What has "too early" got to do with cancer detection testing?

Oh no, you say, another one of those health news articles that is going to tell me to do something different with my life. Well how about doing something to save your life like being "too early". What has "too early" got to do with cancer detection testing? Early detection is the key to increasing your odds of surviving cancer and one of the screening tools for Colorectal Cancer, the Fecal Occult Blood Test, will be offered free during the months of March Through June 8th, 2002 by the Marion County Crusade Against Cancer. But more on that later. The immediate question is "What is this about colorectal cancer and especially here in Marion County, MO.?"

Marion County is located in the American Cancer Society's "Heartland Region, which is made up of four states (MO, NE, KS, and OK). There are a little over 400 counties, yet 28 of these counties carry 50% of the cancer burden. Marion County is one of those 28 counties. This means we have a high rate of cancer compared to most of the counties in these four states. There are four types of cancer that make up 52% of the cancer mortality in Marion County. Colorectal cancer (cancer of the colon or rectum) is the number two cause of death from cancer in Marion County. The number one cause of cancer death is lung and bronchial cancer with breast and prostate cancers being three and four, respectively. Of the 363 cancer deaths in Marion County between 1993 and 1997, 11% were caused by colorectal cancer. That amounts to approximately 8 deaths per year from colorectal cancer in Marion County. The reason we need to be concerned about these deaths is that we know that if colorectal cancer is detected early, there is a 90% survival rate among these people. Colorectal cancer is a very slow growing cancer and when detected early it is very treatable and it is also often preventable by making some lifestyle changes. So what are the symptoms of early colon cancer? Often there are no symptoms, which is another reason to get screened. Perhaps better questions would be: "Who is at risk?" "What can I do to reduce my risk and/or prevent this type of cancer?" and "How do I get screened?"

Risk factors for colorectal cancer (CC) include these unmodifiable factors: 1) advancing age (90% of cases occur after age 50), 2) history of inflammatory bowel disease, 3) a personal or family history of colorectal cancer or colorectal polyps, and certain related hereditary syndromes; and a modifiable factor 4) lack of regular exercise. Additionally several other factors that are thought to contribute to the CC risk and these are: 1) low fruit and vegetable consumption, 2) a low-fiber and high-fat diet, 3) obesity, 4) alcohol and tobacco use. Although we can't change the first three factors mentioned we could do something regarding the last four mentioned above as a preventative measure.

Preventing or reducing our risk for CC is concerned with changing the modifiable factors listed above AND regular screening. There are several lifestyle changes that the American Cancer Society recommends to reduce your risk of developing CC. First of all adopting a regular exercise program is essential. Along with that it's important to maintain a healthful weight throughout life. Eating a variety of healthy foods with a low fat, low red meat emphasis and lots of fresh fruits and vegetables and high fiber is another change we can make. Limiting your consumption of alcohol and stop smoking will also help. Finally have regular screening done that is appropriate for you.

Screening for CC is done to detect and remove precancerous growths as well as detect cancerous growths in their early stages. One or more of the following tests are used for screening: 1) fecal occult blood test (FOBT), 2) double contrast barium enema, 3) colonoscopy, and 4) flexible sigmoidoscopy. Even though we know these screening methods are effective they are often under utilized. It is important for you to ask your doctor about these screenings to aid in early detection and/or prevention. The American Cancer Societies' guidelines for CC screening are that anyone over the age of 50 should have regular screenings and those screenings should includes the following five options:

• FOBT every year plus flexible sigmoidoscopy every five years
• Flexible sigmoidoscopy every 5 years
• Total colon examination by colonoscopy every 10 years
• Double-contrast barium enema every 5-10 years
• Yearly FOBT

If you have one or more of the risk factors that were listed earlier, you should begin your regular screenings before age 50. Consult with your doctor for an appropriate recommendation. Additionally if you have any of the following symptoms, be sure to see your doctor:

• Bleeding from your rectum
• Blood in your stool or in a toilet after you have a bowel movement
• A change in the shape of you stool
• Cramping in your lower stomach
• A feeling of discomfort or an urge to have a bowel movement when there is no need to have one

Well now that you know about the importance of screening for CC, I promised your more information about a free screening that will be offered in Marion County during the months of March through June 8, 2002. The Marion County Crusade Against Cancer will be distributing Fecal Occult Blood Test Kits. The kits will be free as will the cost of having them analyzed for positive or negative results. You will be notified of your results. If you are interested in this free screening that could save your life stop by and get a kit at The Marion County Extension Center in the Palmyra Courthouse, Hannibal Regional Hospital, Hannibal Clinic on Grand Avenue, or contact your local American Cancer Society office at 573-221-4660. And Watch for us next March, when we do this again!

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