February is Cancer Prevention Month, and colorectal cancer (CRC) is a poster child, as one of the few cancers that can be literally seen and removed before it becomes cancer, or can be caught early enough in regular screening to be literally cured.

Ponder these facts, based on 20 years of experience and summarized by Linda Rabeneck, MD, MPH of Cancer Care Ontario at the recent “GI-ASCO” (Gastrointestinal Cancers Symposium of the American Society of Clinica Oncology):

• Annual stool tests (fecal occult blood test, or FOBT) reduce deaths from colorectal cancer by 15 to 33 percent.
• The newer FIT stool test (fecal immunochemical test) appears to be even better than the FOBT stool test at detecting CRC and early adenomas.
• Flexible sigmoidoscopy (a scope exam of the lower colon) can reduce the cases of CRC by 21%, and deaths from CRC by 26%.
• So-called ‘virtual colonoscopy’ (a special screening CT scan) finds up to 90% of people having adenomas or cancers that are at least 1 cm in diameter.

Colonoscopy (examining the entire colon with an endoscope) is still considered by many to be the “gold standard” for detecting and removing precancerous lesions. Dr. Rabeneck noted, however, that colonoscopy continues to be much more effective in detecting lesions in the left (lower) colon than the upper (proximal) right colon, where hard-to-spot “flat” lesions are more likely to occur. (Evidence in the past few years shows that these flat “serrated sessile polyps” may develop differently and more quickly into CRC.)

Dr. Rabenick told the conference that updated national screening guidelines will be released in coming months; one likely change is removing barium enemas as a tool for CRC screening. Other research has raised the question about whether African Americans should start screening earlier (e.g. at age 50): Stay tuned.

We can do better; much better

Despite the remarkable ability to detect and even prevent CRC, about 40% of Americans still don’t get the recommended screening. A recent study of 4000-plus Utah residents showed that 37% didn’t have recommended screening, even if they had a family history of colorectal cancer. The numbers of unscreened were much higher in rural areas.

Although it can be harder for some people (especially rural residents or those without full insurance coverage) to get a screening colonoscopy, they have choices:

• A simple yearly stool test (high-sensitivity FOBT or FIT) that is done at home and mailed in;
• Flexible sigmoidoscopy done every 5 years (most doctor’s offices do this test) along with stool tests every 3 years
• A colonoscopy every 10 years or CT colonoscopy every 5 years.

People aged 76 to 85 without risk factors (such as a family history or certain number of polyps found over the years) usually don’t need routine screening (and those over age 85 can skip it because risks outweigh benefits).

Get more information and breaking CRC news

• See a chart here that describes each screening option.
• Stay tuned here for screening updates, and….

Learn more news with GI-ASCO Keynoter

Next Tuesday, Feb. 19, 2013, from 8 – 9:30 pm (EST), the ASCO-GI keynote speaker, internationally renowned CRC specialist (and member of our own Medical Advisory Board) Dr. Richard Goldberg will talk directly to and with you at our webinar “The Latest in Colorectal Cancer.” He’ll share a “Decade of Progress” plus also give us his take on the most interesting news to come out at ASCO-GI. You don’t get many chances to listen to a world-renowned expert: Register to join it live, or listen later to this and all archived webinars. 

Sources: “CRC Screening Tools–The Date and the Guidelines,” ASCO-GI Jan. 26 2013; “Screening for CRC: which Tool and How Often,” ASCO-GI Educational Summary  and “Rural vs. Urban Residence Affects Risk-Appropriate CRC Screening,” in press Clinical Gastroenterology and Hepatology.

Provided by Kaiser Health News

Experts were surprised this week when the latest government survey showed that consumers actually paid a slightly smaller share of the nation’s total health bill in 2011, even though more people now pay higher deductibles.

Total U.S. spending on health care grew 3.9% in 2011 (including all medical goods and services, public health, cost of health insurance, investments, and government costs). That equals 17.9% of Gross Domestic Product (the same as 2009 and 2010) or about $8,680 per person in the nation.

Consumers paid just over one-quarter (28%) of total costs. Meanwhile, federal government health spending has risen more than three times as fast as consumer health spending since 2007, largely due to increased Medicare and Medicaid services for seniors and the disabled.

But many households hit hard by high deductibles

Even though the federal government is paying more of the nation’s total bill, individuals and families are paying a higher percentage of their personal income on health care. Household medical expenses are rising faster than the families’ income, according to government statistician Micah Hartman.

