American Cancer Society Updates Guidelines for Colorectal Cancer Detection

American Cancer Society
Wednesday, 14 May 1997

The American Cancer Society today (May 14) announced revised guidelines for the early detection of colorectal cancer at a press conference in Washington, D.C. The press conference was part of Digestive Disease Week, the annual medical meeting for gastrointestinal specialists. The Society's revised guidelines were approved at its national Board of Directors meeting in March in Atlanta.

Colorectal cancer is one of the nation's most common cancers in men and women, and is the second leading cause of cancer death. Approximately 131,200 new cases expected this year in the United States. Over a lifetime, colorectal cancer will strike one in 17 Americans.

For people with an average risk, the Society now recommends two courses of action beginning at age 50, from which the individual and his or her physician can choose. The first option includes annual fecal occult blood (stool blood) tests, together with a flexible sigmoidoscopy and digital rectal exam every five years. The second option is a total colon exam, either by colonoscopy with digital rectal exam every 10 years, or by double contrast barium enema with digital rectal exam every 5-10 years.

People should begin colorectal cancer screening earlier and/or undergo screening more often if they have any of the following colorectal cancer risk factors (at ages and intervals recommended in the new guidelines):

- a personal history colorectal cancer or adenomatous polyps

- a strong family history of colorectal cancer or polyps (cancer or polyps in a first degree relative younger than 60 or in two first degree relatives of any age)

- a personal history of chronic inflammatory bowel disease

- families with hereditary colorectal cancer syndromes (familial adenomatous polyposis and hereditary non-polyposis colon cancer).

The fecal occult blood test can detect hidden blood in the stool. A specimen is obtained at home and returned for analysis. In sigmoidoscopy, the physician uses a flexible lighted tube or a fiberoptic sigmoidoscope to inspect the rectum and lower colon. Colonoscopy uses a similar instrument to examine the entire colon, and barium enema is an x-ray procedure in which the intestines are viewed.

Early detection of colorectal cancer clearly saves lives. When detected in its earliest stage and treated promptly, the disease has a relative five-year survival rate of 91%. After the cancer has spread regionally, the rate drops to 63%, and if it has spread to distant parts of the body, just 7% survive. Only 37% of colorectal cancers are detected in the earliest stage; thousands more lives could be saved if more cases of colorectal cancer were detected earlier.

Previously, the American Cancer Society's guidelines for colorectal cancer screening included annual digital rectal exam starting at age 40, and sigmoidoscopy every 3-5 years after age 50. The changes take into account the most recent research on colorectal cancer screening and the improved accuracy of medical diagnostic tests.

For more information, or to contact American Cancer Society, see their website at: www.cancer.org