COLON CANCER: Simple Test Could Cut Deaths 33%

      Though a new study shows that a cheap, simple screening test could cut deaths from colon cancer by one third, just 20% of Americans 50 and older receive them, prompting the CDC to launch a campaign yesterday to boost screening rates (Rothenberg, New York Post, 3/3). The study, published in the Journal of the National Cancer Institute, followed 46,000 patients for 18 years and found that those who used the $10 home screening test annually had 33% fewer deaths from colon cancer, compared to 21% fewer for those tested every other year. Patients in the study had a compliance rate of 75%, but if that could be raised to 100%, deaths from colon cancer would drop by 50%, according to study authors John Bond, a gastroenterologist at the Minneapolis Veterans Affairs Medical Center, and Jack Mandel of the University of Minnesota's School of Public Health (Majeski, St. Paul Pioneer Press, 3/3).

How It Works
      Patients send their home test results to a doctor for analysis, and those testing positive for blood in the colon are called back to undergo a colonoscopy, which can cost several thousand dollars. Using a fiberoptic scope, doctors can check the colon for polyps, remove them and test them for cancer (Ricks, Newsday, 3/3). The home test returns false-positives on 65% of the readings, but about 9% of patients have cancer and about 26% have precancerous polyps (New York Post, 3/3). Despite the high rate of false positives and the expense of colonoscopies, Bond said the costs are "much less than finding and treating the cancer later, not only in money, but in the pain and suffering of the patients. ... It is a very valuable way to identify people who are healthy and have no symptoms who nevertheless have a developing cancer in their colon" (Recer, AP/Philadelphia Inquirer, 3/3).

Public Campaign
      Using the same tactics that made breast cancer screening a public health priority, the CDC, HCFA and the National Cancer Institute yesterday launched a campaign to boost colon cancer screening among Americans 50 and older. Medicare began covering colon cancer screening last year, and the Screen for Life campaign plans to use public service announcements and information materials to prod beneficiaries to get screened. For more information, visit the campaign's Web site, www.cdc.gov/cancer/screenforlife, or call (888)842-6355 (CDC release, 3/2).

Hope on the Horizon
      For those whose cancer defies early screening and treatment, a University of Maryland researcher has begun clinical trials for a chemotherapy regimen he hopes will cut the mortality rate for patients with advanced colon cancer from 50% to 5%. The treatment was a new drug, CPT-11 (irinotecan), and two standard anti-cancer drugs. "What's new is this particular sequencing and a more frequent administration of the drugs at higher doses," said Dr. David Van Echo, who is leading the study (release, 3/3).