Y o u r C o u n t y

C r u s a d e

A g a in s t C a n c e r

COLORECTAL CANCER

Let’s Get Talking . . .

(colorectal cancer) It can be “embarrassing” to talk about colorectal

cancer

DON’T DIE FROM EMBARRASSMENT

Colorectal Cancer CAN Be Prevented

S o , L e t s G e t T a

l k i n g . . .

Colorectal Cancer Overview Where & What is the Colon? What is Colon Cancer? Why the Concern? Who’s at Risk? What Can be Done?

– Prevention– Screening– Treatment

Where to Get More Information

Where is the Colon ?

What does it do?As part of the digestive system the colon:

– Stores mainly non-absorbed food, fiber and water

– Re-absorbs nearly all the water

– Moves solid waste to the rectum where it is eliminated by defecation

What is cancer?

Cancer is the uncontrolled growth and spread of abnormal cells.

It includes 100’s of different diseases, usually classed by the part of the body where it is first found.

How does colorectal cancer develop? Most colorectal cancers begin as polyps, or

tiny abnormal growths on the inside walls of the colon or rectum.

Polyps vary in size, from tiny to a few centimeters.

Some polyps become cancerous after several years and should be removed to prevent development of colorectal cancer.

X-Ray of Colon and Polyps

Why the Concern? 4th leading cause of cancer-related

death in world 2nd leading in US

– Why a difference between world and US ?– Stay tuned

2nd leading in Missouri 2nd leading in YOUR County

Who Is At Risk of Developing Colorectal Cancer? Men AND Women are at similar risk

Risk increases with age– 90% occurs in people aged 50 +

85% of people with colorectal cancer had NO medical history related to colorectal cancer.

What are Risks for Developing Colorectal Cancer? Poor Diet

– high amount of fats– high amount of red meat– high temperature cooking of red meats– low amount of vegetables– high alcohol consumption– low water consumption

What are Risks for Developing Colorectal Cancer? Physical inactivity

Why the Difference Between World and U.S. Rates?

Colorectal Cancer has been Called a “Cancer of Economically

Developed Countries”– Diet is different– Physical activity is different

Ways to Reduce Your Risk

Regular moderate exercise

Healthy diet Proper weight Avoid smoking Limit alcohol use GET REGULAR

SCREENING

Ways to Reduce Your Risk

Healthy Diet

“Five-A-Day” is 5 servings of fruits & vegetables / day

This can reduce your risk for a number of diseases, including some types of cancer, such as colorectal cancer

Ways to Reduce Your Risk

Physical activity recommendations:– For 30 minutes (can be three

10 -minute segments)– At least 5 times per week– At the pace of brisk walking

Other possible risk reducers

Aspirin

Non-steroidal anti-inflammatories

Calcium

Vitamin D

Screening is KEY ! American Cancer Society estimates for

the impact of colorectal cancer in 1999:– 129,400 cases diagnosed in the U.S.– 56,000 deaths in the U.S.– 1,300 deaths in Missouri

At least 1/3 of deaths could be reduced with widespread adoption of screening.

Don’t wait...

Colorectal cancer can develop with few or no symptoms at first.

Screening can lead to reductions in the number of deaths:– FOBT: 33%– Flexible sigmoidoscopy: 70%– Colonoscopy: 80%

How does screening save lives?

Prevention– By finding polyps in the colon and

removing them before they become cancerous

Early detection– Finding cancer early when treatment works

best

Who should be screened for colorectal cancer?

EVERYONE aged 50 and older:– Women and men– All races and ethnicities

May be younger than 50 for those with a family history of colorectal cancer or colorectal polyps (talk to your doctor!)

Why don’t some people get screened?

Don’t think they are at risk for colorectal cancer

Embarrassed to ask their doctor

Think it will hurt

Don’t realize that screening is covered by their insurance plans, including Medicare

The screening tests

Fecal Occult Blood Test (FOBT)

Flexible Sigmoidoscopy

Colonoscopy

Double Contrast Barium Enema

Fecal Occult Blood Test (FOBT) Looks for hidden (occult) blood in the

stools

Stool sample is collected at home

Test preparation will likely include dietary and medicinal restrictions (check test kit instructions)

Example of One Type of FOBT

Positive test results may be due to: Colorectal cancer or polyps. Failure to follow pre-test dietary and medicinal

restrictions. Other bowel disorders which could cause

bleeding (though not always a lower GI source):– colitis - diverticulitis - hemorrhoids, among others

Follow-up is IMPORTANT- your physician will usually recommend a full colon exam using colonoscopy or barium enema.

Fecal Occult Blood Test

Annual screening can lead to 33% reduction in deaths

Annual FOBT test is worth the effort !!!

Flexible sigmoidoscopy Uses a flexible lighted tube to

examine the inside of the lower part of the colon (sigmoid).

The slender tube allows for discovery of polyps.

Polyps can be removed during sigmoidoscopy or by

a follow-up colonoscopy.

Flexible Sigmoidoscopy

Regular screening can lead to 70% reduction in deaths

Regular Flexible Sigmoidoscopy is worth the effort !!!

Colonoscopy Uses a flexible lighted

tube to examine the inside of the entire colon

The slender tube allows for removal of polyps and tissue for biopsy

Colonoscopy

Regular screening can lead to 80% reduction in death

Regular Colonoscopy is worth the effort !!!

Double Contrast Barium Enema Radio-opaque liquid

with barium put into colon

Barium coats lining of colon and rectum

Allows organs and any signs of disease to show more clearly on x-rays

Double Contrast Barium Enema

Regular screening can lead to 80% reduction in deaths

Regular Barium Enema is worth the effort !!!

American Cancer Society recommendations for screening For adults aged 50+ with no family history

of colon cancer or polyps:– Annual FOBT PLUS– Flexible sigmoidoscopy every 5 years - - OR - -– Total colonic exam

• Colonoscopy every 10 years; or• Double-contrast barium enema every 5-10

years

Treatment More than 90% of people whose

colorectal cancer is treated early survive at least 5 years after their diagnosis

Only 8% of people who are diagnosed in later stages survive past 5 years

THIS IS WHY SCREENING IS SO IMPORTANT !!!

Remember…Lifestyle risk reducers:Healthy food choices Maintain a healthy weight

Physical activityAvoid smoking

Plus screening tests...FOBT and *** Colonoscopy or

Sigmoidoscopy *** Double contrast barium enema

Combine to save lives!

Where Can You Get Screening?

Talk to your health care professional

Where Can You Get More Info?

American Cancer Society33 East Broadway, Suite 100 Columbia MO 65203

573-443-1496 800-429-7753 ed.johnson@cancer.org www.cancer.org

Toll-free National Phone 1-800/ACS-2345

Where Can You Get More Info? Missouri Department of Health & Senior Services

Bureau of Cancer ControlP.O. Box 570 920 Wildwood Jefferson City MO 65102

ph 573/522-2841fax 573/522-2899e-mail cowans@dhss.state.mo.us

Presented in Cooperation of

Your County Community Council of the American Cancer Society

Missouri Department of Health . & Senior Services Bureau of Cancer Control

Special thanks to the

U.S. Centers for Disease Control & Prevention