By CINDY LADAGE
Illinois Correspondent

SPRINGFIELD, Ill. — Colorectal cancer is the third most common cancer in the United States and occurs frequently to people older than 50.
For those in the agricultural industry, staying on top of such health issues is important to future planning. While thinking about ordering seed corn and beans is easy, it is a little more difficult to include health decisions that make farming an enjoyable occupation.
When found early, colorectal cancer is easily treated and often, can be cured. The “Healthwise” website states, “Because it usually is not found early, it is the second leading cause of cancer deaths in the United States.
“Fairly simple screening tests can prevent this cancer, but fewer than half of people older than 50 are screened. According to the American Cancer Society (ACS), if everyone were tested, tens of thousands of lives could be saved each year.”
Shayne Squires, regional communications manager of the ACS, said the ACS, the American College of Radiology and the U.S. Multi-Society Task Force on Colorectal Cancer (a group made up of representatives from the American College of Gastroenterology, American Gastroenterological Assoc. and American Society for Gastrointestinal Endoscopy) just released the first-ever joint consensus guidelines for colorectal cancer screening.
The guidelines recommend stool DNA (sDNA) and CT colonography (CTC). CTC is also known as virtual colonoscopy, and the ACS prefers screening tests that can detect cancer early and detect precancerous polyps that provide a greater potential for cancer prevention through polyp removal.
The guidelines will be in the May/June issue of CA: A Cancer Journal for Clinicians, are published early online on CA First Look and will also be published in upcoming issues of the journals Gastroenterology and Radiology.
Shayne said, “In addition to the new tests, the focus on quality and the new delineation of tests into two major types, the expert panel also concluded that any proposed colorectal screening test that has not been shown in the medical literature to detect the majority of cancers present at the time of testing should not be offered to patients for colorectal cancer screening. That includes some types of previously endorsed guiaic-based stool tests.
“Based on a review of the historic and recent evidence, the following tests were deemed acceptable options for the early detection of colorectal cancer and adenomatous polyps for asymptomatic adults aged 50 years and older.”
Tests that will detect the Adenomatous Polyps and cancer are Flexible sigmoidoscopy every five years, a colonoscopy every 10 years, a Double contrast barium enema (DCBE) every five years or a CTC every five years.
Tests that will detect only primarily cancer are the annual guaiac-based fecal occult blood test (gFOBT) with high test sensitivity for cancer, annual fecal immunochemical test (FIT) with high test sensitivity for cancer or sDNA with high sensitivity for cancer, interval uncertain.
“Despite clear evidence that colorectal cancer screening saves lives and the existence of several effective tests, screening rates have lagged, costing thousands of lives every year,” said Dr. Otis W. Brawley, M.D., national chief medical officer of the American Cancer Society.
“Our hope is that these new recommendations will help relieve some of the challenges health care providers have had in promoting screening to their patients, and lead to more Americans preventing colon cancer by having polyps removed before they turn into cancer.”
The primary goal of colorectal cancer screening is to detect both early cancer and adenomatous polyps.
“This is the first time that a guideline from the American Cancer Society will express a strong preference for tests that can identify both polyps and cancer and lead to cancer prevention,” noted Dr. David A. Lieberman, M.D., on behalf of the U.S. Multi-Society Task Force on Colorectal Cancer. “We feel strongly that this will help consumers make decisions that can, quite literally, save their lives.”
Some patients will not want to undergo an invasive test that requires a bowel prep. They may prefer screening in the privacy of their home, or may not have access to the invasive tests so will opt for stool occult blood or DNA testing, which can be performed at home, without bowel prep.
Shayne added, however, “The panel said providers and patients should understand that those tests are less likely to prevent cancer compared with the invasive tests; they must be repeated at regular intervals to be effective; and if the test is abnormal, an invasive test (colonoscopy) will still be needed.”
“The addition of these new technologies can potentially encourage many more people to choose to be screened for colorectal cancer,” said Dr. Arl Van Moore, M.D., FACR, chair of the American College of Radiology Board of Chancellors. “This could result in early detection of the disease for more patients, increasing the chance of successful treatment, and potentially reduce colorectal cancer deaths nationwide.”
The full guidelines can be viewed at http://caonline.amcancersoc.org or for more information, log onto the ACS site at www.cancer.org
Other sites of interest are the American Gastroenterological Assoc. at www.gastro.org and the American College of Radiology at www.acr.org
Still other sites to check out are the American College of Gastroenterology at www.acg.gi.org and the American Society for Gastrointestinal Endoscopy at www.asge.org