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March is National Colorectal Cancer Awareness Month

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Margo Kerrigan, M.P.H., Area Director
Indian Health Service California Area Office

March 2007 - Colorectal cancer- cancer of the colon or rectum - affects both men and women. Colorectal cancers are the third most common type of cancer in the United States, and are the third leading cause of cancer death. People over age 50 are at the greatest risk for colorectal cancer. About 91% of new cases and 94% of deaths from colorectal cancers occur in people over age 50.

However, approximately 90% of colorectal cancers and deaths are thought to be preventable. Low levels of exercise, high-fat, low-fiber diets, and low consumption of fruits and vegetables are all associated with an increased risk of colorectal cancer. Other risk factors for colorectal cancer include a family history of the disease, a history of inflammatory bowel disease, high alcohol use, and tobacco use. Through lifestyle changes and regular screening, people can lower their risk of developing colorectal cancer.

There are some steps you can take to reduce your risk of developing colorectal cancer:

  • Exercise regularly and maintain a healthy weight
  • Eat a diet rich in fruits, vegetables, and whole grains
  • Use alcohol in moderation
  • Stop smoking
  • Get regular screening tests for colorectal cancer starting at age 50


    Screening tests can detect polyps (grape-like growths on the lining of the colon or rectum) that can turn into cancer. Removing these polyps can prevent colorectal cancer from ever occurring.

    Screening should include one or a combination of four recommended screening tests:

  • A fecal occult blood test (FOBT), performed every year. This test determines if there is any blood in your bowel movements. Blood may come from polyps. The test is usually done with a kit that you take home with you and return to your provider for testing.
  • A flexible sigmoidoscopy every five years. In this procedure, a flexible, lighted tube the thickness of your finger is placed into the rectum and lower part of the colon so that the physician can search for polyps.
  • A colonoscopy every 10 years. This is a test using a scope (tube) and video that lets your doctor examine the lining of the colon and rectum. It can detect polyps and early cancers. This is an outpatient procedure performed at a hospital or clinic.
  • A barium enema every 5 years. This is a procedure using Barium Sulfate (U.S.P.), a water insoluble, unabsorbed, non-toxic salt of barium that is considered very safe. Barium Sulfate is used as a diagnostic aid for many GI problems, and when used as an enema, helps to show the image of the colon and rectum on an X-ray.

    The frequency and choice of screening method depends on a person's medical history. Also, patients should have a digital rectal exam every 5-10 years at the time of the screening procedure. Men and women who have a higher risk of the disease because of personal or family medical history need to be tested earlier and should talk to their health care professional about when.


    The Indian Health Service has a GPRA measure for colorectal cancer screening for patients ages 50-80. In FY 2006, GPRA results showed that 22% of eligible patients received appropriate colorectal cancer screening at IHS and tribal sites. In the California Area, 17% of eligible patients received appropriate colorectal cancer screening in FY 2006. The measure includes all recommended screenings: a fecal occult blood test during the past year, a flexible sigmoidoscopy in the past 5 years, a double contrast barium enema in the past five years, or a colonoscopy in the past 10 years.

    Raising colorectal cancer screening rates is a priority for the Agency. Due to low rates of screening, American Indians and Alaska Natives are less likely to be diagnosed with colorectal cancer at the earliest, localized stage, and more likely to be diagnosed at the distant (most advanced) stage, compared to whites and Asian Americans. Patients diagnosed at the local stage have a five-year relative survival rate of about 90%, while those diagnosed at the distant stage have a 10% five-year relative survival rate.

    For more information

    National Colorectal Cancer Awareness Month website:
    http://www.preventcancer.org/colorectal/ Exit Disclaimer – You Are Leaving www.ihs.gov

    American Cancer Society
    http://www.cancer.org/docroot/home/index.asp Exit Disclaimer – You Are Leaving www.ihs.gov

    The Colon Cancer Alliance:
    http://www.ccalliance.org/ Exit Disclaimer – You Are Leaving www.ihs.gov

    Colorectal Cancer Network:
    http://www.colorectal-cancer.net/ Exit Disclaimer – You Are Leaving www.ihs.gov

    Medical Providers may find more specific information at:
    http://www.ihs.gov/MedicalPrograms/CIR/index.cfm?module=cir_answering_clinical_questions Exit Disclaimer – You Are Leaving www.ihs.gov

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