UI Advances Colorectal Cancer Awareness
One of the most important things to know about colorectal cancer detection is that screening should be done before you have any symptoms, University of Iowa experts emphasized today.
With March serving as Colorectal Awareness Month, the disease was highlighted at a presentation of the annual State Health Registry of Iowa's "Cancer in Iowa: 2009" report. In addition, UI research efforts are under way to make colorectal screening more available to -- and actually used by -- more people.
The annual report estimates there will be 960 new colorectal cancer cases in women and 860 new colorectal cancer cases in men, collectively accounting for slightly more than one in 10 of all new cancer cases in the state in 2009. Deaths from the disease are estimated at 350 for women and 280 for men, collectively representing approximately one in 10 cancer deaths in the state this year.
"Colon cancer is very curable if caught early. But if it's caught late, mortality is very high. It's important to get screened before you have any symptoms," said Barcey Levy, M.D., Ph.D., professor of family medicine at the UI Carver College of Medicine and a physician with the Family Care Center at UI Hospitals and Clinics.
Levy, who studies colorectal screening, said the incidence of colorectal cancer goes up with age, which is why the recommended age to begin screening is age 50 for those without a family history of the disease. People with a family history should start screenings when they are 10 years younger than the age at which their family member was diagnosed with colon cancer.
"Colon cancer usually starts off as a precancerous polyp. If you find and remove a polyp, you can remove the chance for that particular polyp to become cancerous," said Levy, who also is a member of Holden Comprehensive Cancer Center at the UI.
A common screening method used by many doctors is colonoscopy. However, a less invasive screening can be done with a mail-in test called a fecal immunochemical test (FIT). Levy said less common screenings methods are barium enema-based tests and flexible sigmoidoscopy.
An in-progress research project led by Levy and Bruce Luxon, M.D., UI professor of internal medicine, and funded by the Iowa Department of Public Health has focused on improving access to colorectal screening for high-risk populations in Iowa. The effort found 298 eligible individuals, and of those, 235 returned FIT kits that were provided at no charge.
About 21 percent of the study participants who were tested had positive findings, indicating blood in the stool. These individuals were recommended to have a colonoscopy. More than two-thirds of those undergoing colonoscopy have required a biopsy. Forty percent of those having a colonoscopy have had at least one precancerous polyp removed.
Previous research by Levy focused on screenings in family physician offices. That investigation revealed that only about 46 percent of eligible patients are getting screenings when they should.
"This finding is very similar to national reports that show that the screening rate is about 50 percent," Levy said. "Our study was unique in that we asked the physicians, not patients, why the patients weren't up-to-date. Common reasons were the patient did not come in for regular visits, the physician hadn't discussed it, or the physician discussed the screening but the patient declined."
In a related current project, Levy and colleagues are studying how family physicians can encourage and provide colorectal screenings. Levy noted that this intervention study uses the Iowa Research Network, known as IRENE.