An effort to eliminate colorectal cancer as a major public health problem
UnityPoint Health – Peoria is proud to be part of “80% by 2018,” a National Colorectal Cancer Roundtable (NCCRT) initiative to eliminate colorectal cancer as a major public health problem. More than 500 organizations have committed to work toward the goal of 80 percent of adults ages 50 and older being regularly screened for colorectal cancer by 2018. The NCCRT, an organization cofounded by the American Cancer Society and the Centers for Disease Control and Prevention, is rallying organizations to embrace this shared goal.
“Colorectal cancer is the second leading cancer killer of both men and women in the United States,” says Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, “but most colorectal cancer can be prevented.”
“A day or two of annoyance is a small price to pay to avoid the risk of months of painful misery and loss of life,” adds Dr. James Ausfahl. “We look both ways before crossing the street to avoid being run over by oncoming traffic—why is it that we fear the colonoscopy that might catch the cancer before it runs us over?”
Early Detection Is Key
Colorectal cancer causes considerable suffering among the more than 140,000 adults who are diagnosed with it each year. The good news is that when adults get screened for colorectal cancer, it can be detected early—when treatment is most likely to be successful—and in some cases, it can be prevented through the detection and removal of precancerous polyps. However, about one in three adults between 50 and 75 years old—around 23 million people—are not getting tested as recommended.
“We are excited that UnityPoint Health – Peoria has become a pledge partner… dedicated to increasing colorectal cancer screening rates in their communities,” says Courtney Heiser of the American Cancer Society. “Screening tests provide the most effective way in detecting colorectal cancer at an early stage, and the 80% by 2018 initiative will help our providers put colorectal health at the forefront.”
Colorectal cancer, commonly known as colon cancer, is estimated to have caused nearly 50,000 deaths during 2015. However, routine testing beginning at age 50 can actually prevent many cases—or find it at an early stage. But because many people are not getting tested, only about four out of 10 are diagnosed at this early stage, when treatment is most likely to be successful.
“I suspect what people fear most is that cancer will be found,” notes Dr. Ausfahl. “There is no doubt that they fear the preparation somewhat, and the procedure as well—it is, after all, rather embarrassing to think about having it done. But compared to the fear of finding cancer, that seems to me to be small. Of course, finding the cancer when it is small and more easily addressed is by far less fearful and miserable than waiting until it’s obvious and likely to be beyond treatment. People often don't think through the fact that the cancer will, if present, continue to get worse with time.”
Targeting the Unscreened
In order to get to 80 percent, the NCCRT’s Public Awareness Task Group targeted three key unscreened audiences: the “Newly Insured”; the “Insured Procrastinators/Rationalizers”; and the “Financially Challenged.” Demographic and psychographic data were assessed to determine which audiences were best to microtarget:
- Age. More likely to be younger than those screened; nearly two thirds are 50 to 59 years of age.
- Insurance status. More likely to be uninsured (nearly one quarter) than those screened.
- Income. Slightly lower income than those screened, with more than half earning under $40,000 per year.
- Race/ethnicity. More likely to be Hispanic than those screened (nearly two in 10).
- Education. Slightly more likely (around seven in 10) to have less than a four-year college degree than those who have been screened.
- Cancer connection. Less likely to be a cancer survivor and less likely to have a close friend or family member with cancer than those screened (just over half).
The American Cancer Society recommends colon cancer screening begin at age 50 for people at average risk. Those with certain risk factors that make them more likely to develop colon cancer—such as family history or colon problems—should start screening earlier, or get tested more often. Talking to your doctor is the best way to determine when to begin screening.
“Not everyone is willing to undergo colonoscopy,” says Dr. Ausfahl. “The FIT screening or ‘virtual colonoscopy’ is better than nothing, but not as good as the ‘gold standard’ of colonoscopy—if for no other reason than that it can not only detect, but often handle the issue.”
The death rate has been dropping for the last 20 years, largely because of increased screening. Yet fewer than six in 10 American adults ages 50 to 75 were up-to-date on screening in 2013. Those less likely to get tested include people with lower education and income, and those without health insurance. Approximately one in 20 Americans will be diagnosed with cancer of the colon or rectum in their lifetime. iBi