Men Choose Prostate Over Colon for Cancer Screening  

Many avoid colon screenings, although they save more lives

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 appeared in a recent issue of the Journal of the American Medical Association (JAMA), Sirovich and her colleagues used data from the Centers for Disease Control and Prevention (CDC) 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 is an area for future research.

Prostate cancer screening is a simple blood test. Colorectal cancer screening may include the following:

• digital rectal examination (DRE) - a physician or healthcare provider inserts a gloved finger into the rectum to feel for anything unusual or abnormal.

• fecal occult blood test - checks for hidden (occult) blood in the stool. It involves placing a very small amount of stool on a special card, which is then tested in the physician's office or sent to a laboratory.

• one of the following:
  • sigmoidoscopy - a diagnostic procedure that allows the physician to examine the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. The scope blows air into the intestine to inflate it and make viewing the inside easier.
  • colonoscopy - a procedure that allows the physician to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the physician to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.
    

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 cannot 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 is the probe, which physicians say does not cause pain.

"I'm not surprised by this," Brooks says. "Colon cancer is the number one 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 have undergone a colonoscopy, most physicians say you can forgo the fecal occult blood test for several years.

Always consult your physician for more information.

Online Resources

American Cancer Society

Centers for Disease Control and Prevention (CDC)

Journal of the American Medical Association (JAMA)

Men's Health Network

National Cancer Institute

National Institutes of Health (NIH)

Pediatrics