U.S. Cancer Deaths Down But Far Too Few Americans Screened for Colon Cancer

Screening Rates Worst Among Racial Minorities, the Uninsured and
Medicare Patients



BETHESDA, Md., Feb. 20 /PRNewswire-USNewswire/ -- New data revealing
decreasing trends in cancer deaths in the United States overall, and in
colorectal cancer deaths in particular, highlight the remarkable benefits
of colorectal cancer screening tests, but the lifesaving potential of these
tests is unrealized for many Americans, according to experts from the
American College of Gastroenterology. Racial minorities, uninsured
Americans and even Medicare patients who should be tested are not being
screening appropriately, and other recent studies reveal that they are
diagnosed with more advanced cancers compared to patients with private
insurance.



Today, the American Cancer Society reported a downward trend in cancer
deaths between 2004 and 2005. Deaths from cancer of the colon and rectum
decreased from 1998 to 2004 among both men and women, according to ACS. The
report attributes early detection to this sharp decline in colon cancer
deaths. Early detection of colorectal cancer, when it is most treatable,
directly results in improved survival, exceeding 90 percent when detected
at the earliest stage.



According to ACG President Amy E. Foxx-Orenstein, D.O., FACG, "The good
news is that colorectal cancer deaths are down, but marked differences in
the experience of colorectal cancer, its impact on quality of life, and
death rates are seen between whites and blacks, and between the uninsured,
and even those with health coverage under Medicare and Medicaid." According
to Dr. Foxx-Orenstein, "The American College of Gastroenterology is
committed to national policy changes to improve access to colorectal
screening and increased use of these proven prevention strategies,
including reversing Medicare's massive cuts to reimbursement for these
tests since the benefit was first introduced, as well as to payments in
ambulatory surgery centers where many screening tests are performed."



Recent Studies Reveal Underuse of Colorectal Screenings, Late Stage
Cancer Diagnoses

An analysis published in ACS' journal CANCER in January 2008 of over
150,000 Medicare beneficiaries revealed that only 25 percent received
recommended screenings for colorectal cancer since Medicare started to
cover preventive screening tests. This finding reflects a significant
underuse of proven screening tests among Medicare patients, and echoes
other recent findings that Medicaid patients and the uninsured generally
are being diagnosed with colorectal cancer at later stages, when the
prognosis is far worse.



A study by Halpern et al. published in The Lancet Oncology on February
18, 2008 found a correlation between insurance status and stage of cancer
diagnosis. According to the Halpern analysis, uninsured patients were two
to three times more likely to be diagnosed at late stages (Stage III or
State IV) than at Stage I. The disparity was most pronounced among cancers
that could be detected early through screening or symptom assessment
including colorectal cancer. The analysis also looked at racial background
and found late state diagnosis for ten of twelve cancers among African
Americans compared to whites.



ACG Recommends Earlier Screening for African-Americans: Begin at Age 45

African-Americans are diagnosed with colorectal cancer at a younger age
than other ethnic groups, and African-Americans with colorectal cancer have
decreased survival compared with other ethnic groups. Physician experts
from the American College of Gastroenterology in 2005 issued new
recommendations to healthcare providers to begin colorectal cancer
screening in African-Americans at age 45 rather than 50. Colonoscopy is the
preferred method of screening for colorectal cancer and data support the
recommendation that African-Americans begin screening at a younger age
because of the high incidence of colorectal cancer and a greater prevalence
of proximal or right-sided polyps and cancerous lesions in this population.
The recommendations were published in the March 2005 issue of The American
Journal of Gastroenterology.



Colorectal Cancer Screening -- Recommendations from the American
College of Gastroenterology

For normal risk individuals, the American College of Gastroenterology
recommends screening beginning at age 50 (age 45 for African-Americans).
The preferred screening test according to the American College of
Gastroenterology is colonoscopy every 10 years. An alternative strategy for
average risk individuals is an annual stool test for blood, and a flexible
sigmoidoscopic exam every 5 years. Unlike colonoscopy, this approach does
not allow identification and removal of polyps in the entire colon.



For those with a family history of colorectal cancer, testing should
begin at 40 years of age or 10 years younger than the age of the youngest
affected relative at the time of colon cancer diagnosis, whichever is
earlier. For both average and high risk individuals, all potential
precancerous polyps should be removed.



About Colorectal Cancer

Colorectal cancer is the number two cancer killer in the United States,
affecting men and women equally. However, with screening and early
detection, many of these deaths can be prevented. Most colorectal cancers
develop from polyps, which are abnormal growths in the colon. Left
undetected and free to grow, some polyps may develop into cancer. Screening
tests can find and remove pre-cancerous polyps before they turn into
cancer.



About the American College of Gastroenterology

Founded in 1932, the American College of Gastroenterology (ACG) is an
organization with an international membership of more than 10,000
individuals from 80 countries. The College is committed to serving the
clinically oriented digestive disease specialist through its emphasis on
scholarly practice, teaching and research. The mission of the College is to
serve the evolving needs of physicians in the delivery of high quality,
scientifically sound, humanistic, ethical, and cost-effective health care
to gastroenterology patients.















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Via: Healthcare