Colorectal Cancer Deaths Declining, But Millions Still Aren't Getting Screened

Jul 5, 2011

Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, is taking a page from TV anchor Katie Couric by going public about colonoscopy.

Three years ago Couric, whose husband died of colon cancer, had her colonoscopy on camera as a way of encouraging others to have one too. It was so effective that epidemiologists named the resulting increase in colonoscopy tests "the Couric effect."

Now 50-year-old Frieden, hoping for a "Frieden effect," is revealing the results of his recent colonoscopy. His gastroenterologist found four polyps, two of them large. The doctors snipped them out during the procedure.

"Now I anticipate that I will never have colon cancer because I will continue to have follow-ups to ensure that if there are growths, they're removed before they become cancerous," Frieden told reporters during a teleconference to promote colon cancer screening. (He also noted he has a strong family history of colon cancer.)

Frieden's agency, the CDC, also published a report with some good news. Two out of every three Americans between 50 and 75 are up-to-date with colon cancer screening guidelines. That means they've had an annual test for blood in the stool, had a lower-colon exam with a device called a flexible sigmoidoscope once every five years, or had a colonoscopy every 10 years.

By comparison, in 1997 only 41 percent of people in this high-risk age group got with the guidelines.

The CDC says screening prevented 16,000 deaths from colorectal cancer between 2003 and 2007. Screening is responsible for half the decline in colorectal cancer deaths, with the rest due to reduction in risk factors such as smoking and obesity and improved treatment.

Yet for all that, Frieden says 22 million Americans are not getting screened who should.

These laggards — one in three people between 50 and 75 — may be hard to persuade. A 2009 survey found that 31 percent of North Americans would choose not to be screened for colorectal cancer even when offered the screening test of their choice.

But Frieden says the "largest single risk factor for not being screened for colorectal cancer is someone's doctor not recommending that they be screened."

If President Obama's new health insurance law gets implemented as planned, that could help. It will cover colorectal cancer screening along with other proven preventive services, with no out-of-pocket contributions from patients.

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