superficial part of the colon, the survival rate is about 75 percent; if it has spread to organs such as the liver or the lung, the survival rate drops to about 11 percent, according to the American Cancer Society. Chemotherapy is often given to patients with advanced colon cancer to slow the cancer and advance the rate of cure.

So, what can employers do? The National Business Group of Health says employers can help to save lives by:

• Ensuring that health benefits include provisions for preventive, diagnostic and treatment services for colorectal cancer.
• Educating employees over age 50 about the importance of routine colorectal screening.
• Providing employees with free educational materials such as colorectal cancer risk assessments, cancer fact sheets or schedules of recommended screenings.

Virginia is one of 27 states that have screening laws that ensure coverage for a range of tests. Check with your insurer or the state government to see what is covered.

For more information about colorectal cancer and how colonoscopies help save lives, visit CentraHealth.com.