Early Screening Crucial to Preventing Colorectal Cancer

It is often the “butt” of cancer jokes, but those working to raise awareness of colorectal cancer don’t mind the humor. They engage in a bit of it themselves if that is what it takes to get the message across that Alaskans 50 years and older need to get an initial screening for the disease that actually has one of the highest rates of success in terms of providing a cure with early detection.

In fact, in March during National Colorectal Awareness Month, professionals working within this specific cancer niche suggested screening become a topic of dinner conversation.

“Why not?” Christina Kelly, communications manager with the American Cancer Society, posed. “We all know the colon is not a body part that we typically discuss in regular conversation, but why not? If the family is sitting at the dinner table and there is someone of the potential age for screening, why not talk about it? Why not talk about the importance of early detection?”

Noting that discussion of the colon might be enough to make a teenage boy snicker for a half hour, but at least he would know about where that body part is and what it does, she adds.

Dr, Thomas Mego, a cancer pathologist at Providence Alaska Medical Center in Anchorage, agrees with Kelly regarding the idea of allowing humor to break the ice of this touchy subject. He used a bit of humor to lighten the mood when it was his turn to have a colonoscopy. He doesn’t mind sharing his own experience as he encourages others – both personally and professionally – to get screened.

“The more people that get screened, the better off our population is going to be,” he said.

This is where the EightyBy2018 initiative from the National Colorectal Cancer Roundtable comes in to play. Working in conjunction with the national organization and the Alaska Dept. of Health and Social Services Division of Public Health operates the Alaska Comprehensive Cancer Control Program to increase awareness of cancer prevention and screenings. Its goal is to have 80 percent of all age-eligible Americans screened by the end of 2018.

Colorectal cancer is of a significant concern in the state of Alaska. Only 61 percent of all adults of eligible screening age have done so. The rate of colorectal cancer among the Native Alaskan population – particularly those living in rural Alaska – is higher. It is now recommended that Native Alaskans begin screening at age 40 versus age 50, which has been the standard for all people for decades.

“Yes, it is a bit of a hassle,” Amy Myers, director of the digestive health service line at Providence, admits in regards to the colonoscopy procedure. “You have to take a day off work and do the prep, and get someone to give you a ride home, but it is worth the effort – especially if it provides early detection of this form of cancer.”

That last sentence is an important one: In most cases, someone with colorectal cancer does not experience symptoms until the disease has advanced.

“Getting screened is just a no-brainer,” Kelly said. “This is one of the few cancers you can prevent from happening.”

For those without insurance to pay for the more spendy colonoscopy procedure that run cost upwards of $1,000, there are less expensive and less invasive options.

Thirty bucks or even less – the typical cost of an at-home colorectal screening kit – is affordable for many people. For those meeting income eligibility requirements, Providence provides no-cost kits. These can be picked up at Providence in Anchorage or mailed.

An at-home kit involves the use of a pre-sterilized round container mounted to the residential toilet. One has a bowel movement in to the container and then uses a specialized scraper stick to attach fecal matter to the scraper stick which is inserted in to a sterilized bottle. One then pours the fecal preservative over the sample in the round container and screws on an air-tight lid. All of the above-mentioned items are placed in a pre-paid shipping package for delivery to the laboratory.

An at-home test does not offer the same high level of accuracy as a colonoscopy performed in a medical. An at-home test should be repeated every year in comparison to the colonoscopy, which if it returns normal results is only recommended every ten years.

Which is the better test?

“The better test is the one that the patient will do,” Mego said.

The advantages of a colonoscopy are in its lack of false positives, he said.

“Unlike other cancer screenings that we regularly do such as lung, mammogram or prostate that people say at times return too many false positive causing people to have to chase something that does not exist, no one ever says that about a colorectal or pap smear,” Mego said. “Those types of screenings are incredibly accurate.”

The trifecta of Kelly, Mego and Myers say they hope the increased awareness of probiotic activity in the digestive system that currently exists in American culture will pave the way for more Americans to get screened for colorectal cancer.

“With all the funny television commercials with the little colon character running around encouraging people to use probiotics to aid their digestive systems, perhaps we are becoming more comfortable with this and won’t be as embarrassed to talk about it,” Kelly said.

Learn more about colorectal cancer via Providence Alaska Medical Center online at: www.alaska.providence.org/health-library/content?contentTypeID=3&contentID=85201.

Learn more about various types of colon cancer screening and treatment via the American Cancer Society online at: www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/how-diagnosed.html.