Y o u r C o u n t y C r u s a d e A g a in s t C a n c e r

1. Y o u r C o u n t y C r u s a d e A g a in s t C a n c e r

3. COLORECTAL CANCER Let’s Get Talking . . .

4. (colorectal cancer) • It can be “embarrassing” to talk about colorectal cancer • DON’T DIE FROM EMBARRASSMENT • Colorectal Cancer CAN Be Prevented S o , L e t s G e t T a l k i n g . . .

5. Colorectal Cancer Overview • Where & What is the Colon? • What is Colon Cancer? • Why the Concern? • Who’s at Risk? • What Can be Done? • Prevention • Screening • Treatment • Where to Get More Information

6. Where is the Colon ?

7. What does it do? As part of the digestive system the colon: • Stores mainly non-absorbed food, fiber and water • Re-absorbs nearly all the water • Moves solid waste to the rectum where it is eliminated by defecation

8. What is cancer? • Cancer is the uncontrolled growth and spread of abnormal cells. • It includes 100’s of different diseases, usually classed by the part of the body where it is first found.

9. How does colorectal cancerdevelop? • Most colorectal cancers begin as polyps, or tiny abnormal growths on the inside walls of the colon or rectum. • Polyps vary in size, from tiny to a few centimeters. • Some polyps become cancerous after several years and should be removed to prevent development of colorectal cancer.

10. X-Ray of Colon and Polyps

11. Why the Concern? • 4th leading cause of cancer-related death in world • 2nd leading in US • Why a difference between world and US ? • Stay tuned • 2nd leading in Missouri • 2nd leading in YOUR County

12. Who Is At Risk of Developing Colorectal Cancer? • Men ANDWomen are at similar risk • Risk increases with age •  90% occurs in people aged 50 + • 85% of people with colorectal cancer had NOmedical history related to colorectal cancer.

13. What are Risks for Developing Colorectal Cancer? • Poor Diet • high amount of fats • high amount of red meat • high temperature cooking of red meats • low amount of vegetables • high alcohol consumption • low water consumption

14. What are Risks for Developing Colorectal Cancer? • Physical inactivity

15. Why the Difference Between World and U.S. Rates? • Colorectal Cancer has been Called a “Cancer of Economically Developed Countries” • Diet is different • Physical activity is different

16. Ways to Reduce Your Risk • Regular moderate exercise • Healthy diet • Proper weight • Avoid smoking • Limit alcohol use • GET REGULAR SCREENING

17. Ways to Reduce Your RiskHealthy Diet“Five-A-Day” is  5 servings of fruits & vegetables / dayThis can reduce your risk for a number of diseases, including some types of cancer, such as colorectal cancer

18. Ways to Reduce Your Risk • Physical activity recommendations: • For 30 minutes (can be three 10 -minute segments) • At least 5 times per week • At the pace of brisk walking

19. Other possible risk reducers • Aspirin • Non-steroidal anti-inflammatories • Calcium • Vitamin D

21. Screening is KEY ! • American Cancer Society estimates for the impact of colorectal cancer in 1999: • 129,400 cases diagnosed in the U.S. • 56,000 deaths in the U.S. • 1,300 deaths in Missouri • At least 1/3 of deaths could be reduced with widespread adoption of screening.

22. Don’t wait... • Colorectal cancer can develop with few or no symptoms at first. • Screening can lead to reductions in the number of deaths: • FOBT: 33% • Flexible sigmoidoscopy: 70% • Colonoscopy: 80%

23. How does screening save lives? • Prevention • By finding polyps in the colon and removing them before they become cancerous • Early detection • Finding cancer early when treatment works best

24. Who should be screened for colorectal cancer? • EVERYONE aged 50 and older: • Women and men • All races and ethnicities • May be younger than 50 for those with a family history of colorectal cancer or colorectal polyps (talk to your doctor!)

25. Why don’t some people get screened? • Don’t think they are at risk for colorectal cancer • Embarrassed to ask their doctor • Think it will hurt • Don’t realize that screening is covered by their insurance plans, including Medicare

26. The screening tests • Fecal Occult Blood Test (FOBT) • Flexible Sigmoidoscopy • Colonoscopy • Double Contrast Barium Enema

27. Fecal Occult Blood Test (FOBT) • Looks for hidden (occult) blood in the stools • Stool sample is collected at home • Test preparation will likely include dietary and medicinal restrictions (check test kit instructions)

28. Example of One Type of FOBT

29. Positive test results may be due to: • Colorectal cancer or polyps. • Failure to follow pre-test dietary and medicinal restrictions. • Other bowel disorders which could cause bleeding (though not always a lower GI source): • colitis - diverticulitis - hemorrhoids, among others • Follow-up is IMPORTANT- your physician will usually recommend a full colon exam using colonoscopy or barium enema.

30. Fecal Occult Blood Test • Annual screening can lead to 33% reduction in deaths • Annual FOBT test is worth the effort !!!

31. Flexible sigmoidoscopy • Uses a flexible lighted tube to examine the inside of the lower part of the colon (sigmoid). • The slender tube allows for discovery of polyps. • Polyps can be removed during sigmoidoscopy or by a follow-up colonoscopy.

32. Flexible Sigmoidoscopy • Regular screening can lead to 70% reduction in deaths Regular Flexible Sigmoidoscopy is worth the effort !!!

33. Colonoscopy • Uses a flexible lighted tube to examine the inside of the entire colon • The slender tube allows for removal of polyps and tissue for biopsy

34. Colonoscopy • Regular screening can lead to 80% reduction in death Regular Colonoscopy is worth the effort !!!

35. Double Contrast Barium Enema • Radio-opaque liquid with barium put into colon • Barium coats lining of colon and rectum • Allows organs and any signs of disease to show more clearly on x-rays

36. Double Contrast Barium Enema • Regular screening can lead to 80% reduction in deaths Regular Barium Enema is worth the effort !!!

37. American Cancer Society recommendations for screening • For adults aged 50+ with no family history of colon cancer or polyps: • Annual FOBT PLUS • Flexible sigmoidoscopy every 5 years - - OR - - • Total colonic exam • Colonoscopy every 10 years; or • Double-contrast barium enema every 5-10 years

38. Treatment • More than 90% of people whose colorectal cancer is treated early survive at least 5 years after their diagnosis • Only 8% of people who are diagnosed in later stages survive past 5 years THIS IS WHY SCREENING IS SO IMPORTANT !!!

39. Remember…Lifestyle risk reducers: Healthy food choices Maintain a healthy weight Physical activity Avoid smoking Plus screening tests... FOBT and *** Colonoscopy or Sigmoidoscopy *** Double contrast barium enema Combine to save lives!

40. Where Can You Get Screening? Talk to your health care professional

41. Where Can You Get More Info? • American Cancer Society 33 East Broadway, Suite 100 Columbia MO 65203 573-443-1496 800-429-7753 ed.johnson@cancer.org www.cancer.org • Toll-free National Phone 1-800/ACS-2345

42. Where Can You Get More Info? • Missouri Department of Health & Senior ServicesBureau of Cancer ControlP.O. Box 570 920 Wildwood Jefferson City MO 65102ph 573/522-2841fax 573/522-2899e-mail cowans@dhss.state.mo.us

43. Presented in Cooperation ofYour County Community Council of the American Cancer Society Missouri Department of Health . & Senior Services Bureau of Cancer Control

44. Special thanks to theU.S. Centers for Disease Control & Prevention