There’s encouraging news for the millions of Americans at risk for colon cancer. A new, easy-to-use fecal occult blood test (FOBT) is available for at-home screening and is designed specifically to detect colon cancer at its earliest stages.
Hemoccult ICT is a new, safe and affordable FOBT screening option for colon cancer-the second leading cause of cancer-related death in the United States. Despite its high incidence, colon cancer is a highly treatable cancer, with a 90 percent survival rate when detected early. Unfortunately, only half of the more than 80 million Americans over age 50 have been screened for colon cancer.
The American Cancer Society recommends annual screening with a FOBT for both men and women beginning at age 50. Annual colon cancer screening with FOBT has been proven to decrease mortality by 33 percent when compared with no screening. Because colon cancer can take three to 10 years or longer to develop in the average patient, it is important to begin screening prior to developing symptoms.
FOBT vs. Colonoscopy
For years colonoscopy has been the most well-known test in colon cancer screening. While widely regarded as the gold standard, colonoscopy does have some drawbacks:
• Colonoscopy costs between $300 and $1,000, and while covered by insurance for many, millions of Americans lack health insurance.
• Standard colonoscopy can be overwhelming for some people due to the fact that the procedure is usually done under sedation, and because patients are required to follow a special diet and take a very strong laxative before the exam.
• Due to a limited number of trained professionals and the equipment needed to perform the tests, the maximum number of colonoscopies that can be performed in the United States each year can accommodate only a quarter of the Americans in need of screening.
Unlike other available FOBTs, the new Hemoccult ICT has no drug or dietary restrictions-allowing people to begin testing at their convenience. If a test comes back positive, a follow-up colonoscopy typically is recommended.
Colon cancer patients who are 65 and older may benefit from a caregiver’s involvement, and caregivers may ultimately have a major impact on patients’ disease management, according to a survey of oncologists commissioned by the Alliance for Aging Research.
Ninety percent of oncologists feel that caregivers have a moderate to major impact on the decision-making process. Unfortunately, only about 64 percent of colon cancer patients in this age group have caregivers’ support.
“Physicians should encourage patients to enlist a caregiver and involve them in the treatment decision-making process,” said Dr. Stuart Lichtman, associate attending physician at the Memorial Sloan-Kettering Cancer Center.
More than half of oncologists who agree that colon cancer patients 65 and older have a more difficult time managing their disease than younger patients also agree that these patients are generally less proactive about researching available treatment options. Seventy-seven percent said that such patients experienced better disease outcomes with a caregiver’s involvement due to increased communication. Additionally, caregivers play an important role in providing emotional support, participating in doctors’ visits and in decisions about disease management options and providing transportation to appointments.
“It is clear that caregivers are key to ensuring that colon cancer patients 65 and older receive the best care,” said Daniel Perry, executive director of Alliance for Aging Research. “Since managing colon cancer can be a complicated and confusing process especially for the aging population, a caregiver, whether a spouse, child, friend or neighbor, should be actively involved.”
“Crossing Jordan” star Miguel Ferrer, who lost his father, José Ferrer, to colon cancer, is partnering with the Alliance for Aging Research in a program called “Caring for the Aging,” to educate colon cancer patients and caregivers about the importance of active involvement in the treatment of the disease. This awareness program is sponsored by sanofi-aventis.
“The involvement of my stepmother helped ease my father’s decision-making process as he went down a difficult path,” Ferrer said. “I encourage all caregivers and family members to become actively involved and ask the right questions to ensure the best possible outcomes for their loved one.”
There is good news for those concerned about colon cancer. Physicians know that colon cancer screening saves lives. Yet an estimated 148,000 Americans, both women and men, are diagnosed with colorectal cancer each year, and every year approximately 55,000 will die-the nation’s second deadliest cancer. Yet, it’s believed most of these deaths could be prevented through proper screening.
However, experts from the American College of Gastroenterology (ACG) warn that too few Americans are getting screened. Colorectal screening rates remain very low, even though Medicare and many private plans pay for screening tests.
Despite increasing public awareness of colon cancer screening tests through the efforts of Katie Couric and others, many people continue to face obstacles to screening. Even Medicare beneficiaries, for whom incidence and death from the disease are highest, encounter problems with access to screening colonoscopy.
