This weekend, Congress completed work on a large spending bill that maintains funding for colorectal cancer research and prevention. In the current budget-cutting environment, holding the line on research and prevention programs is a remarkable accomplishment and reflects the power of grassroots advocacy.

I congratulate the Fight Colorectal Cancer volunteers who took action this year to protect colorectal cancer research and prevention funding. We should be proud of our achievements, but we cannot become complacent. We must prepare for the Fiscal Year 2013 budget battle that lies ahead. Please register to attend Fight Colorectal Cancer’s Call-on Congress next March – where advocates from around the country will be urging their legislators to continue to protect colorectal cancer research funding.

The following are the spending outcomes on Fight Colorectal Cancer’s three appropriations priorities:

• The Colorectal Cancer Control Program (CRCCP)
• The National Cancer Institute (NCI) and
• The Peer Reviewed Cancer Research Program (PRCRP)

Note: The funding levels described below for the CRCCP and NCI do not reflect a 0.189 percent across-the-board cut that will be applied to all discretionary programs under the Departments of Labor, Health and Human Services (HHS), Education, with the exception of the Pell Grant Program.

Colorectal Cancer Control Program
Despite threats of deep spending cuts, the Centers for Disease Control and Prevention (CDC) received a slight increase, which allowed funding for the CRCCP to be preserved at its current level of $43.07 million. The CRCCP currently funds colorectal cancer programs in 25 states and four tribal organizations. Funded sites can use up to one-third of funds to provide no-cost screening services to eligible low-income men and women age 50-64. The remaining two-thirds of funds are for colorectal cancer education and outreach strategies. Maintaining CRCCP funding allows education and screening programs currently underway to continue. If funding for CRCCP was increased, education and screening programs could be expanded to more states.

National Institutes of Health

For FY2012, the NIH will receive a $299 million increase in its budget, with the various Institutes and Centers receiving
proportional increases, resulting in $5.082 billion for the NCI. The outcome reflects compromise between the $1 billion increase for the NIH in the House Labor-HHS -Education spending bill and the $190 million cut in the Senate bill. In addition to $30.698 billion for the NIH, the bill also includes $10 million for the Cures Acceleration Network (CAN), which was established under the Patient Protection and Affordable Care Act. The purpose of CAN is to accelerate the testing of high-need cures – drugs, biologics and devices – that are not attractive for development within the commercial market.

Peer Reviewed Cancer Research Program
Another important victory for the colorectal cancer community was the inclusion of $12.8 million for the Department of Defense’s (DoD) PRCRP. Comparatively, the PRCRP received $16 million for FY2011. While the program’s budget was decreased, some in Congress have called for the elimination of non-defense spending, including funding for medical research, from the DoD spending bill. The PRCRP funds research on several forms of cancer, including colorectal cancer.

Between 2003 and 2007, there were 32,000 fewer deaths from colorectal cancer in the United States. At least half of the drop was due to improved colorectal cancer screening rates according to the Centers for Disease Control and Prevention.

In addition, to fewer deaths, 66,000 people didn’t get colorectal cancer at all during the same four years.

The good news is that the percentage of Americans who are up-to-date with colorectal cancer screening is rising steadily. About two-thirds now report an FOBT in the last year or a colonoscopy or sigmoidoscopy in the past 10 years.

The bad news is that 1 out of 3 people aged 50 to 75 hasn’t been screened.

The CDC conducts telephone surveys every year through the Behavioral Risk Factor Surveillance Systemn (BRFSS) asking people in the United States about key health issues including whether or not they’ve had colorectal cancer screening.

• In 2002 52.3 percent of BRFSS responders said they had.
• In 2010 the rate was up to 65.4 percent.

Rates were highest for whites at 66.1% and blacks at 65.8%. Hispanics had the lowest rates at 53.8%.

If screening progress continues and meets the Healthy People 2020 goals, 1,000 more deaths will be prevented every year.

Decreases in colorectal death rates are falling at 3.4 percent a year:

• 2003: 19.0 deaths per 100,000 Americans
• 2007: 16.7 deaths per 100,000
• Healthy People 2020 Goal: 14.5/100,000

It costs $14 billion a year to treat colorectal cancer in the United States, and that is expected to rise to $20 billion by 2020. The lifetime cost of screening one person with guaiac-based FOBT is $71 or $1,397 with colonoscopy.

The most frequent reason people give for not being screened is that their doctor didn’t recommend it. Other barriers include lack of insurance, not knowing that screening decreases risk of colorectal cancer, and fear of the screening test or of finding cancer.

SOURCE:

Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR), Vital Signs: Colorectal Cancer Screening, Incidence, and Mortality — United States, 2002–2010, July 8, 2011.

