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April 2008 Newsletter

Hello Everyone & Welcome to our April 2008 Newsletter

Colorectal cancer (CRC) screening is the least used preventive health screening benefit available to Medicare recipients. Less than 40% of all people who should be screened have been.1 Although not all deaths caused by CRC may be prevented, screening is an important means for reducing the morbidity and mortality caused by CRC.2 More than one-third of colorectal cancer deaths could be avoided if people over 50 had regular screening tests.3 Screening for CRC can prevent most cancers by detection and removal of benign or premalignant adenomatous polyps. It takes an average of 10 years for a polyp to become malignant,4 so this 10-year period provides an opportunity for screening and, most importantly intervention.

A newer kind of stool blood test kit, known as an immunochemical fecal occult blood test (iFOBT) or fecal immunochemical test (FIT), detects occult (hidden) blood in the stool. Neither vitamins nor foods affect the iFOBT or FIT, so people may find it easier to use this type of test than the older guaiac-type tests. Because an FIT detects the presence of human hemoglobin in the sample, it may not detect a tumor that it is not bleeding. This stresses the importance of annual testing, as it may take ten years for a polyp to develop into a cancer. If the results are positive for hidden blood, a colonoscopy should be performed to investigate further.

With the recent release of the new American Cancer Society guidelines in March it is important to point out the benefits of FIT as one of the recommended screening options.

The American Cancer Society recommends that, beginning at age 50, men and women should be screened regularly for colorectal cancer. People should talk to their doctor about starting colorectal cancer screening earlier and/or undergoing screening more often if they have any of the following colorectal cancer risk factors:5

A personal history of colorectal cancer or adenomatous polyps.
A strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60 or in 2 first-degree relatives of any age).
A personal history of chronic inflammatory bowel disease.
A family history of an hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary non-polyposis colon cancer).

For those patients over the age of 50 who are at average risk for CRC the American Cancer Society, together with the US Multi-Society Task Force on Colorectal Cancer and the American College of Radiology have identified the following testing options at the indicated intervals, as acceptable:6

Tests that Detect Adenomatous Polyps and Cancer

Flexible sigmoidoscopy every 5 years, or
Colonoscopy every 10 years, or
Double-contrast barium enema every 5 years, or
Computed tomographic colonography every 5 years

Tests that Primarily Detect Cancer

Annual guaiac-based fecal occult blood test with high test sensitivity for cancer, or
Annual fecal immunochemical test with high test sensitivity for cancer, or
Stool DNA test with high sensitivity for cancer, interval uncertain

Quidel Corporation offers a cost effective solution to colorectal cancer screening. The QuickVue® iFOB test, a FIT, requires only one specimen, and because it is specific to human hemoglobin, patients are not required to adhere to strict dietary restrictions. The result is a more patient-friendly test that is easier to complete.7 Additionally, immunochemical FOB tests are more analytically sensitive than traditional guaiac based methods.8 The QuickVue iFOB test has the potential to increase patient compliance and offers higher analytical performance (as compared to guaiac tests) to positively impact both patient care and satisfaction. Ask your doctor about the QuickVue iFOB test. For more information on the QuickVue iFOB test visit www.colorectal-test.com or www.quidel.com or call 1-800-874-1517.

Your generosity will continue to enable our foundation to continue its mission to eradicate Colon Cancer as a life threatening disease. Please visit the donations section of our website and help us to reach our goals. For assistance please call our National headquarters at 410 244 1778. As always, you can reach me at bobby@coloncancerfoundation.org.

1 Smith et al., 2003 Cancer Journal for Clinicians, 53(1), 44–55.

2 Ransohoff & Lang, 1991 New England Journal of Medicine, 325(1), 37–41.

3 Smith et al., 2001 Cancer Journal for Clinicians, 51(1), 38–75.

4 Wineman, 2003 Postgraduate Medicine, 113(2), 49.

5 “American Cancer Society Guidelines for the Early Detection of Cancer,” http://www.cancer.org/docroot/PED/content/PED_2_3x_ACS_Cancer_Detection_Guidelines_3b.asp?sitearea=PED. Revised 3/20/08.

6 Levin et al., “Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology”, CA Cancer JClin 2008 (published online 3/5/08) doi:10.3322/CA.2007.0018.

7 OncoLog, February 2004, Volume 49 No.2.

8 Castiglione, G. and Zappa, M., Debate on Colorectal Cancer Screening by Faecal Occult Blood. Annals of Oncology, February 2003, 14(2): 342-344.

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