Colorectal cancer is second only to lung cancer in the number of cases diagnosed in the United States, and it is one of the top cancer killers for both men and women. Fortunately, most cases can be prevented with good health care. The Centers for Disease Control and Prevention (CDC) reported that as screening rates have risen over the last decade, both the number of cases and the number of deaths have decreased markedly.
Colonoscopy offers a chance for doctors to remove pre-cancerous polyps before they develop into colon or rectal cancer. Thus, screening offers more than early detection for these types of cancer; it is also a form of prevention.
Dr. Lisa C. Richardson and colleagues at the CDC prepared a report on colorectal screening, incidence, and mortality rates. From 2002 to 2010, the percentage of persons aged 50 to 75 who were adequately screened increased from 52.3 percent to 65.4 percent. The last year for which incidence data are available is 2007. Over the period 2003 to 2007, colorectal cancer incidence decreased by 13 percent and mortality decreased by 12 percent.
Further improvements in screening could save many more lives, Richardson explained. In addition, the medical costs for treating colorectal cancer were estimated at $14 billion for 2010. Screening tests are much less expensive.
Colonoscopy is not the only option, Richardson pointed out. Three different regimens are available:
1.Fecal occult blood testing every year
2.Sigmoidoscopy once every 5 years, combined with fecal occult blood testing every 3 years
3.Colonoscopy once every 10 years
The CDC provides a link to the U. S. Preventive Services Task Force's recommendation statement about the risks and benefits of each type of screening. Serious complications occur in an estimated 25 of every 10,000 colonoscopy procedures.
For flexible sigmoidoscopy, the rate is 3.4 serious complications per 10,000 procedures. Fecal occult blood testing has no evidence of harm.
Colonoscopy is the only screening procedure which also allows removal of polyps. Thus, many patients choose this option. Richardson reported that fecal occult blood testing declined from 21.1 percent to 11.8 percent over the time period 2002 to 2010.
1. Centers for Disease Control and Prevention, “Vital Signs: Colorectal Cancer Screening, Incidence, and Mortality – United States, 2002 – 2010”, MMWR Morbidity and Mortality Weekly Report 2011 Jul 8; 60(26): 884-9.
2. U. S. Preventive Services Task Force. Screening for Colorectal Cancer. Web. Nov. 27, 2011.
Reviewed December 7, 2011
by Michele Blacksberg RN
Edited by Jody Smith