Thursday, December 2, 2004
Delaware Cancer Consortium targets a preventable cancer

By Melinda Huffman
Colorectal Cancer Screening Advocate
Nanticoke Memorial Hospital

Colorectal Cancer is the third most commonly occurring cancer and the second leading cause of cancer deaths in the United States. Since this cancer follows a predictable natural history of disease from benign polyp to cancer, it is one of the most preventable cancers. Colorectal cancer is a significant contributor to disease and death in the United States. Studies published in the Early 1990s showed that screening for colorectal cancer could reduce mortality. This led many organizations to recommend screening at the age of 50 years. By 2002, national-screening rates remained low. Only 44 percent of adults older than 50 report having been screened. Public efforts have turned to raising awareness among men and women of the risk of colorectal cancer and the benefit of available screening, accurate diagnosis, and effective surgery for early-stage cancer. Not only can early-stage disease be detected and treated surgically, but also the detection and removal of pre-cancerous polyps can prevent colorectal cancer almost entirely. Colorectal cancer is the most frequent form of hereditary cancer, with research studies demonstrating that relatives of individuals with colorectal cancer or pre-cancerous polyps have an excess risk for the disease. The risk is further increased if two or more first-degree relatives (parents, siblings, and children) are affected or if a diagnosis of a relative is made at age 50 years or younger. The lifetime risk of colorectal cancer is five to six percent in the general population, but the risk is 10 to 18 percent in persons who have first-degree relatives with a diagnosis of pre-cancerous polyps or colon cancer. Delaware’s cancer rate ranks as one of the highest in the nation. The state has recognized that more than one-third of colorectal cancer deaths within the state could be prevented if people over the age of 50 had regular screening tests.
Unlike many other cancers, there are reliable and cost effective tests that can find colorectal cancer early. Yet, tragically, too few Delawareans know about or take advantage of these life-saving tests. Screening tests can help prevent colorectal cancer by finding pre-cancerous polyps so they can be removed before they develop into cancer. The Delaware Cancer Consortium, the Governor’s Office, and the Delaware Legislature have joined in an effort to reduce the colorectal cancer rates in the state of Delaware by setting aside a colorectal cancer screening advocate and care coordinator in the hospitals. There are seven colorectal care advocates in the six major health systems serving the adult populations. The advocate/coordinators will be responsible for providing culturally sensitive outreach and recruitment, assuring screening access and scheduling, monitoring screening compliance, and assuring prompt clinical evaluation and follow-up to positive testing. These individuals are the employees of the hospital that they represent, but the position is funded by the Delaware Health Fund, proposed tobacco excise tax, and existing resources. A new multimedia campaign will be launched soon to urge every Delawarean age 50 and older to get tested. Part of this grassroots campaign called “Champions of Change” will take the “get tested” message to the African American communities, since their death rates from colorectal cancer are significantly higher. Public education through media presentations and local colorectal cancer screening advocates is the means the Delaware Cancer Consortium is using as front lines tactics to get people age 50 and over screened. Colorectal cancer has long been regarded as an attractive target for screening for these reasons:
  • It is a common cancer.
  • Its natural history is reasonably well understood.
  • Early disease is detectable by means of tests that are acceptable to people.
  • Treatment of early disease is highly effective.
Delaware’s goal is to screen everyone according to the American Cancer Society guidelines. The state’s message is that no one needs to die from colorectal cancer. Screening for Life will now cover the cost of a colonoscopy and the first year of cancer treatment for individuals who meet income guidelines. Colorectal cancer is a preventable, treatable, beatable disease. The more people screened for polyps and colorectal cancer, the sooner this disease can be eliminated.