Early Screening for Colon Cancer Greatly Improves Survival Rate by Gina Shaw Somewhere in the midst of all the bleeps and mumbles and the poorly housetrained animals, ìThe Osbournesî has managed to become one so-called ìrealityî show thatís intensely relevant to the real world. Since Sharon Osbourneís colon cancer diagnosis, there hasnít been one episode that hasnít brought home the daily intrusions of the disease: signs on the bedroom door (though often ignored) warning of the need for masks, Ozzy debating anxiously over the animalsí risk to Sharonís chemotherapy-weakened immune system, the vibrant and indomitable Sharon herself frequently in bed and clearly weak, despite her jokes about body parts. March is Colorectal Cancer Awareness Monthóthe perfect time to ask yourself: Do you know how your colon is doing? The good news is that more people can answer ìyesî to that question than ever before. A study published in September 2002 in the Journal of Family Practice found that screening rates for colon cancer among people over the age of 50 increased significantly between 1997 and 1999, from 49 percent to 55 percent. (Whether that rate will improve even more in the wake of the Osbournes-generated awareness remains to be seen.) Now, the bad news: Do the math. If 55 percent of people over 50 are being screened for colon cancer, that means 45 percent of themónearly halfóstill are not getting screenedóand that can have deadly consequences. Colorectal cancer is the second leading cause of cancer-related deaths in the United States for both men and women combined. According to the Journal of Family Practice study, in 2002, approximately 150,000 Americans will be diagnosed with the disease and nearly 56,000 will die from it. Around the world, half a million people die of colon cancer every year, and itís the third most common cancer worldwide. Studies estimate those death rates could be cut by at least one-third if everyone who needed to be screened did so. In February, the American Gastroenterological Association (AGA) released new guidelines for colorectal cancer screening, stressing just how important it is for people age 50 and olderóand younger if there are risk factors in your medical or family historyóto get an initial screening, usually by colonoscopy. ìColonoscopy allows us to visualize the entire colon and to detect and remove polyps in one procedure. Itís invaluable in patients who are at high risk of developing colon cancer,î said Dr. Douglas Rex, a professor at the Indiana University School of Medicine and a member of the AGA task force that developed the screening guidelines. When colon cancer is detected early, before it has spread to the lymph nodes, survival rates are high: about 92 percent over five years. When patients wait too long to be screened and the lymph nodes become involved, however, that rate drops drastically to just 64 percent. So why donít more people get screened? For one thing, some people are still embarrassed about it, theorize the Journal of Family Practice authors, including lead investigator Dr. Laura Seeff of the Centers for Disease Control and Prevention in Atlanta. But come on now, if Sharon Osbourne can talkóin graphic though sometimes bleeped detailóabout medical care for her nether regions in front of millions of people on national television, surely the rest of us can handle a brief, private visit to the doctor. Insurance coverage for colon cancer screening has also been spotty, but thatís starting to improve. In July 2001, Medicare expanded its coverage of colorectal cancer screenings by funding four types of screenings for all beneficiaries. Not all insurance companies fully reimburse for colonoscopies and other screening tests yet, but Medicare coverage tends to point the way for the industry, so one should expect better coverage for these lifesaving tests in the future. People also tend to believe that if they donít have symptoms or a family history, theyíre not at risk. That could not be further from the truth. About 75 percent of new colon cancer cases occur in people whose only risk factor for the disease is their age: 50 or over. Still not convinced that you might need to be screened? Look for the giant colon coming soon to a city near you. Not kidding. As part of National Colorectal Cancer Awareness Month, the Colossal Colon Tour will visit 20 cities across the United States this year. Created by 26-year-old colon cancer survivor Molly McMaster and dedicated to her friend, Amanda Sherwood Roberts, who lost her fight with the disease at age 27, the ìColossal Colonî is a 40-foot long, four-foot high replica ofówhat elseóthe human colon. You can crawl through it or look through viewing windows to see healthy colon tissue, colon disease, polyps and various stages of colon cancer. ìThe colon was modeled after a real colon taken from colonoscopy film footage and is extremely lifelike,î says a release from the Cancer Research and Prevention Foundation, which is sponsoring the tour. It will also feature family-friendly ìeducation stationsî focused on prevention, early detection and treatment. You can find out more about the tour by visiting www.preventcancer.org/colossalcolon/. Gina Shaw is the medical writer for The Washington Diplomat. Screening and Diet Tips If you canít get to the Colossal Colon Tour in the next few months, hereís what you need to know about colon cancer screening and prevention: Get an initial colonoscopy at age 50, or as soon after that as possible. Get screened earlier if you have risk factors, including: ï Personal or family history of benign colorectal polyps ï Personal or family history of colon cancer ï Personal or family history of inflammatory bowel disease, such as ulcerative colitis or Crohnís disease ï Smoking, excessive drinking or obesity Lower your cancer risk by eating a low-fat diet rich in vegetables, fruits and whole grains, and exercise half an hour to an hour every day. Up your folate intake. Several studies have pointed to folate as a possible colon cancer fighter. While the juryís still out, folate, found in leafy green vegetables and many breakfast cereals as well as supplements, is definitely a healthy part of any diet. --Gina Shaw