COLORECTAL CANCER -
for Program Managers and Coalition Members
CDC's multi-year Screen for
Life: National Colorectal Cancer Action Campaign informs
men and women aged 50 years or older about the importance
of having regular colorectal cancer screening tests.
Screening tests can find precancerous polyps so they
can be removed before they have a chance to turn into
cancer, thus preventing the disease. However, an estimated
40% of adults aged 50 or older—the age group at greatest
risk of developing colorectal cancer—have not been
screened appropriately. Please
click here
CDC Colon Cancer Screening Guidelines
Regular screening, beginning at age
50, is the key to preventing colorectal cancer. [1] Several
scientific organizations, including the U.S. Preventive
Services Task Force (USPSTF) and other federal agencies,
recommend regular screening for all adults aged 50 or
older. According to USPSTF, routine screening can reduce
the number of people who die of colorectal cancer by
as much as 60%. [3]
Recommended screening tests and intervals
are:
Fecal occult blood test
(FOBT), which checks for hidden blood in
three consecutive stool samples, should be administered
every year.
Flexible sigmoidoscopy,
where physicians use a flexible, lighted tube (sigmoidoscope)
to inspect visually the interior walls of the rectum
and part of the colon, should be administered every
5 years.
Double-contrast barium
enema, a test that uses a series of X-rays
of the colon and rectum (taken after the patient
is given an enema containing barium dye followed
by an injection of air in the lower bowel), should
be administered every 5 years.
Colonoscopy,
where physicians use a flexible, lighted tube (colonoscope)
to inspect visually the interior walls of the rectum
and the entire colon, should be administered every
10 years. During this procedure, samples of tissue
may be collected for closer examination, or polyps
may be removed. Colonoscopies can be used as screening
tests or as follow-up diagnostic tools when the results
of another screening test are positive. [2]
People at higher risk of developing
colorectal cancer should begin screening at a younger
age, and may need to be tested more frequently. For more
information, read the current colorectal cancer screening
guidelines from the U.S. Preventive Services Task Force.
For References
click here
What methods are
used to screen people for colorectal cancer?
Fecal occult blood test (FOBT)— This
test checks for hidden blood in fecal material (stool).
Currently, two types of FOBT are available. One type,
called guaiac FOBT, uses the chemical guaiac to detect
heme in stool. Studies have shown that FOBT, when performed
every 1 to 2 years in people ages 50 to 80, can help
reduce the number of deaths due to colorectal cancer
by 15 to 33 percent (13–15).
Sigmoidoscopy - In
this test, the rectum and lower colon are examined using
a lighted instrument called a sigmoidoscope. During sigmoidoscopy,
precancerous and cancerous growths in the rectum and
lower colon can be found and either removed or biopsied.
Colonoscopy - In
this test, the rectum and entire colon are examined using
a lighted instrument called a colonoscope. During colonoscopy,
precancerous and cancerous growths throughout the colon
can be found and either removed or biopsied, including
growths in the upper part of the colon, where they would
be missed by sigmoidoscopy.
Virtual colonoscopy (also
called computerized tomographic colonography)—In this
test, special x-ray equipment is used to produce pictures
of the colon and rectum. A computer then assembles these
pictures into detailed images that can show polyps and
other abnormalities. Because it is less invasive than
standard colonoscopy and sedation is not needed, virtual
colonoscopy may cause less discomfort and take less time
to perform.
Double contrast barium enema
(DCBE) - In this test, a series of x-rays
of the entire colon and rectum are taken after the
patient is given an enema with a barium solution and
air is introduced into the colon.
Digital rectal exam (DRE) -
In this test, a health care provider inserts a lubricated,
gloved finger into the rectum to feel for abnormal areas.
DRE allows examination of only the lower part of the
rectum. It is often performed as part of a routine physical
examination.
For detailed information about the
colorectal cancer screenings listed here (from NCI) please
download the pdf (80K) “fact sheet: colorectal cancer
screening” please
click here.
For additional screening guidelines
please go to the resources section about screening.
What do we know about diet
and colorectal cancer?
The
Panel concludes (Chapter 7.10, pages 280-288): To
download the chapter
click here
The evidence that physical activity protects
against colorectal cancer is convincing, although
the evidence is stronger for colon than for rectum.
The evidence that red meat, processed
meat, substantial consumption (more than about 30 g per
day ethanol) of alcoholic drinks (by men, and probably
by women), body fatness and abdominal fatness, and the
factors that lead to greater adult attained height, or
its consequences, are causes of colorectal cancer is
convincing.
Foods containing dietary fibre, as
well as garlic, milk, and calcium, probably protect against
this cancer.
There is limited evidence suggesting
that non-starchy vegetables, fruits, foods containing
folate, as well as fish, foods containing vitamin D,
and also selenium and foods containing it, protect against
colorectal cancer, and that foods containing iron, and
also cheese, foods containing animal fats, and foods
containing sugars are causes of this cancer.
Source: Second Expert Report:
Food, Nutrition, Physical Activity, and the Prevention
of Cancer: a Global Perspective. World Cancer
Research Fund / American Institute for Cancer Research
(WCRF/AICR), Washington DC: AICR, 2007. 537 Pages.
Note: PDF file of the complete report is 12 MB in size.
More about this report can be found on the “diet” link
[or some other name later] of this website. To download
the entire report (pdf 12MB) please
click here.
To download a summary of the report (16 pages, pdf 1.2MB) please
click here
To download the report’s summary
in other languages than English (WCRF website), please
click here
MedlinePlus - Colorectal
Cancer Link
Please make sure you check the MedlinePlus online for
Colorectal Cancer with an extensive, constantly updated
resource list. MedlinePlus
will direct you to information to help answer health
questions. MedlinePlus brings together authoritative
information from NLM, the National Institutes of Health
(NIH), and other government agencies and health-related
organizations. MedlinePlus also has extensive information
about drugs, an illustrated medical encyclopedia, interactive
patient tutorials, and latest health news. Please
click here
More Resources
The resources listed here are organized
by relevance. They are published by well-known organizations
working on breast cancer. All PDF files listed can be
downloaded from the pacificcancer.org website, without
having to visit any other site.
