Columbia Weill Cornell Cancer Centers Prevention Newsletter



	Spring 2003, Issue 1 Home From the Editors Calendar of Events

	Colorectal Cancer: Raising Awareness, Saving Lives Population Screening for Cancer-Related Inheritable Gene Mutations This One is Not Debatable-Colon Cancer Screening Can Save Lives News from the War on Cancer Colorectal Cancer Virtual Colonoscopy Cancer Prevention Working Group Defines Endpoints to Promote Cancer Prevention Research Cancer Prevention Clinical Trials Cancer Prevention Legislation (Federal) Cancer Prevention Legislation (State) Make Your Voice Heard

Colorectal Cancer

What You Should Know
Each year, over 147,000 Americans will be diagnosed with colorectal cancer, making it the third most common cancer in both men and women. And over 57,000 Americans will die from this disease. The key to success in reducing the number of these deaths is prevention. Early detection is integral to that process. An awareness of risk factors, a knowledge of signs of the disease, and adherence to screening guidelines can help reduce your chances of developing this malignancy. Two good places for more information on colorectal cancer are the National Cancer Institute of the National Institutes of Health at www.cancer.gov and the American Cancer Society at www.cancer.org.

Risk Factors

Family history of colorectal cancer
Personal history of colorectal cancer
Personal history of polyps or inflammatory bowel disease
Hereditary conditions, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer
Age 50 or older
A diet based mainly on animal sources, rather than fruits, vegetables, and grains
No exercise.
Obesity
Tobacco use

Signs of Possible Colorectal Cancer

Change in bowel habits.
Bloody stool
Unusually narrow stools
Diarrhea
Constipation
Feeling that the bowel does not empty completely.
Abdominal discomfort, such as cramps, gas pains, fullness, or bloating
Vomiting
Constant fatigue
Unexplained weight loss

Colorectal Screening Guidelines

The colorectal screening guidelines shown below were developed by the American Cancer Society (www.cancer.org). You can use this information to discuss your own screening options with your physician.

American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer - Average-Risk Women and Men Ages 50 and Older
Test	Interval (beginning at age 50)	Comment
Fecal occult blood test (FOBT) & flexible sigmoidoscopy	FOBT annually and flexible sigmoidoscopy every 5 years	Flexible sigmoidoscopy together with FOBT is preferred compared with FOBT or flexible sigmoidoscopy alone. All positive tests should be followed up with colonoscopy.*
Flexible sigmoidoscopy	Every 5 years	All positive tests should be followed up with colonoscopy.*
Fecal occult blood test	Yearly	The recommended take-home multiple sample method should be used. All positive tests should be followed up with colonoscopy.*, †
Colonoscopy	Every 10 years	Colonoscopy provides an opportunity to visualize, sample and/or remove significant lesions.
Double contrast barium enema (DCBE)	Every 5 years	All positive tests should be followed up with colonoscopy
* If colonoscopy is unavailable, not feasible, or not desired by the patient, DCBE alone, or the combination of flexible sigmoidoscopy and DCBE are acceptable alternatives. Adding flexible sigmoidoscopy to DCBE may provide a more comprehensive diagnostic evaluation than DCBE alone in finding significant lesions. A supplementary DCBE may be needed if a colonoscopic exam fails to reach the cecum, and a supplementary colonoscopy may be needed if a DCBE identifies a possible lesion, or does not adequately visualize the entire colorectum. † There is no justification for repeating FOBT in response to an initial positive finding.


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