In 2007, 62 out of every 100,000 black men in the United States were diagnosed with colon or rectal cancer, the highest rate of colorectal cancer of any US group.

Overall, men were more likely to get colorectal cancer than women — almost 53 of every 100,000 American males compared to 40 per 100,000 females.

Reporting colorectal cancer incidence rates for 2007, the Centers for Disease Control and Prevention urged regular colorectal cancer screening for all average risk adults 50 years and older to cut deaths from colorectal cancer.

According to the CDC, 142,672 Americans were diagnosed with colorectal cancer in 2007, including 72,755 men and 69,917 women.

Incidence rate means how many people out of a given number get a disease in a given year.  Colorectal cancer incidence rates are reported per 100,000 people.

Across all groups, 52.7 of every 100,000 men were diagnosed with colorectal cancer in 2007 and 39.7 per 100,000 women.

The incidence rates per 100,000 men were:

• Blacks: 62.0
• Whites: 51.5
• Hispanics: 44.8
• Asian/Pacific Islanders: 39.7
• American Indians/Alaska Native: 33.5

For women,  incidence rates were

• Blacks: 47.1
• Whites: 38.5
• Hispanics: 32.6
• Asian/Pacific Islanders: 31.1
• American Indians/Alaska Native: 28.8

The CDC estimates that as many as 60 percent of colorectal cancer deaths could be prevented if all men and women age 50 and over were screened routinely.

Data comes from the United States Cancer Statistics: 1999–2007 Cancer Incidence and Mortality Web-based Report.

Among the nearly 12 million US cancer survivors, there are 1.1 million who have been diagnosed with colon or rectal cancer.

The number of all US cancer survivors has increased steadily from about 3.8 million in 1971 to 9.8 million in 2001 to 11.7 million in 2007.

More than half of survivors had colorectal, breast, or prostate cancer.

Individuals are considered cancer survivors from the time of diagnosis through the balance of their lives.

As of January 1, 2007:

• 64.8 percent of survivors had lived 5 years of more since their diagnosis.
• 1.1 million of the 11.7 million had lived more than 25 years.
• 59.5 percent were 65 years old or older.
• 54.3 percent were female, 45.7 percent male.

Most common cancer diagnoses were

• female breast: 22.1 percent of all survivors,
• prostate: 19.4 percent.
• colorectal: 9.5 percent.

People in the United States diagnosed with cancer:

• In 1971 there were 3 million cancer survivors, 1.5 percent of the US population.
• By 2001, the number of survivors had increased to 9.8 million, 3.5 percent of people in the US.
• In 2007, survivors grew to 11.7 million, 3.9 percent of population.

Almost all survivors were over 40 in 2007

• 59.5 % were 65 and older.
• 35.2 % were 40 to 60.
• 4.5 % were 20 to 39.
• less than 1 % were 19 or younger.
• of the young survivors under 20, 1/3 had been diagnosed with leukemia.

SOURCE: Centers for Disease Control, Morbidity and Mortality Weekly Report, Volume 60, Number 9, pages 269-272.

Overall, colorectal cancer screening rates were higher in 2008 than in 2006.

By 2008 almost 2 of every 3 Americans over the age of 50 had either had a fecal occult blood test in the past year or sigmoidoscopy or colonoscopy within the past ten years.

Health insurance made a huge different with two-thirds (66.6 percent) of people with insurance up-to-date with screening compared to about one-third (37.5 percent) of those without health insurance.

From 2002 through 2008, screening rates for people with health insurance went up almost 11 percentage points, while rates for the uninsured went up less than 5 percent.

Rates also lagged for the poor, for those without a high school education, and Hispanics.

States with the highest rates included New Hampshire, Utah, and Connecticut while Mississippi, Louisiana, and New Mexico had the lowest.

People who were 65 and older were much more likely to have been screened than younger adults — 72.8 percent compared to 58.2 percent for those from 50 to 64.

Overall screening rates were:

• 53.8 percent in 2002
• 60.7 percent in 2006
• 64.2 percent in 2008

Information for the Centers for Disease Control analysis comes from the 2002, 2004, 2006, and 2008 Behavioral Risk Factor Surveillance System (BRFSS) surveys.  The BRFSS surveys come from randomly dialed telephone calls to people in the United States over the age of 15.  About half of calls made reached someone, and three out of four of those reached were willing to answer the survey questions.  In 2008, 250,000 people were surveyed.

SOURCE: Centers for Disease Control, Morbidity and Mortality Weekly Report, January 14, 2011

Almost half of the colorectal cases in the United States are diagnosed at late-stages of the diseases when treatment is more difficult, according to a new report released today by the Centers for Disease and Control and Prevention (CDC). Significant findings of the study “Surveillance of Screening-Detected Cancers (Colon and Rectum, Breast, and Cervix) — United States, 2004-2006” include:

* Incidence rates of late-stage colorectal cancer increased with age and were highest among black men and women.
* Late-stage colon and rectum incidence rates ranged from 51.0 to 86.5, and were highest in Connecticut, Delaware, Illinois, Iowa, Kentucky, Louisiana, Maine, Nebraska, New Jersey, and Pennsylvania.

