Conquering Colon Cancer

Colorectal cancer is the second leading cause of cancer death in the United States. Thanks in large part to colorectal cancer screening, the death rate from colorectal cancer has been going down for the past two decades. Treatments have improved as well. As a result, there are around 1 million survivors of colorectal cancer in the U.S.

Why Is Screening So Important?

Screening in necessary to detect colorectal cancer in its early stages.

Beginning at 50, adults at average risk should have one of the following: 1) fecal occult blood test (FOBT) every year, or 2) flexible sigmoidoscopy every 5 years, or 3) FOBT every year and flexible sigmoidoscopy every 5 years (The American Cancer Society prefers the FOBT/flex sig option over either of these 2 tests alone), 4) double-contrast barium enema every 5 years, or 5) colonoscopy every 10 years.

A digital rectal exam should be done at the same time as sigmoidoscopy, colonoscopy, or double-contrast barium enema. People at increased or high risk should talk with a doctor about about getting screened at a younger age.

Who's At Risk For Colon Cancer?

The risk of colorectal cancer increases with age; more than 90 percent of cases are diagnosed in persons aged 50 and over. Persons also at increased risk have personal or family history of colorectal cancer or polyps, and inflammatory bowel disease. Other possible risk factors include smoking, physical inactivity, high-fat and/or low-fiber diet, alcohol consumption, as well as low intake of fruits and vegetables.

What Is The Treatment?

Surgery is the most common form of treatment for colorectal cancer, and for cancers that have not spread, it is frequently curative. Chemotherapy, or chemotherapy plus radiation is given before or after surgery to most patients whose cancer has deeply perforated the bowel wall or has spread to the lymph nodes.

How Many States Require Insurance Companies Cover Screening Colonoscopies?

Another obstacle to getting a colonoscopy is that it's not an inexpensive test and some insurance companies will not cover it. The cost of a colonoscopy typically ranges between $600 and $3,000. That includes both the physician's fee and the facility fee.

So far, only 19 states have laws requiring insurance companies cover screening colonoscopies. The federal government provides colorectal cancer screening coverage for all Medicare beneficiaries, so it's available to everyone 65 and over.

The Centers for Disease Control has information on the locations for a nationwide pilot project providing free colonoscopy screenings. Federal legislation to be introduced later this month that would expand this program, and provide colorectal cancer screening and treatment to uninsured men and women ages 50-64.

What Can You Do To Push For Screening Coverage?

Employers can play an important role in making sure employees get coverage. Companies can insist that all the health insurance policies available to their employees provide coverage of colonoscopies; some companies do that now. People should ask their employers about this.

To Learn More About Colorectal Cancer:

• The Jay Monahan Center for Gastrointestinal Health is a clinical center of the NewYork-Presbyterian Hospital and the Weill Medical College of Cornell University.

• To learn about colorectal cancer legislation, and to find out how your state measures up, click here.

• The Centers for Disease Control is funding a three-year colorectal cancer screening demonstration program aimed at increasing colorectal cancer screening among low-income adults age 50 and over who have little or no health insurance coverage for regular screenings.

• To read more about the Center for Disease Control's pilot program, click here.

• The Colon Cancer Alliance has additional resources.