Congress Can Help
“Pending legislation in the U.S. Congress, such as the Colon Cancer Screen for Life Act (S.1010/ H.R. 1632), promises to remove Medicare’s barriers to screening,” says ACG President Dr. Jack A. DiPalma of Mobile, Alabama. “But only one small improvement, the waiver of the Medicare deductible, was approved for 2006, so much remains to be done.”
Research indicates that colon cancer arises from precancerous growths or polyps that grow in the colon. When detected early, these growths or polyps can be removed, actually preventing the development of colon cancer.
“With improved use of colon cancer screening, we can save lives,” adds Dr. DiPalma.
The College currently recommends colonoscopy every 10 years beginning at age 50 for average-risk individuals as the preferred screening strategy to prevent colon cancer.
For patients with higher risk factors such as a family history of colon cancer or a previous personal history of polyps, and for African Americans, ACG recommends earlier and/or more frequent screening with colonoscopy.
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States for both women and men. This disease surpasses both breast and prostate cancer in mortality, second only to lung cancer in the number of cancer deaths. Despite the fact that it is highly preventable, it is estimated that 148,610 new cases of colorectal cancer will be diagnosed and 55,170 people will die from the disease in 2006. However, when detected and treated early, colorectal cancer has a five-year survival rate of greater than 90 percent. For that reason, routine screening is vital in the prevention and detection of this deadly disease.
According to the American Cancer Society, “beginning at age 50, both men and women at average risk for developing colorectal cancer should follow one of these five testing schedules:
• yearly fecal occult blood test (FOBT)* or fecal immunochemical test (FIT)
• flexible sigmoidoscopy every five years
• yearly FOBT* or FIT plus flexible sigmoidoscopy every five years**
• double-contrast barium enema every five years
• colonoscopy every 10 years
* For FOBT, the take-home multiple sample method should be used.
** The combination of yearly FOBT or FIT plus flexible sigmoid-oscopy every five years is preferred over either of these options alone.
All positive tests should be followed up with colonoscopy.”
One simple, easy-to-use test is Quidel’s QuickVue® iFOB test. QuickVue iFOB is a fecal immunochemical test (FIT) where the sample is collected by the patient in the privacy of his/her home and mailed to the physician for testing. The test detects the presence of blood in stool specimens, an indication of a number of gastrointestinal disorders, including colorectal cancer.
The QuickVue iFOB test requires only one specimen. Because it is specific to human hemoglobin (blood), there are no dietary restrictions and only certain medication restrictions, distinguishing it from guaiac-based tests that have onerous restrictions. In fact, according to the American Cancer Society, in comparison with guaiac-based tests, commonly known as Fecal Occult Blood Tests (FOBTs), immunochemical tests are more patient-friendly.
“We are committed to saving lives through early screening and detection of colon cancer,” said John Tamerius, Ph.D., Vice President, Clinical and Regulatory Affairs, Quidel Corporation. “We believe our unique, patient-friendly sample collection device makes this screening process as easy as possible for the patient.”
Despite these recent advancements in CRC screening, less than 50 percent of people age 50 or older have had a recent test. There appears to be a significant opportunity for CRC prevention since it takes an average of 10 years for cancerous cells to develop. Therefore, if you’re over the age of 50 or have a family history of colon cancer, you should speak with your physician about taking an iFOB test. The test is simple, takes a minimal amount of time and may help save your life.
Cancer occurs when something goes wrong with this system, causing uncontrolled cell division and growth. Colon cancer is cancer of the large intestine (colon), the lower part of your digestive system. Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Rectal cancer is cancer of the last 6 inches of the colon. Together, they’re often referred to as colorectal cancers.
Colorectal cancer is the second most common cancer killer overall and third most common cause of cancer-related death in the United States in both males and females. Who is at risk for colorectal cancer. Men tend to get colorectal cancer at an earlier age than women, but women live longer so they catch up with men and thus the total number of cases in men and women is equal. Women diagnosed with uterine or ovarian cancer before age 50 are at increased risk of colorectal cancer. Woman with a personal history of breast cancer have only a very slight increase in risk of colorectal cancer. The average age to develop colorectal cancer is 70 years, and 93% of cases occur in persons 50 years of age or older. You have a higher risk for colon cancer if you have:
Cancer elsewhere in the body.
