Men Choose Prostate Over Colon for Cancer Screening

Many avoid colon screenings, although they save more lives

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HealthDay Reporter

TUESDAY, March 18, 2003 (HealthDayNews) -- Men, would you rather have a screening for colorectal cancer or prostate cancer?

Your answer appears to clearly focus on the prostate, or maybe the ease of the test. A new study shows men are far more likely to get screened for prostate cancer than for cancer of the colon or rectum.

This trend is troubling to cancer prevention experts, because colorectal cancer screening has been proven to reduce deaths, while the benefits of prostate cancer screening are far less sure.

Prostate cancer is slow-growing and tends to develop late in life. That means many men are likely to die of another cause before the prostate cancer would pose any risk to their health, says Dr. Brenda Sirovich, lead author of the study and a staff physician at the Veteran's Administration Medical Center in White River Junction, Vt.

"We expected to find more men would be tested with the proven technique than the unproven test," Sirovich says. "What we found was the reverse."

For the study, which appears in the March 19 issue of the Journal of the American Medical Association, Sirovich and her colleagues used data from the U.S. Centers for Disease Control and Prevention on 49,000 men from 50 states.

The researchers found that 75 percent of men aged 50 and older reported having had a prostate cancer screening test at least once, while only 63 percent had colorectal cancer screening.

In only four states -- Hawaii, Maine, Minnesota and Vermont -- were men equally likely to have had both.

"We don't know why that is," Sirovich notes. "It's an area for future research.

Prostate cancer screening is a simple blood test. Colorectal cancer screening includes one of three methods: a fecal occult blood test, which tests for hidden blood in the stool; a sigmoidoscopy, an examination of the rectum and the lower colon with a flexible light instrument; or a colonoscopy, in which the entire colon is examined with a long, flexible, tubular instrument.

Among men aged 50 to 79, 54 percent were up-to-date on prostate cancer screening, while only 45 percent were up-to-date on colorectal cancer screening, the study found.

Colorectal cancer is the second leading cause of cancer deaths among men and women in the United States. This year, an estimated 150,000 people will be diagnosed with the disease and 57,000 will die from it, according to the National Cancer Institute.

When caught early, colorectal cancer is highly treatable, says Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in Baton Rouge, La. About 95 percent of colon cancer cases begin with polyps, he says, which are highly curable.

But many people are uncomfortable with having that part of their bodies examined. And a colonoscopy is inconvenient. You can't consume anything other than clear liquids the day before the test. You have to drink another liquid that makes you have repeated bowel movements. Then there's the probe, which doctors say does not cause pain.

"I'm not surprised by this," Brooks says. "Colon cancer is the No. 1 cancer that is not screened for adequately. It's a silent killer and patients do not avail themselves of the excellent cancer screening tests we have."

The American Cancer Society and other major medical organizations recommend men and women over the age of 50 get screened for colon cancer with a fecal occult blood test yearly and a flexible sigmoidoscopy or colonoscopy every five to 10 years.

People with a family history of colon cancer, or history of polyps, should get tested more often. If you've undergone a colonoscopy, most doctors say you can forgo the fecal occult blood test for several years.

More information

Learn more about colorectal cancer and the American Cancer Society's screening guidelines by clicking here. For more information on a colonoscopy, visit the American Society of Colon and Rectal Surgeons.

The American Cancer Society also has information about prostate cancer.

SOURCES: Brenda Sirovich, M.D., staff physician, Veterans Administration Medical Center, White River Junction, Vt., and assistant professor, Dartmouth Medical School, Hanover, N.H.; Jay Brooks, M.D., chairman of hematology/oncology, Ochsner Clinic Foundation, Baton Rouge, La.; March 19, 2003, Journal of the American Medical Association

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