“This report causes concern because so many preventable cancers are not being diagnosed when treatment is most effective,” said Marcus Plescia, MD, MPH, Director, Division of Cancer Prevention and Control. “More work is needed to widely implement evidence-based cancer screening tests which may lead to early detection and, ultimately, an increase in the number of lives saved.”

The CDC report is the first to highlight the nationwide incidence of late-stage cancer diagnosis and cancer screening prevalence, the incidence rates of late-stage cancers differed by age, race/ethnicity, and state.

The CDC’s Colorectal Cancer Control Program currently funds colorectal cancer screening programs in 25 states and 4 tribal organizations. However, we need your help to make this program permanent! In order to expand the CDC’s Colorectal Cancer Control Program nation-wide and allow the CDC to cover treatment costs we need to get Representative Kay Granger’s “Colorectal Cancer Early Detection, Prevention and Treatment Act” enacted into law. If you haven’t already done so, please take a minute to call your Representative and ask them to cosponsor H.R. 1189.

How to Call Your Representative
* Dial the Capitol Switchboard at 202-224-3121 and ask to be connected to your Representative (you’ll need to know your Rep’s name).
* Once you are connected to your Representative’s office, identify yourself as a constituent.
* Leave a message asking your Representative “to cosponsor H.R. 1189 to save thousands of lives and save Medicare billions.”

Want to help increase awareness of the importance of early detection and screening in your city and state? Download our Proclamations 101 toolkit and request a proclamation recognizing March as Colorectal Cancer Awareness Month from your city council, mayor, and/or governor. Our toolkit includes sample letters to the editor and press releases you can use to get the word out about the importance of early detection and screening. The toolkit and more information is available online at http://link.fightcrc.org/proclamations101.

The House and Senate are finishing up a continuing resolution (CR) that will fund the federal government through December 3, and plan to adjourn after voting on the CR until November. Under the CR, funding will continue at FY 2010 enacted levels for most programs – including cancer research programs at the National Institutes of Health and colorectal cancer control programs at the Centers for Disease Control and Prevention. Congress is not expected to finish the fiscal year 2011 appropriations bills until after the election.

Take action today, and tell Congress to increase fiscal year 2011 cancer research funding. As they head home for the election, take a minute to remind Members that they have work to finish when they come back to DC in November. Tell your Senators and Representative that you expect them to make colorectal cancer a top priority.

On Facebook? Take action and share this alert with your friends and family so that they can help in the fight too.

The Colorectal Cancer Coalition is working with Congressional leaders to increase fiscal year 2011 funding for the following colorectal cancer research and control programs:

• $50 million in funding for the Peer Reviewed Cancer Research Program (PRCRP) at the Department of Defense
• $35.2 billion for the National Institutes of Health (NIH)
• $5.79 billion for National Cancer Institute (NCI)
• $240 million for the National Center on Minority Health and Health Disparities (NCMHD)
• $601 million for Centers for Disease Control and Prevention (CDC) cancer programs
• $50 million for CDC’s National Comprehensive Cancer Control Program
• $50 million for CDC’s Colorectal Cancer Screening, Education & Outreach Initiative
• $65 million for CDC’s National Program of Cancer Registries
• $2.857 billion for the Food and Drug Administration (FDA)

Thanks to research, we have made great strides in the fight against colorectal cancer and treatment options have expanded to seven drugs. Today, people diagnosed with metastatic colorectal cancer are living longer than ever. But there is more work to be done, and we need continued federal funding of research programs to win the fight against colorectal cancer.

Take action today, and help us secure an increase in federal funding for fiscal year 2011.

Check the eggs in your refrigerator!

The FDA, collaborating with the Centers for Disease Control, the Department of Agriculture, and state health departments, have traced a nationwide spike in Salmonella Enteritidis (SE) infections to a single firm in Iowa.

Eggs shipped from Wright County Egg of Galt, Iowa after May 16,2010 have been recalled.

The CDA received approximately 200 reports of Salmonella Enteritidis every week in late June and early July, more than four times the usual 50 weekly reports over the past five years.

Wright County Egg says that the affected eggs are packaged under the following brand names: Lucerne, Albertson, Mountain Dairy, Ralph’s, Boomsma’s, Sunshine, Hillandale, Trafficanda, Farm Fresh, Shoreland, Lund, Dutch Farms and Kemps in various carton sizes.

Check your egg carton to see if what you have is part of the recall.

