Volume 1, Number 6
Colorectal Cancer Screening
What is Colorectal Cancer?
Colorectal cancer is cancer that occurs in the colon or rectum. The colon is the large intestine (bowel). The
rectum is the passageway connecting the colon to the anus. Colorectal cancer usually starts from polyps in the
colon or rectum. A polyp is a growth that shouldn’t be there. Over time, some polyps can turn into cancer.
Screening tests can find polyps, so they can be removed before they turn into cancer. Screening tests can also
find colorectal cancer early, when the chance of being cured is good.
Facts about Colorectal Cancer in the United States:
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Third most common cancer diagnosed in both men and women in the United States.
Second leading cause of death in both men and women; about 50,300 deaths during 2014.
More than 96,800 new cases of colon cancer and 40,000 new cases of rectal cancer in 2014
Lifetime risk of developing colorectal cancer is about 1 in 20 (5%) – slightly lower in women and slightly
higher in men.
Because of increased screening (and earlier detection), there are now more than 1 million survivors of
colorectal cancer in the United States.
African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups
in the United States. The reasons for this are not yet understood.
Risk Factors for developing Colorectal Cancer include:
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Age (90% occur in persons age 50 and older)
Personal history of polyps or inflammatory bowel disease
Close family history of colorectal polyps/cancer or genetic syndrome associated with colorectal cancer
Diabetes
Lifestyle factors: diet high in red meat; physical inactivity; obesity; smoking; heavy alcohol
consumption
The prognosis (chance of recovery) depends on:
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The patient’s age and general health.
The type of cancer.
The stage of the cancer (whether it has spread to lymph nodes or other areas of the body).
The size of the tumor.
Routine screening with early detection of colorectal polyps and/or cancer is the key to longterm survival.
Regular screening for colorectal cancer is recommended for all persons aged 50 – 75. (Persons
who are at high risk for the development of colorectal cancer may start screening at a younger
age and may have a colonoscopy at first screening.) There are 2 main options for screening of
average risk patients:
 Fecal immunoassay test (FIT) is done every year; this test requires a small sample of
stool be placed on the test card at home by the patient, who then returns the kit to the
office for testing. If the result of this test is positive, a colonoscopy is scheduled.
 Colonoscopy is done at least every 10 years; this test requires the patient to complete a
“bowel preparation” (which consists of a special diet and laxatives) prior to the exam,
then have the procedure (insertion of a long, thin tube with a light, camera, and
instruments for possible polyp removal through the anus so that the rectum and entire
large colon can be examined) at a specialty testing site. Persons who have polyps (or
cancers) removed through this process will have treatment and/or repeat testing at
more frequent intervals as directed.
HDI monitors and reports Colorectal Cancer Screening rates annually; results for 2012 – 2014
show a steady decline in rates:
2012 = 44%
2013 = 36%
As of July 31, 2014 = 27%
Part of this decline is attributed to HDI’s conversion to computerized records (many
patients had colonoscopy in the ‘paper’ world that were not recorded in the computer)
and a conscious decision not to retrieve paper charts from storage for UDS report.
Call to Action:
o If you are age 50 – 75 and you have not had a FIT test in the last year OR a colonoscopy
in the last 10 years OR you are not sure when your last screening was, discuss the
options with your ‘doctor’ and complete your colorectal cancer screening now.
o If you are younger than age 50 and are at “high risk” for developing colorectal cancer,
discuss your situation with your ‘doctor’ to determine the screening plan for you.
HDI is committed to providing “Quality Healthcare for Everyone.” Look for more information
about our quality projects and PCMH in future editions of the HDI Quality Insider. If you have
questions, please talk to any member of our staff.