Yo u r Co u
n ty
Cru sa d e
A g a in s t
Ca n c e r
COLORECTAL CANCER
Let’s Get
Talk

(colorectal cancer)
It can be “embarrassing” to talk about colorectal
cancer

DON’T DIE FROM EMBARRASSMENT

Colorectal Cancer CAN Be Prevented
So,
Le ts Get Ta l kin g . . .
Colorectal Cancer Overview
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Where & What is the Colon?
What is Colon Cancer?
Why the Concern?
Who’s at Risk?
What Can be Done?
– Prevention
– Screening
– Treatment

Where to Get More Information
Where is the Colon ?
What does it do?
As part of the digestive system the colon:
– Stores mainly non-absorbed food, fiber
and water
– Re-absorbs nearly all the water
– Moves solid waste to the rectum where
it is eliminated by defecation
What is cancer?

Cancer is the uncontrolled growth and
spread of abnormal cells.

It includes 100’s of different diseases,
usually classed by the part of the body
where it is first found.
How does colorectal cancer
develop?

Most colorectal cancers begin as polyps,
or tiny abnormal growths on the inside
walls of the colon or rectum.

Polyps vary in size, from tiny to a few
centimeters.

Some polyps become cancerous after
several years and should be removed to
prevent development of colorectal cancer.
X-Ray of Colon and Polyps
Why the Concern?


4th leading cause of cancer-related
death in world
2nd leading in US
– Why a difference between world and US ?
– Stay tuned

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2nd leading in Missouri
2nd leading in YOUR County
Who Is At Risk of Developing
Colorectal Cancer?

Men AND Women are at similar risk

Risk increases with age
–  90% occurs in people aged 50 +

85% of people with colorectal cancer
had NO medical history related to
colorectal cancer.
What are Risks for Developing
Colorectal Cancer?

Poor Diet
– high amount of fats
– high amount of red meat
– high temperature cooking of red meats
– low amount of vegetables
– high alcohol consumption
– low water consumption
What are Risks for Developing
Colorectal Cancer?

Physical inactivity
Why the Difference Between
World and U.S. Rates?

Colorectal Cancer has been Called a
“Cancer of Economically
Developed Countries”
– Diet is different
– Physical activity is different
Ways to Reduce Your Risk
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Regular moderate
exercise
Healthy diet
Proper weight
Avoid smoking
Limit alcohol use
GET REGULAR
SCREENING
Ways to Reduce Your Risk
Healthy Diet
“Five-A-Day” is  5 servings of fruits &
vegetables / day
This can reduce your risk for a number of
diseases, including some types of cancer,
such as colorectal cancer
Ways to Reduce Your Risk

Physical activity recommendations:
– For 30 minutes (can be three
10 -minute segments)
– At least 5 times per week
– At the pace of brisk walking
Other possible risk reducers

Aspirin

Non-steroidal anti-inflammatories

Calcium

Vitamin D
Screening is KEY !

American Cancer Society estimates for
the impact of colorectal cancer in 1999:
– 129,400 cases diagnosed in the U.S.
– 56,000 deaths in the U.S.
– 1,300 deaths in Missouri

At least 1/3 of deaths could be reduced
with widespread adoption of screening.
Don’t wait...

Colorectal cancer can develop with few
or no symptoms at first.

Screening can lead to reductions in the
number of deaths:
– FOBT: 33%
– Flexible sigmoidoscopy: 70%
– Colonoscopy: 80%
How does screening save lives?

Prevention
– By finding polyps in the colon and
removing them before they become
cancerous

Early detection
– Finding cancer early when treatment
works best
Who should be screened for
colorectal cancer?

EVERYONE aged 50 and older:
– Women and men
– All races and ethnicities

May be younger than 50 for those with a
family history of colorectal cancer or
colorectal polyps (talk to your doctor!)
Why don’t some people
get screened?
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Don’t think they are at risk for colorectal
cancer
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Embarrassed to ask their doctor
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Think it will hurt
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Don’t realize that screening is covered by
their insurance plans, including Medicare
The screening tests
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Fecal Occult Blood Test (FOBT)
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Flexible Sigmoidoscopy
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Colonoscopy
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Double Contrast Barium Enema
Fecal Occult Blood Test (FOBT)

Looks for hidden (occult) blood in the
stools
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Stool sample is collected at home
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Test preparation will likely include
dietary and medicinal restrictions
(check test kit instructions)
Example of One Type of FOBT
Positive test results may be due to:
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Colorectal cancer or polyps.
Failure to follow pre-test dietary and medicinal
restrictions.
Other bowel disorders which could cause
bleeding (though not always a lower GI source):
– colitis - diverticulitis - hemorrhoids, among others

Follow-up is IMPORTANT- your physician will
usually recommend a full colon exam using
colonoscopy or barium enema.
Fecal Occult Blood Test

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Annual screening can lead to 33%
reduction in deaths
Annual FOBT test is worth the effort !!!
Flexible sigmoidoscopy

Uses a flexible lighted tube to
examine the inside of the lower
part of the colon (sigmoid).

The slender tube allows
for discovery of polyps.
Polyps can be removed
during sigmoidoscopy
or by a follow-up
colonoscopy.

Flexible Sigmoidoscopy

Regular screening can lead to 70%
reduction in deaths
Regular Flexible Sigmoidoscopy is
worth the effort !!!
Colonoscopy

Uses a flexible lighted
tube to examine the inside
of the entire colon

The slender tube
allows for removal
of polyps and
tissue for biopsy
Colonoscopy

Regular screening can lead to 80%
reduction in death
Regular Colonoscopy is
worth the effort !!!
Double Contrast Barium Enema

Radio-opaque liquid
with barium put into
colon

Barium coats lining of
colon and rectum

Allows organs and
any signs of disease
to show more clearly
on x-rays
Double Contrast Barium Enema

Regular screening can lead to 80%
reduction in deaths
Regular Barium Enema is
worth the effort !!!
American Cancer Society
recommendations for screening

For adults aged 50+ with no family history
of colon cancer or polyps:
– Annual FOBT
PLUS
– Flexible sigmoidoscopy every 5 years
- - OR - – Total colonic exam
• Colonoscopy every 10 years; or
• Double-contrast barium enema every 5-10
years
Treatment

More than 90% of people whose
colorectal cancer is treated early survive
at least 5 years after their diagnosis

Only 8% of people who are diagnosed
in later stages survive past 5 years
THIS IS WHY SCREENING
IS SO IMPORTANT !!!
Remember…
Lifestyle risk reducers:
Healthy food choices
Maintain a healthy weight
Physical activity
Avoid smoking
Plus screening tests...
FOBT and
***
Colonoscopy or
Sigmoidoscopy
***
Double contrast barium enema
Combine to save lives!
Where Can You Get Screening?
Talk to your health care professional
Where Can You Get More Info?

American Cancer Society
33 East Broadway, Suite 100
Columbia MO 65203
573-443-1496
800-429-7753
ed.johnson@cancer.org
www.cancer.org

Toll-free National Phone 1-800/ACS-2345
Where Can You Get More Info?

Missouri Department of Health & Senior Services
Bureau of Cancer Control
P.O. Box 570
920 Wildwood
Jefferson City MO 65102
ph 573/522-2841
fax 573/522-2899
e-mail cowans@dhss.state.mo.us
Presented in Cooperation of
Your County Community Council
of the American Cancer Society
Missouri Department of Health
.
& Senior Services
Bureau of Cancer Control
Special thanks to the
U.S. Centers for Disease
Control & Prevention