The shipment date uses a Julian format ranging from 136 to 225.  Eggs were shipped from plant numbers 1026, 1413 and 1946. Dates and codes can be found stamped on the end of the egg carton. The plant number begins with the letter P and then the number. The Julian date follows the plant number, for example: P-1946 223.

Salmonella infections often cause fever, diarrhea, nausea, vomiting and abdominal pain.  Infections can be serious and even fatal in young children, the elderly or frail, or people with compromised immune systems.  Cancer patients and those undergoing chemotherapy may be at high risk.

Wright County Egg and the FDA urge anyone with eggs involved in the recall not to eat them and either throw them out or return them to the store where they bought them for a refund.  If you think you are sick from eating eggs, call your doctor!

The FDA offers this advice for preparing and eating eggs in general:

• Keep eggs in their shells refrigerated at 45 degrees (Fahrenheit) or lower.
• Never eat raw eggs.
• Throw out dirty or cracked eggs.
• Wash your hands, cooking utensils, and food preparations surfaces thoroughly with soap and water after preparing raw eggs.
• Cook all eggs until both yolks and whites are firm.
• Don’t keep eggs warm or at room temperature more than 2 hours.
• Refrigerate all leftovers containing eggs promptly.
• Avoid estaurant dishes made with raw or undercooked, unpasteurized eggs. Restaurants should use pasteurized eggs in any recipe (such as Hollandaise sauce or Caesar salad dressing) that calls for raw eggs. Ask to be sure.
• Eating raw or undercooked eggs should be avoided, especially by young children, elderly persons, and person with weakened immune systems or debilitating illness.

More information about egg safety from FoodSafety.Gov.

The House Labor-HHS-Education Appropriations Subcommittee approved its fiscal year 2011 funding bill on Thursday, July 15 by a vote of 11-5.

The bill would provide $76.7 billion for the Department of Health and Human Services.  This is $3.8 billion more than last year’s funding level and about $270 million more than the President requested.

For the National Institutes of Health (NIH), the bill would provide $32 billion.  This is an increase of $1 billion over last year’s funding level or about a 3.2% increase and is equal to the President’s request for NIH.  The funding for NIH includes $50 million for the Cures Acceleration Network.

Chairman Obey’s statement identifies NIH funding as one of the bill’s priorities:

“this year’s bill puts the emphasis on translating basic research results into practical and available cures and treatments. Among other things, it permits NIH to use up to $50 million to launch a newly authorized program aimed at that objective, which is called the Cures Acceleration Network.”

For the Centers for Disease Control and Prevention (CDC), the bill would provide nearly $6.8 billion.  This is an increase of $32 million over last year’s funding level and $170 million over the President’s request.  The bill also appropriates an additional $594 million from the Prevention and Public Health Fund to the CDC.

The CDC funding includes:

• $7.6 billion for the Health Resources and Services Administration
• $3.58 billion for the Substance Abuse and the Mental Health Services Administration
• $411 million for the Agency for Healthcare Research and Quality

The Senate Labor-HHS-Education Appropriations Subcommittee is scheduled to consider its funding bill on Thursday.

A growing number of foodborne illnesses are tied to salsa and guacamole dips, according to a just-reported CDC study.

The popular dips that combine chopped raw veggies and herbs have been implicated in 1 in 25 outbreaks of food poisoning since 1998.

Most of the problem has been in restaurants and delis where 84 percent of salsa or guacamole-associated (SGA) outbreaks were discovered.  Since the dips are prepared in large batches, many customers may be exposed to dangerous bacteria in them.  Lack of refrigeration is also an issue.

About a third of the outbreaks were traced to poor refrigeration, and one in five to food service staff.

Magdalena Kendall, an Oak Ridge Institute for Science and Education researcher, and her team reviewed all CDC foodborne illness reports looking for ones that had been traced to salsa, guacamole, or pico de gallo.

CDC has kept track of food poisoning outbreaks since 1975, but no there were no salsa or guacamole associated illness until 1984.  From 1984 through 1997 about 1.5 percent of foodborne illnesses were connected to the dips.  Since 1998 that percentage has more than doubled and now is almost 4 percent.

Kendall said,

Fresh salsa and guacamole, especially those served in retail food establishments, may be important vehicles of foodborne infection. Salsa and guacamole often contain diced raw produce including hot peppers, tomatoes and cilantro, each of which has been implicated in past outbreaks.

She continued,

We want restaurants and anyone preparing fresh salsa and guacamole at home to be aware that these foods containing raw ingredients should be carefully prepared and refrigerated to help prevent illness.

People with cancer and those who are receiving chemotherapy may be especially vulnerable to foodborne illness.

The research results were reported at the 2010 International Conference on Emerging Infectious Diseases being held this week in Atlanta.

Salsa Image by Photographer William Berry