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Quick Facts
- Despite effective screening CRC continues to be disproportionately (20%) diagnosed at an advanced stage
- The American Cancer Society (ACS) recommends that all asymptomatic adults begin colon cancer screening at age 50 since 90% are diagnosed over the age of 50
- Today, slightly more than 50% of adults older than 50 have been screened
- Recent studies suggest ethnic variations in location of CRC and need for different screening procedures
Colorectal Cancer Screening

CRC is one of the few cancers for which there is an effective method of detecting abnormalities, such as polyps, before cancer ever occurs. Fecal occult blood screening and colonoscopy are recommended methods of colon cancer screening. The American Cancer Society (ACS) recommends that all asymptomatic adults begin colon cancer screening at age 50.1,2 Today, slightly more than 50% of adults older than 50 have been screened. The goal of the ACS is to screen 75% of these individuals by 2015.3Rule

Recommended CRC Screening Procedures

Test/Procedure

Frequency

Fecal occult blood test (FOBT) or Fecal immunochemical test (FIT)

Annually

Flexible sigmoidoscopy (FSIG) (detects cancers in the rectum and sigmoid)

Every 5 years

FOBT or FIT plus FSIG: preferred to either alone*

Annual FOBT or FIT, and FSIG every 5 years

Double-contrast barium enema (DCBE)

Every 5 years

Colonoscopy (detects cancer in the cecum and ascending, transverse, and descending colon)

Every 10 years or follow-up if other screening tests are abnormal

*Individuals at moderate or high risk for CRC should talk with a doctor about a testing schedule. Data from the American Cancer Society. Cancer Facts & Figures 2009.1
Rule

Figure 1. Colorectal system

 

Rule

CRC Myths

There are myths concerning CRC:

Myth:

Colon cancer occurs more often among men than women

Fact:

Colon cancer affects men and women equally

Myth:

Flexible sigmoidoscopy is equivalent to colonscopy

Fact:

Flexible sigmoidoscopy visualizes only the lower portion of the colon;
colon cancer can occur anywhere along the length of the colon
(Figure 1)

Myth:

Colonoscopy procedure is painful

Fact:

Conscious sedation is used, very little discomfort is experienced

Myth:

Preparation for colonoscopy is extensive and difficult to complete

Fact:

Different preparations are available including a “half-volume solution” and laxative pills. Discuss options with the ordering physician or endoscopist about which preparation is best for you

Note: Based on information from University of Michigan Comprehensive Cancer Center, 2007.4

A patient education sheet by Zeller et al (JAMA. 2006;296:1552) which discusses colorectal cancer screening and diagnosis, can be viewed and printed here.
http://jama.ama-assn.org/cgi/reprint/296/12/1552

References 
 

  1. American Cancer Society. Cancers Facts and Figures 2009. Retrieved on June 10, 2009 from http://www.cancer.org/downloads/STT/500809web.pdf
  2. National Cancer Institute. Colorectal Cancer Prevention PDQ®, 2008. Retrieved June 11, 2009 from http://www.cancer.gov/cancertopics/pdq/prevention/colorectal/HealthProfessional/page4
  3. American Cancer Society. Colorectal cancer facts and figures special edition 2005. Retrieved on June 11, 2009 from  http://www.cancer.org/downloads/STT/CAFF2005CR4PWSecured.pdf
  4. University of Michigan Comprehensive Cancer Center. Twelve myths about colon cancer, 2007. Retrieved on June 10, 2009 from http://www.cancer.med.umich.edu/news/colon_myths.shtml
 Article Last Updated On : 8/7/2009 11:12:45 AM

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