COLON CANCER Doctors urge people to get screenings

Early detection is key in treating the cancer.
SAN FRANCISCO CHRONICLE
Dr. Wallace Sampson was one of the lucky ones.
As an oncologist practicing in San Francisco for much of his career, he knew more than most people about the importance of regular screening for colon cancer. But although he had one exam in his early 50s, he went for years without getting another.
Then one day in 1993 he noticed blood in his stool. A visit to his doctor and a procedure called a colonoscopy, in which a flexible scope is used to examine the length of the colon, confirmed the findings: He had cancer. Fortunately, it hadn't spread. After surgery -- and a painful recovery -- he is still cancer-free, 12 years later.
"I was lucky, because it obviously had been there for quite a while," said Dr. Sampson, 75, who is retired from medical practice but still teaches at Stanford University Medical School. "If I had been screened, it would have been picked up earlier. I was lucky that it was still localized, even though it was picked up later."
Cancer of the colon and rectum is the third most common type of cancer in the United States and the second-leading cause of cancer-related deaths. This year, the American Cancer Society estimates, 145,290 people will be diagnosed, and 56,290 people will die from the disease.
Screening
The sad fact is that most of those deaths are preventable, if only more people were screened.
Although experts hotly debate which screening method is best, most of them agree that the debate should not be allowed to drown out the public health message that too few people are getting any kind of test.
Typically, colon cancer is slow-growing. It first arises as precancerous polyps, or growths, inside the colon. Identifying those polyps through any of four recommended screening methods and then removing them is extremely effective. The five-year survival rate for colon cancer found early is 90 percent.
Yet less than 40 percent of people age 50 and older get screened, as is recommended by the cancer society and other groups.
That's well behind screening rates for other types of cancer. About 70 percent of women over 40 have regular mammograms for breast cancer, while 82 percent of women over 25 have regular PAP smears for cervical cancer. Among men 50 and older, about 54 percent have regular prostate cancer exams.
Rates of colon cancer screening are where testing for those other diseases were 15 or 20 years ago.
Public awareness
That's starting to change. The cancer society and other groups spent years educating people about the value of screening for breast, cervical and prostate cancer. Now they're starting to roll out large campaigns on colorectal cancer in an effort to raise public awareness and de-stigmatize the disease.
One of the biggest boosts for colon cancer screening rates occurred in 2000 when Katie Couric, the NBC's "Today" show host who lost her husband to colon cancer at an unusually young age, ran a five-part series on colon cancer and underwent a colonoscopy that was broadcast on her show.
A University of Michigan study found that the colonoscopy screening rate jumped 20 percent after the broadcast and remained high for the nine months that the study tracked it. Gastroenterologists still talk about the "Couric effect."
Couric's broadcast helped to reduce the "yuck factor" that some doctors cite as one of the reasons more people don't get screened: Patients are embarrassed or uncomfortable talking about it.