March 13, 2006
CORRECTION: Most Americans still skip colon screening
By Anne Harding
NEW YORK (Reuters Health) - Three out of four Americans
aged 50 to 70 aren't getting regular colon cancer screening,
according to a survey sponsored by the maker of a new screening
test for the disease.
Colon cancer is currently the second leading cancer killer
in the United States, with 60,000 Americans expected to die
from the disease this year.
The American Cancer Society recommends that starting at age
50 everybody should discuss colon cancer screening with their
doctor and get tested. But 26 percent of the 1,200 people
surveyed said their doctor had never discussed colon cancer
screening with them, and 24 percent said they didn't get
screened because they had no symptoms of the disease.
Twenty-eight percent said they didn't want to have a
colonoscopy, which is one of the test options.
Dr. David Stein, director of education for the Colon Cancer
Foundation and the chief of the division of colorectal surgery
at Drexel University College of Medicine in Philadelphia,
points out that this test isn't something most people are
comfortable chatting about around the water cooler, despite
efforts by Katie Couric and others to raise awareness of the
need for colon cancer screening. "The stigma of a colonoscopy
is pretty significant," he told Reuters Health.
However, if a person with no family history of the disease
has a colonoscopy at 50, the doctor performing the test is able
to review the entire colon, and no problems are found, he or
she doesn't need to have the test again for 10 years, Stein
added. "At 50 you can go get it done and you're good 'til 60,"
The American Cancer Society points out that besides having
a colonoscopy every 10 years, there are several other
colorectal cancer early detection tests:
-- A yearly fecal occult blood test (FOBT)
-- Flexible sigmoidoscopy every five years
-- Yearly FOBT and flexible sigmoidoscopy every five years
(preferred over either FOBT alone, or flexible sigmoidoscopy
--Double-contrast barium enema every five years
However, if any of these tests are positive, they should
always be followed up with colonoscopy, the ACS points out.
Also, it says that people with a family or personal history of
colon cancer or polyps, or history of chronic inflammatory
bowel disease, should be tested earlier than age 50, and may
need to undergo testing more often.
The current survey, conducted by Harris Interactive, was
sponsored by EXACT Sciences Corporation, a Marlborough,
Massachusetts-based company that discovers and develops
technologies that assist in colon cancer screening.
Stool DNA tests, which can be done at home, have a roughly
60 percent rate of detection, and rarely yield false-positive
results. "When it does detect something, it's pretty accurate,"
Such non-invasive tests are better than nothing for people
who refuse to have colonoscopies, according to Stein.
The worst thing about a colonoscopy is not the test itself,
which is usually performed with some sort of anesthesia, Stein
noted, it's the preparation beforehand -- in which a person
takes laxatives and, in some cases, enemas to clear the bowel.
Virtual colonoscopy, in which a CAT scan or MRI is used to scan
the bowel, still requires the colon-clearing prep, Stein said,
while its effectiveness remains controversial and insurance
does not cover it.
Despite the prep's unpleasantness, Stein added, it's a
small price to pay for a test that can be lifesaving. "In the
big picture it's a no-brainer."