Colorectal cancer screening rates for colorectal cancer improved between 2000 and 2008 for white, black and Asian-Americans aged 50 and over—but barely improved for Hispanics and actually worsed for American Indians and Alaska Natives.

The latest statistics, just reported by the federal Agency for Healthcare Research and Quality on March 23, found that:

• In 2008, among adults aged 50 or over, about 60 percent of whites reported ever having been screened (up from 51 percent in 2000);
• About 55 percent of blacks and Asian Americans had been screened at least once (compared to 44 percent in 2000);
• In the same age group, only 44 percent of Hispanics reported ever having been screened (slightly increased from just 35 percent in 2000), even though this population has the third-highest death rate from colorectal cancer;
• Screening rates actually decreased among American Indians and Alaska Natives, to only 37 percent in 2008 (compared to 41 percent in 2000).

Among people without health insurance, screening rates were significantly lower in all ethnic groups:

• Among both whites and blacks with no health insurance, the at-least-once screening rate was about 30 percent (increased barely from 26% in 2000);
• Screening worsened to an abysmal 13 percent (down from 16 percent in 2000) among Hispanics with no health insurance.

In summary, even among those with insurance, only half—and often far fewer—people over age 50 are getting even one screening. Among the uninsured, screening is just not being done for a cancer that can be prevented or cured if caught early.

Source: Agency for Healthcare Research and Quality, 2010 National Healthcare Quality and Disparities Reports

As the Australian government considers the future of its National Bowel Cancer Screening Program, Australian and US researchers provide compelling evidence of the cost-effectiveness of expanding the national screening program.

Australia has one of the highest colorectal cancer (CRC) mortality rates in the world. Its current screening program (costing about $29 million a year) provides a one-time immunochemical fecal test (iFOBT) for people aged 50, 55, and 65 years. Program funding expires in mid-2011.

A study funded by the Australian government and the US National Cancer Institute, published in the Feb. 21 Medical Journal of Australia, found that expanding the program to screen all 5 million Australians aged 50 -74 years every two years by iFOBT could end up costing only about $50 million more a year, while saving 300 to 500 lives every year.

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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. Read the rest of this entry »

If doctors ask  healthy people simple questions about cancers in their families, they can find people who are at increased risk for Lynch syndrome, an inherited condition that greatly increases risk for colorectal and uterine cancer.

Doctors can use a simple set of screening questions available online to pinpoint an individual’s risk before that person ever gets cancer.   The online tool takes less than two minutes to complete.

If family history shows an individual to be at higher risk, genetic testing not only saves lives but is cost-effective.

Once Lynch syndrome is diagnosed, active steps can be taken to prevent Lynch-associated cancers or diagnose them early when they can be cured. Read the rest of this entry »

In a computer simulation, FIT — fecal immunochemical testing — done every year saved more lives and cost the least of any colorectal cancer screening method, including colonoscopy.

The computer model looked at 100,000 average risk people and compared screening methods results for

• number of colorectal cancer cases
• number of colorectal cancer deaths
• cost of screening and treating colorectal cancer for each screened person

Compared to not screening at all, annual FIT  could save 3 out of 4 deaths from colorectal cancer. For every 100,000 people between 50 and 75, nearly 3,500 people wouldn’t get colorectal cancer, and over 1,300 wouldn’t die.

Not only did FIT screening save the most lives, it was the most cost effective.  It saved about $70 (Canadian) in screening and cancer treatment expenses for each person screened, better than any other method. Read the rest of this entry »