Higher Screening Rates Credited With Drop in Colorectal Cancer
Colorectal cancer is on the decline in the United States, but doctors aren't declaring victory just yet against the deadly disease.
It's one of the few completely preventable forms of cancer -- but only if people get regular screenings, doctors say.
"Unfortunately, only about half of individuals who should be screened are not up to date in their screenings," said Dr. Durado Brooks, director of colorectal cancer for the American Cancer Society.
The American Cancer Society estimates there will be about 112,340 new cases of colon cancer and 41,420 new cases of rectal cancer in 2007 in the United States. Combined, they will cause about 52,180 deaths.
A recent study by researchers at the University of California, Irvine, found that increased screening for colorectal cancer may have contributed to the disease's decline in the United States between 1988 and 2002. According to the researchers, colorectal cancer decreased from 42.8 cases per 100,000 people in 1988-90 to 38.6 cases per 100,000 in 2000-02.
Meanwhile, there was an 80 percent increased use of colonoscopy to test for the disease by Americans between 1997 and 2002.
Many health experts also credit the "Katie Couric Effect," citing the TV newswoman's nationally televised 2000 colonoscopy, prompting more Americans to get screened for the malignancy.
The falling colorectal cancer rates and the climbing colonoscopy rates are linked, because the disease can be averted by removing polyps in the colon that are known to lead to cancer. Those polyps are found through colonoscopy and other screening methods.
"By finding non-cancerous polyps and removing them, we can actually prevent cancer," Brooks said. "Avoiding the disease is probably the most important reason screening needs to be done."
Beginning at age 50, both men and women should follow one of five screening options, according to the American Cancer Society:
A yearly stool blood test or fecal immunochemical test.
A flexible sigmoidoscopy every five years.
A yearly stool blood test plus flexible sigmoidoscopy every five years.
A double contrast barium enema every five years.
A colonoscopy every 10 years.
Colonoscopy has been presented as the best option, because polyps can be detected and removed during the same procedure. During a colonoscopy, a slender, lighted tube is inserted through the anus up into the colon, allowing a thorough scan of the organ.
But Dr. Bernard Levin, vice president of cancer prevention at the University of Texas M.D. Anderson Cancer Center in Houston, said the emphasis on a colonoscopy shouldn't keep people from pursuing other forms of screening if colonoscopy isn't available where they live.
Any screening test that gets done is the best, Levin said. "We have to accept that colonoscopy is not available to everybody. Other screening methods should not be considered second-rate," he said.
Other screening methods might also seem more palatable to patients who don't want to be anaesthetized, undergo the cleansing process necessary to prepare themselves for a colonoscopy, or have some other objection to the procedure.
"Some patients absolutely refuse having anything inserted into their body as a screening tool," Brooks said.
Flexible sigmoidoscopy is similar to colonoscopy, but the tube is inserted only into the lower part of the colon, making the procedure less invasive.
In a barium enema screening, a chalky substance is used to partly fill and open up the colon. Air is then pumped in to cause the colon to expand, allowing X-rays to be taken.
An additional screening tool, virtual colonoscopy, could make it easier than ever to be checked. Virtual colonoscopy uses CT scans and computers to produce two- and three-dimensional images of the colon and display them on a screen.
However, Brooks said, it's too soon to tell whether virtual colonoscopy is a dependable means of detecting or preventing colon cancer.
"Right now, virtual colonoscopy is not recommended as a screening tool," he said. "There is a significant body of evidence that supports its usefulness as a test, but it is being evaluated."
Levin decries another misconception about colon cancer, that men are more likely than women to get the disease.
"Over a woman's lifetime, they have the same chance as men," Levin said. "It's not a man's disease."
Those who are screened regularly for colorectal cancer are being met halfway by the medical profession, which is working to improve the quality of its screenings.
For example, a recent study found that doctors are more likely to get better results during a colonoscopy if they spend at least six minutes looking for abnormal growths.
The key is withdrawing the instrument slowly after it has been fully inserted, Levin and Brooks said.
"You have to do a high-quality examination for that examination to be effective," Brooks said. "Doctors who took their time and removed the scope slowly were able to find abnormalities at a rate of three times more compared with doctors who removed the scope at a more rapid rate."
Levin agreed. "If you're not withdrawing slowly enough to see every aspect of the colon, you're short-changing that patient," he said.
A Safe Summer Means More Fun for Kids
Following simple safety rules can help protect children from injury while they're having fun this summer, say experts from Safe Kids East Central and the Medical College of Georgia's Children's Medical Center.
Here are some safety guidelines:
When riding in a vehicle, children age 12 and under should be secured in the back seat in a child safety seat, booster belt or safety belt that's appropriate for their age and size. Children ages 4 to 8, or those weighing more than 40 pounds, should be in a car booster. Children taller than 4 feet 9 inches may use an adult seat belt.
Teach children never to play in or around parked cars. They should be taught where the trunk release is located. Never leave a child alone inside a car.
Never let a child under age 10 cross a street alone. Make sure all children know when and where to cross a street. At night, make sure children wear reflective materials. Never let children walk alone at night.
Always supervise young children around pools, spas, baths and buckets. Children should always wear a personal flotation device when on boats, near open water, and when taking part in water sports.
Enroll children in swimming lessons with a certified instructor, but don't assume that swimming lessons make children "drown-proof." They still need to be supervised when doing water-related activities.
Children should always wear proper protective equipment (such as helmets and pads) when using bicycles, scooters, inline skates and skateboards. Teach children the rules of the road.
Always supervise children at the playground or in the backyard. Make sure they play on a safe surface, such as mulch, rubber or fine sand. Check that playground equipment is in good shape and safe.
Girls Who Like Dad Favor Partners Who Look Like Him
Women who had a good childhood relationship with their father are more likely to choose partners who resemble their father, new research suggests.
The study, published in the July issue of the journal Evolution and Human Behavior by British and Polish psychologists, also found that women who had a negative/less positive childhood relationship with their father weren't attracted to men who looked like their father.
The researchers had 49 Polish women (eldest daughters) look at pictures of 15 faces and choose the one they found most attractive. Their selections were compared to their fathers' faces. The women were also asked to rate their childhood relationship with their father.
The findings offer new insight into how people select partners and the effect that parents have on the process, the researchers said. Until recently, it was believed that this parental influence was a passive process. But this study adds to growing evidence that it's actually an active process.
The results of this study "show for certain that the quality of a daughter's relationship with her father has an impact on whom she finds attractive. It shows our human brains don't simply build prototypes of the ideal face based on those we see around us, rather they build them based on those to whom we have a strongly positive relationship. We can now say that daughters who have very positive childhood relationships with their fathers choose men with similar facial characteristics to their fathers," study author Dr. Lynda Boothroyd of Durham University said in a prepared statement.