At work with the CDC

Screening is key to preventing colorectal cancer

By Georgia Moore, MS

Although cancer of the colon and rectum (colorectal cancer) is the second leading cause of cancer-related deaths in the United States, it is also one of the most preventable. The key to prevention is to encourage and enable people age 50 or older to get screened routinely.

The American Cancer Society (ACS) estimates that in 2001 there will be 135,400 new cases of colorectal cancer, and 56,700 people will die from the disease. Colorectal cancer treatment costs more than $6.5 billion per year and is second only to breast cancer ($6.6 billion per year).

The risk for colorectal cancer increases with age, and nine out of 10 cases occur in people 50 years old and older. Routine screening of this age group is especially important because three out of four colorectal cancers occur in average-risk people with no known risk factors for the disease. People at increased risk are those with a personal or family history of colorectal polyps, cancer or inflammatory bowel disease. Lack of physical activity also increases risk.

People who have colorectal polyps (growths that sometimes become cancerous) or early-stage colorectal cancer usually have few or no symptoms initially. When present, signs and symptoms may include rectal bleeding, pain, blood in the stool and a change in bowel habits.

Many cases of and deaths from colorectal cancer can be prevented by screening for and removing colorectal polyps and by detecting and treating the cancer in its early stages. The challenge, however, is getting people screened. Statistics show that only 37 percent of colorectal cancers are diagnosed before the cancer has spread to other organs. This fact underscores the need to increase awareness of the effectiveness of screening and to promote the widespread use of colorectal cancer screening at regular intervals.

According to the Partnership for Prevention, a national, nonprofit organization dedicated to preventing disease and promoting health, employers can do the following:

• Ensure that employee health insurance covers routine screening with minimal or no copayments;

• Offer flexible work schedules to facilitate use of preventive health services, including colorectal cancer screening;

• Encourage employees to use preventive health services by providing educational materials, intraoffice e-mails, or reminders in employee paycheck envelopes;

• Arrange for worksite wellness programs to help employees lower cancer risk through increased physical activity, nutritious food choices, and appropriate weight loss.

Resources

The Centers for Disease Control and Prevention can provide employers with the information and tools they need to educate their employees about colorectal cancer screening, including information on the benefits of screening, screening procedures and current screening guidelines.

CDC also makes available to employers the "Screen for Life" colorectal cancer education campaign to use in the workplace. Materials—including brochures, posters, and radio public service announcements (PSAs)—can be viewed, downloaded, or ordered at: www.cdc.gov/cancer/screenforlife/preview.htm . Television PSAs can be previewed on the site but must be ordered by e-mailing cancerinfo@cdc.gov. Materials may take up to several weeks to arrive.

Georgia Moore is a health communications specialist at the CDC in Atlanta. For a bibliography of the research used to prepare this article, contact the author at gbm7@cdc.gov.

Screening recommendations

Several organizations recommend regular screening of all average-risk adults who are 50 years or older, using one or a combination of the following:

• Fecal occult blood test (FOBT) every year,

• Flexible sigmoidoscopy every 5 years,

• Total colon examination by colonoscopy every 10 years or by double-contrast barium enema every 5-10 years.

People at higher risk should talk with their doctors about whether they need a more intensive or frequent screening schedule.

 

Georgia Moore. Screening is key to preventing colorectal cancer. Business and Health 2001;6:40.