Colorectal polypsCrohn’s disease
Family history of colon cancer
Personal history of breast cancer
What are the symptoms of colorectal cancer. Symptoms of colorectal cancer vary depending on the location of the cancer within the colon or rectum, though there may be no symptoms at all. The most common presenting symptom of colorectal cancer is rectal bleeding. Cancers arising from the left side of the colon generally cause bleeding, or in their late stages may cause constipation, abdominal pain, and obstructive symptoms. On the other hand, right-sided colon lesions may produce vague abdominal aching, but are unlikely to present with obstruction or altered bowel habit. Other symptoms such as weakness, weight loss, or anemia resulting from chronic blood loss may accompany cancer of the right side of the colon.
If your doctor learns that you do have colorectal cancer, more tests will be done to see if the cancer has spread. Colonoscopy is currently the only test recommended for colorectal cancer screening in average-risk persons at 10 year intervals. Colonoscopic surveillance (also called screening colonoscopy) needs to be available at more frequent intervals for individuals at high risk for colon cancer (for instance, those with a personal history of colorectal cancer or adenomatous polyps; family history of colorectal cancer; non-hereditary polyposis; colorectal cancer; or a pre-disposing condition such as inflammatory bowel disease.
The first step to avoiding this ailment is prevention with regular tests at the doctor, but there are other ways of getting around this disease in between checkups. Nevertheless, it appears that increasing the fiber content in the Western diet would be useful in the primary prevention of colorectal cancer. It is recommended that physical activity messages promoting at least 30-45 minutes of moderate to vigorous activity on most days of the week be included in primary prevention interventions for cancer. The population prevalence for meeting proposed physical activity criteria for colon cancer prevention is low and much lower than that related to the more generic public health recommendations.
Our bodies need lots of calcium and not only for building strong bones. Colon cancer prevention is one of the most exciting uses for calcium. However, instead of using calcium supplements, this study relied on low-fat dairy products to supply 1,200mg calcium per day. Investigators found this amount of calcium decreased the incidence of changes in the cells lining the colon, which is often seen in the initial stages of colon cancer. A significant protective factor is adequate dietary calcium intake during the period of maximum growth (ages 9 and 25 y), so that proper peak bone mass is achieved by age 20and 30 y and maintained until mid-life, with only slow bone loss in the following years. As already noted, dietary surveys indicate a significant gap between the recommended calcium intake and the actual intake in the United States in the critical years of adolescence and young adulthood and later in life. In addition, several large-scale, recent studies in humans indicate a role for increased dietary calcium in reducing colon cancer risk, as briefly discussed below.
Both men and women are equally at risk for colorectal cancer. Men over the age of 50 and women over 55 should have this test on an annual basis to detect colon cancer early. Yet colorectal cancer is the third most common malignancy in women after breast and lung cancer. Incidence is slightly higher in men than women, and is highest in African American men. It is believe that the time has come for a full scientific review of cereal-grain enrichment with calcium and vitamin D as a low-cost, safe, and useful route for the reduction of osteoporosis and colon cancer in the United States in both men and women.
Colorectal cancer is 90 percent preventable and 90 percent treatable when detected early, yet it continues to be the second leading cause of cancer-related death in the United States.
To help spread the message about the importance of early detection, the Cancer Research and Prevention Foundation and its 54 partners have joined together to celebrate National Colorectal Cancer Awareness Month by introducing the “Buddy Bracelet,” a unique and powerful way to promote public awareness of the disease.
“Today, in a sea of colored bracelets, the blue Buddy Bracelet stands out by creating a clever way for people to take their health into their own hands,” said Carolyn Aldigé, president and founder of the Cancer Research and Prevention Foundation. “The bracelet spreads the message that colorectal cancer is preventable, treatable and beatable.”
Launched in 2004 to celebrate National Colorectal Cancer Awareness Month, the Buddy Bracelet reminds those who wear it to get screened for colorectal cancer. After the person is screened, he or she gives the bracelet to a family member, friend or colleague, passing on the powerful message about talking with a health care professional about colorectal cancer. The bracelet then is transferred from that person to another person and so on.
The bracelet’s theme, “Wear it, share it, because you care,” is a message that could save thousands of lives.
People at average risk for
colorectal cancer should get screened starting at age 50. Younger people can help support the Buddy Bracelet effort by learning about their families’ medical histories, starting a dialogue about colorectal cancer with their health care professionals and reminding loved ones to get screened.