Cancer screening can save lives

By Robert Madoff, M.D.

March is Colorectal Cancer Awareness Month. Why is increasing awareness about colorectal cancer important?

First, cancer is the leading cause of all deaths in Minnesota. Colorectal cancer is second to lung cancer as the leading cause of cancer death in Minnesota and the United States. In 2006, there will be an estimated 2,400 new cases of colorectal cancer in the state and almost 900 deaths from the disease.

But, more importantly, colorectal cancer is largely preventable with appropriate screening. Many are surprised to learn that the main goal of colorectal cancer screening is not to diagnose cancers that already are present. Colorectal cancer almost always arises from benign (non-cancerous) polyps, and this progression takes many years. Identification and removal of these polyps stops this progression and prevents that potential cancer from forming.

The secondary goal of screening is to diagnose cancer at an early stage, when it is highly treatable. The vast majority of patients who undergo screening have either normal examinations or benign polyps only.

For average-risk individuals who have no symptoms, screening should begin at age 50. Individuals with a family history of colorectal cancer, who have had colitis (inflammation of the colon) for longer than 10 years, or who have certain uncommon hereditary conditions have a higher risk and need earlier or more frequent screening.

If you have symptoms, such as rectal bleeding or changes in your usual bowel habit, you should be evaluated by your doctor. These symptoms are usually due to an innocent cause, but require evaluation to be certain. Screening can be performed in a few ways, including testing stool for hidden blood annually or examining the bowel with a lighted tube (colonoscopy). If you are at average risk, and your colonoscopy screening is normal, you don't need another one for 10 years.

We have made important progress in the fight against colorectal cancer. Between 1988 and 2003, the incidence of colorectal cancer has decreased 17 percent and deaths from the disease have decreased 25 percent. These gains are due both to increased screening and improved treatment.

But there is more to be done. Currently, only about 60 percent of Minnesotans are considered up to date with colorectal cancer screening, compared with 80 percent for breast cancer (mammography) and 88 percent for cervical cancer (Pap smears).

Cancer Plan Minnesota 2005-2010, the state's comprehensive cancer-control plan, recognized the importance of colorectal cancer screening by selecting it as one of its four initial priorities in its efforts to reduce the cancer burden among Minnesotans. You, too, should consider it a priority.

For more information, visit or call:

• American Cancer Society, www.cancer.org, or 1-800-227-2345.
• University of Minnesota Cancer Center, www.cancer.umn.edu, or 1-888-CANCER MN (888-226-2376).

Robert Madoff, M.D., is professor of surgery at the University of Minnesota Medical School and a member of the University's Cancer Center. He sees patients through University of Minnesota Physicians. This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu.