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Colon Cancer Screening

The American Cancer Society

and

Living Well

March Module

TOPIC: Colon Cancer Screening

MARCH CONTENT

Content Overview

• Event Notice
• Sample Newsletter: American Cancer Society Encourages Dialogue About Colon Cancer
• Sample Newsletter: Knowing Colon Cancer Risk Factors May Save Your Life
• Sample Newsletter: Colon Cancer Screening
• Fact Sheet
• Colon Cancer Quiz – Are You at Risk?
• Colon Cancer Quiz – Can You Reduce Your Risk for Colon Cancer?
• Colon Cancer Misconceptions and Truths
• Presentation Speaker’s Notes
• Presentation

TOPIC: Colon Cancer Screening

OVERVIEW

TALKING POINTS

• Colon cancer is the second most common cancer in both men and women. But the great news is that colon testing can save your life and even prevent colon cancer.

• Everyone 50 or older should have regular colon testing.

• The tests can keep you from getting colon cancer! Testing can find non-cancerous colon polyps when they can be easily removed. Polyps are small growths that may turn into cancer if not removed.

• Testing can find colon cancer early when it can be easily cured.

• People with a personal history of polyps, colon cancer, inflammatory bowel disease, or a family history of colon cancer or polyps are at higher risk for colon cancer. They may need to start being tested before age 50 and have the tests done more often.

• A family history of other cancers (breast, ovarian, or uterine) may also raise one’s risk for colon cancer.

• African Americans and Ashkenazi Jews appear to have higher rates of colon cancer.

• Insurance, Medicare, and Medicaid usually pay for testing.

BULLETIN BOX

RESOURCES

American Cancer Society Web site: www.cancer.org

American Cancer Society phone number: 1-800-ACS-2345

National Cancer Institute Web site: www.cancer.gov

National Cancer Institute phone number: 1-800-4CANCER

Join us for an informative discussion on colon cancer screening.

Location:

Date:

Time:

For more information, contact:

Colon cancer almost always starts with a polyp. Get the polyp early and stop colon cancer before it starts. Colon cancer. Get the test. Get the polyp. Get the cure.

For more information, call 1-800-ACS-2345 or visit www.cancer.org.

Join Us for an Informative Discussion on

Colon Cancer Screening

Learn about:

Benefits of early detection

How colon cancer can be prevented

What tests are used to screen for colon cancer

Location:

Date:

Time:

For more information, contact:

TOPIC: Colon Cancer Screening

SAMPLE NEWSLETTER:

AMERICAN CANCER SOCIETY ENCOURAGES DIALOGUE ABOUT COLON CANCER

The diagnosis of colon cancer in high-profile individuals, such as Supreme Court Justice Ruth Bader Ginsburg and baseball players Darryl Strawberry and Eric Davis, helped generate awareness of the disease. Yet, despite the recent national attention on colon cancer, people often are reluctant or embarrassed to talk about the disease.

Even though the exact cause of most colon cancer is not known, it is possible to prevent many colon cancers through regular screening and a healthy lifestyle. The hope is that, as more people speak publicly about this disease, it will encourage others to address the issue of colon cancer – leading to recommended screenings, early diagnosis, and ultimately, more lives saved.

Colon cancer, unlike other cancers, is a highly preventable disease and one that can be detected early through screening. To learn more about the disease, the American Cancer Society encourages people to use their resources — a toll-free information line at 1-800-ACS-2345 and Web site at www.cancer.org — to get accurate, unbiased colon cancer information and support.

TOPIC: Colon Cancer Screening

SAMPLE NEWSLETTER:

KNOWING COLON CANCER RISK FACTORS MAY SAVE YOUR LIFE

One of the best ways to protect yourself from colon cancer is to know the risk factors of the disease. By knowing the risk factors, you can adjust your screening schedule so that you can detect the disease earlier and possibly save your life!

• Family history of colon cancer: Relatives of colon cancer patients are at an increased risk for developing the disease. Some doctors recommend that all people with colon cancer have an evaluation of their family history of the disease.

• Personal history of colon cancer: Even when a colon cancer has been completely removed, new cancers may develop in other areas of the colon and rectum.

• Personal history of intestinal polyps: Some types of polyps (hyperplastic polyps and inflammatory polyps) do not increase the risk of colon cancer. Other types, such as adenomatous polyps, or adenomas, do increase the risk of colon cancer, especially if they are large or there are many of them.

• Personal history of chronic inflammatory bowel disease: Chronic inflammatory bowel disease is a condition in which the colon is inflamed over a long period of time and may have ulcers in its lining. This increases a person’s risk of developing colon cancer, so starting colonoscopy earlier and doing this test more often (every one to two years) is recommended.

• Age: About 90 percent of people found to have colon cancer are 50 years of age or older.

• Diet mostly from animal sources: A diet that consists mostly of foods that are high in fat, especially from animal sources, can increase the risk of colon cancer.

• Physical inactivity and obesity: People who are overweight and those who do not get at least a moderate degree of physical activity have an increased risk of developing colon cancer.

• Familial colon cancer syndromes: Familial adenomatous polyposis (FAP) is a hereditary condition in which people typically develop hundreds of polyps in the colon and rectum. Cancer nearly always develops in one or more of these polyps between the ages of 30 and 50 if preventive surgery is not done. Like FAP, Gardner’s syndrome results in polyps and colon cancers that develop at a young age. It can also cause benign tumors of the skin, soft connective tissue, and bones. Hereditary nonpolyposis colon cancer (HNPCC) develops in people at a relatively young age without first having many polyps. Women with this condition also have an increased risk of developing cancer of the endometrium.

For more information on colon cancer, call the American Cancer Society at 1-800-ACS-2345 or visit their Web site at www.cancer.org.

TOPIC: Colon Cancer Screening

SAMPLE NEWSLETTER:

COLON CANCER SCREENING

The American Cancer Society recommends that starting at age 50, men and women at average risk should follow one of the examination schedules for colon cancer below:

1. Yearly fecal occult blood test (FOBT), or
2. Flexible sigmoidoscopy every five years, or
3. FOBT every year and flexible sigmoidoscopy every five years (of these three options, the American Cancer Society prefers option three), or
4. Double contrast barium enema every five years, or
5. Colonoscopy every 10 years.

Those with a strong family (parent or sibling) or personal history of colon or rectal cancer, or polyps and/or chronic inflammatory bowel disease, should talk with their doctor about a different testing schedule.

Colon cancer can be treated successfully if caught early; however, symptoms may not appear until the disease has advanced. That is why open communication with your doctor and screening is so important, even if you do not have symptoms. See your doctor immediately if you have a change in bowel habits that last for more than a few days. This includes bleeding from the rectum, blood in the stool, cramping or gnawing stomach pains, and/or fatigue. While these symptoms may not necessarily point to colon cancer, it is better to be safe and seek treatment right away.

While the exact cause of colon cancer is not known, it occurs more often among men and women over 50. Other risk factors for colon cancer include those with a strong family history of the disease or polyps; people with a personal history of colon or rectal cancer or inflammatory bowel disease; physically inactive people; and those who eat high-fat, low-fiber diets without enough fruit or vegetables. Cigarette smoking has also been recently linked to colon cancer risk. If you or a loved one fall into a high-risk category, set a regular testing schedule with your doctor.

For more information on colon cancer, contact your American Cancer Society at 1-800-ACS-2345 or visit their Web site at www.cancer.org.

TOPIC: Colon Cancer Screening

FACT SHEET

• March is colon cancer awareness month.

• There are steps you can take to reduce your risk for colon cancer.

o Ask relatives about your family’s cancer history.

o Exercise at least 30 minutes on most days.

o Eat five or more servings of vegetables and fruits daily.

o Avoid tobacco and drink alcohol in moderation if you drink at all.

o Stay at your ideal weight.

• Talk to your doctor about your personal risk and testing options.

• Colon cancer is the second most commonly diagnosed cancer in America. By getting tested, you can prevent or cure it.

• It’s not just a man’s disease. Men and women are equally affected. Over 90% of colorectal cancers are diagnosed in people over age 50.

• Early colon cancer often has no symptoms. But, later on, colon cancer symptoms may include rectal bleeding, stomach cramps, weight loss, a change in bowel habits, or just feeling tired.

• Screening tests include:

o Fecal occult blood tests – an at-home procedure that checks stool samples for signs of cancer or polyps.

o Flexible sigmoidoscopy – a procedure using a hollow, lighted tube that detects cancer or polyps inside the rectum and lower third of the colon.

o Colonoscopy – a procedure similar to flexible sigmoidoscopy except the colonoscope is long enough to view the entire colon.

o Double-contrast barium enema – an x-ray examination that allows a radiologist to view the entire colon.

• Colorectal cancers can almost always be cured if they are detected early. Screening tests can detect colon polyps before they become cancerous, as well as early-stage colorectal cancers.

• Medicare and many other health insurance plans now cover routine tests for colon cancer. Contact your personal health insurance carrier for more information and don’t forget to talk with you doctor about which test is right for you.

• Call the American Cancer Society at 1-800-ACS-2345 or visit their Web site at www.cancer.org for questions to ask your doctor.

TOPIC: Colon Cancer Screening

COLON CANCER QUIZ –

ARE YOU AT RISK?

In 2004, colon and rectum cancer will affect more than 146,000 people and their families. Individual risk varies, but knowing your risk for developing the disease and getting tested at the right time could save your life. Can you answer yes to any of the following questions?

• Are you 50 or older?

• Are you of African American heritage?

• Has a doctor ever told you that you have inflammatory bowel disease, ulcerative colitis, or Crohn’s disease?

• Has one of your parents or your brother, sister, or child had colon cancer or colon polyps?

• Do you smoke or use other tobacco products?

• Are you physically inactive – not getting regular exercise?

• Do you often eat red meat?

If you answered yes to any of these questions, you are at an increased risk for colon cancer. Talk to your doctor to make informed decisions about the best testing method and timing for you. For more information on colon cancer, call the American Cancer Society at 1-800-ACS-2345 or visit their Web site at www.cancer.org.

TOPIC: Colon Cancer Screening

COLON CANCER QUIZ –

Can You Reduce Your Risk for Colon Cancer?

Approximately 90 percent of all colon cancer cases and deaths are thought to be preventable. What can you do to lower your risk for the disease or prevent it altogether? From the list below, circle which behaviors can decrease your colon cancer risk.

A. Healthy diet

B. Physical activity

C. Regular checkups, including appropriate cancer screenings

D. Maintaining a healthy weight

E. Eating less red meat

F. Not smoking

G. Limiting alcohol, if you drink at all

Answer: All!

All of these factors decrease your colon cancer risk. By eating a diet high in vegetables, fruits, and grains and low in red meat and alcohol, you can decrease your risk and help maintain a healthy weight. Regular exercise and not smoking are important to living healthy, too. Get regular checkups with your doctor to discuss your health and which cancer screening tests are right for you. Colon cancer may be prevented with tests that can find polyps and remove them before they become cancer.

For more information, contact the American Cancer Society at 1-800-ACS-2345 or visit their Web site at www.cancer.org.

TOPIC: Colon Cancer Screening

TOP FIVE COLON CANCER MISCONCEPTIONS

AND THE TRUTHS YOU SHOULD KNOW

1. Myth: Colon cancer is a man’s disease.

Truth: Colon cancer is the second most common cancer among U.S. men and women. In 2004, an estimated 106,370 people will be diagnosed colon cancer and 40,570 people will be diagnosed with rectal cancer. An estimated 56,730 people will die from colorectal cancer.

2. Myth: Colon cancer cannot be prevented.

Truth: By getting tested for it, you can prevent colon cancer. Colon cancer usually starts with a polyp. Get the polyp early and stop colon cancer before it starts. You can also help reduce your risk of colon cancer by exercising regularly and eating a diet that is low in fat and rich in fruits and vegetables.

3. Myth: African Americans are not at risk for colon cancer.

Truth: All races are affected by colon cancer. African American men and women tend to be at higher risk of getting and dying of colon cancer than men and women of other racial and ethnic groups.

4. Myth: Age doesn’t matter when it comes to getting colon cancer.

Truth: Most colon cancers are diagnosed in individuals 50 or older. The American Cancer Society recommends beginning screening tests at age 50 for people of average risk. You should talk to your doctor about getting tested.

5. Myth: It’s better not to get tested for colon cancer because it’s deadly anyway.

Truth: Colon cancer is highly treatable. If colon cancer is found early and treated, the five-year survival rate is 90 percent; however, only 38 percent of cases are diagnosed at this early stage.

Get Tested

The American Cancer Society recommends one of these five testing options for all people of average risk beginning at age 50.

􀂃 Yearly fecal occult blood test (FOBT), or

􀂃 Flexible sigmoidoscopy every five years, or

􀂃 Yearly FOBT and flexible sigmoidoscopy every five years (preferred over either option alone), or

􀂃 Double contrast barium enema every five years, or

􀂃 Colonoscopy every 10 years.

For more information about colon cancer and how you can prevent it or stop it early, contact your American Cancer Society at 1-800-ACS-2345 or visit their Web site at www.cancer.org. If this disease has touched you or someone you love, we can help.

TOPIC: Colon Cancer Screening

SPEAKER’S NOTES FOR PRESENTATION

Slide 1: Welcome to this presentation on Colon Cancer. My name is __________. I appreciate the opportunity to share this information with you and hope that you will find it useful.

Slide 2: none

Slide 3: none

Slide 4: Approximately 90 percent of colon cancer cases and deaths are thought to be preventable, based on existing approaches for early detection.

Slide 5: none

Slide 6: These symptoms may occur in later, more advanced stages of the disease.

Slide 7: Diet: A diet made up of mostly foods that are high in fat, especially from animal sources, can increase the risk of colon cancer.

Slide 8: People who have a history of either colon cancer or polyps in any first degree relative (e.g. father, mother, brother, or sister) before age 60, or in two or more relatives at any age, have an increased risk of developing colon cancer.

FAP – A hereditary condition resulting in a person having hundreds or even thousands of polyps in the colon or rectum. The polyps usually first appear during the teenage years. Between the ages of 30 – 50, cancer nearly always develops in one or more of these polyps.

HNPCC – People with this hereditary condition tend to develop cancer at a young age without first having polyps.

Gardner’s Syndrome – Like FAP, this hereditary condition results in polyps and colon cancer that develops at a young age. It can also cause benign tumors of the skin, connective tissue, and bones.

Slide 9: none

Slide 10: Early detection is critical to surviving colon cancer.

Slide 11: Fecal Occult Blood Test (FOBT): A test that can be conducted at home and is low cost. It must be performed every year in order to be valid. Multiple stool samples are examined for blood.

Flexible sigmoidoscopy: Performed in a doctor’s office with limited preparation. A slender, lighted, flexible tube is placed in the rectum. Will only screen the lower part of the colon.

Double contrast barium enema: An enema of a chalky substance is used to partly fill up and open the colon. Air is then added to expand the colon. X-ray films are taken. Can usually view entire colon; extensive preparation.

Colonoscopy: A long, flexible tube placed through the rectum into the colon. The tube is linked to a video camera and display. Views entire colon, can biopsy and remove polyps, can diagnose other diseases; extensive preparation.

Slide 12: A consequence of the low screening rate is that only 38 percent of cases are diagnosed when the disease is still localized. Later diagnosis results in a substantially lower survival rate.

Slide 13: Surgery: If colon cancer is detected at an early stage, the patient can undergo a polypectomy (removal of the cancerous polyp) or a local excision (removal of the cancer and a small margin of tissue). If the cancer is large, or invades surrounding tissue or lymph nodes, the individual will most likely have a segmental resection (removal of the cancer, some colon tissue, and the lymph nodes). A colostomy (an opening in the abdomen to allow the elimination of body wastes) is performed if the physician is unable to reconnect the parts of the colon after surgery.

Radiation: Used primarily to treat rectal cancers.

Chemotherapy: Even though nearly 80 percent of colon cancer patients experience complete clearance of their disease after surgery, approximately 40 percent will develop recurrence. Chemotherapy is used to eradicate any remaining cancer cells and to prevent recurrent disease.

Slide 14: Localized: Cancer is confined to the colon or rectum.

Regional: Cancer has spread to the lymph nodes.

Distant: Cancer has metastasized – spread to distant sites.

Unfortunately, most people are not being diagnosed when the cancer is localized. This is because few people aged 50 years and older are following the American Cancer Society’s screening guidelines for colon cancer.

Slide 15: Colon Cancer Awareness – Many activities occur in communities in every state. Check with your local office to get involved!

Polyp Man Media Campaign – This national campaign delivers the message that colon cancer is highly curable and easy to find, if you get tested. An obnoxious man in a polyp suit runs from doctors and police. The message is: "Colon Cancer. Get the test. Get the polyp. Get the cure."

I Can Cope – Facing cancer can be one of the most significant challenges a person faces. I Can Cope helps people meet this challenge by clarifying facts and myths through a series of educational classes.

Cancer Survivors Network – This program gives cancer patients, their families, and their caregivers an opportunity to communicate with others who have experienced cancer.

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