All month long, doctors across the country have been urging their patients over the age of 50 to get tested for colorectal cancer. March is not only colon cancer awareness month; it’s also part of the “80-percent by 2018 initiative.” It’s a movement aimed at getting 80-percent of the population screened for colorectal cancer in the next three-years. Flagstaff Dr. Peter Mathern with Arizona Oncology and Dr. Rodney Engel with Northern Arizona Gastroenterologist joined Arizona Public Radio’s Aaron Granillo to talk about the initiative.
AG: Dr. Engel, do we know how much of the population right now is getting screened?
Dr. Engel: What I have seen most recently is between 50 and 60 percent of the population is getting screened. And with the fecal occult blood test, which is a very effective screening test, and if you’re not getting screened at all it’s certainly a huge step up. You have to do that every year to be adequately screened for colon cancer. Colonoscopy – if you do that – you have multiple years before that’s needed to be done again. If it’s completely negative and there’s no polyps it’s ten years before you’re screened again. Whereas fecal occult blood is every year. So adequately screened is over the half the population, but probably not two-thirds and certainly nowhere near 80 percent. And in northern Arizona I think that number is quite a bit lower than the rest of the nation.
AG: And so Dr. Mathern, right now the recommendation is if you’re over 50-years-old you should get screened for colon cancer. But, are there people who are more at risk than others of getting the cancer?
Dr. Mathern: There are certain individuals that need to have screening or maybe more surveillance for cancer at a much younger age. Especially if they have family history of certain genetic predisposition like lynch syndrome or familial polyposis. Or patients with inflammatory bowel disease. They also are at the very high risk for cancer. So obviously that’s then between those patients and their gastroenterologist. They may need much more aggressive surveillance for cancer.
AG: Dr. Engel, you were mentioning that 50 to 60 percent number of people who are getting screened. Why do you think it is so low?
Dr. Engel: Well just today I had a patient tell me that I’m not a doctor people look forward to seeing. It’s an embarrassing issue, but it’s something that can save your life. So people aren’t excited to have the possibility of a colonoscopy. It’s not pleasant to get prepped for a colonoscopy. However, the sedation and our experience with this has made the procedure much more comfortable and much less of a concern for patients than it may have been in the past. At least in our practice, my experience to this point in a year-and-a-half here in Northern Arizona is everyone’s just slept through it and said the procedure itself has been really easy.
AG: Can you talk about some of the symptoms that you might start feeling that you might think to yourself maybe I should get this checked out.
Dr. Engel: So the important thing about colon cancer awareness is that the vast majority of people, even with early stage cancers, are completely asymptomatic. So you have no symptoms. There’s nothing that suggests you should be checked out. And only 15-percent of colon cancers are associated with a family history of colon cancer. So 85-percent of people have no family history and 70-percent of people generally have no symptoms when, if they have a colonoscopy, there’s a colon cancer discovered. So, that’s why being screened is so important when you don’t have symptoms.
AG: And Dr. Mathern, I want to ask you; where do you see the future in treating colon cancer?
Dr. Mathern: There’s a lot of new research on treatments on many types of cancer. I think that there is a much more emphasis now on the biological type of treatments. Kind of new alternatives to old chemotherapy, where we see using certain antibodies against cancer. Or an antibody against new blood vessel formation. So, there is a lot of new exciting developments in treatment of cancer. But, we don’t want to even get there, right? We want the oncologists to go out of business, so to say, by screening patients early enough so they don’t have to go through chemotherapy. So that’s kind of the goal of this month of awareness of colorectal cancer and screening.