In 2012, one worker in three had medical insurance with a deductible of $1000 or more, meaning they must pay $1000 “out of pocket” before most expenses are covered. (In 2006, only one in 10 workers had a high-deductible plan.)

At the moment, the cost of higher deductibles is being partly offset by lower average prescription costs, as low-cost generics become more available for common medicines.

But more and more employers—as well as insurers under the new “health exchange” insurance marketplaces coordinated by the Affordable Care Act—will offer only high-deductible plans with pretax health savings accounts in the near future, according to employer and insurer surveys.

Fight Colorectal Cancer Answer Line and Upcoming Webinar Both Offer Advice

Public health officials worry that high deductibles may keep patients from getting needed screening or early treatment.

“One of the most common calls to our Answer Line right now is from people due for a colonoscopy, or unable to pay treatment copays, because they can’t afford their high deductible,” says Tavia Gilchrist, one of the friendly voices of Fight Colorectal Cancer’s Answer Line.

People may not have enough cash to pay a plan’s high deductible; or they’ve been laid off and lost all insurance; or they’re in a ‘grandfathered’ plan that isn’t yet required to offer free screenings. Gilchrist helps people define exactly what issue they’re facing, whether it’s insurance or Medicare rules, confusion about what a doctor is ordering, or a lack of local screening programs. “Every state – even areas within a state – is different,” she notes. Her job is to get callers started in the right direction to find answers to their specific question.

Webinar features expert on handling cancer finances

Speaking of questions, you can listen to plenty of answers in the live webinar “Addressing the Financial Burden of Cancer” on Wednesday, Jan. 16 from 8 to 9:30 pm EST. It features Elaine Martinez, a case manager with the Colorectal CareLine at the Patient Advocate Foundation.

Elaine serves as a liaison between colorectal cancer patients and their insurers, employers and/or creditors to resolve insurance, job, and/or debt problems. She helps investigate reimbursement levels for prescribed treatments, researches available clinical trials, and helps people enroll in resource programs for both uninsured and underinsured patients.

If you can’t listen in on Wednesday, the webinar will be archived for later listening, too.

Either way, you can’t afford to miss it.

Sources:

• “Who Knew? Patients’ Share of Health Spending Is Shrinking,” Jan. 14 Kaiser Health News;
• “Employer Health Benefits: 2012 Summary of Findings,” Kaiser Family Foundation and Health Research & Education Trust;
• 2011 National Health Expenditures report, Centers for Medicare & Medicaid Services;

• Fight Colorectal Answer Line: 1-877-427-2111

• Webinar: “Addressing the Financial Burden of Cancer”

Fight Colorectal Cancer’s September 2012 patient webinar focused on issues that run rampant with misunderstanding and fear: palliative and hospice care.

Dr. Jim Meadows, Director of Palliative and Hospice Care at Tennessee Oncology, led the webinar. He spoke at length about palliative care, but not surprisingly, the majority of questions toward the end of the webinar focused on hospice care.

One listener had a good question that elicited a great response from Dr. Meadows. We wanted to share it with you.

Q: Isn’t hospice ‘end of life’ care? Why are you saying it prolongs life when I have heard of many people having to watch for days and even weeks while their loved one wastes away and dies? Why say it prolongs life, at what emotional cost to patient and family?

Read the rest of this entry »

In last night’s monthly webinar, colorectal cancer patients were given access to a nutritionist who specializes in helping cancer patients. Kimberly Moore Petersen of the Minnie Pearl Cancer Foundation was the presenter for our March 2012 webinar, “Shape Your Plate to Fight Colorectal Cancer.”

Extensive research has shown that diet and physical activity can significantly reduce your risk of tumor recurrence. Recently, the American Cancer Society issued new Guidelines on Nutrition and Physical Activity for Cancer Prevention.

But what does that mean for patients making day to day lifestyle choices? Find out in this webinar.

Fight Colorectal Cancer has posted a recording of its February webinar, Report from the 2012 GI Cancers Symposium, held in partnership with the Colon Cancer Alliance.

Each year, the best and brightest minds in gastrointestinal oncology meet to discuss the latest research into colorectal, pancreatic, esophageal and other GI cancers. The 2012 symposium offered major news for people living with colorectal cancer, and we were proud to be able to bring that information to you.

Listen in as Dr. Dan Sargent of the Mayo Clinic Cancer Center and Kim Ryan, Fight Colorectal Cancer’s Director of Patient Information Services, discuss what is on the horizon for patients living with colorectal cancer.