Cancer deaths dropping twice as fast as last decade

Between 2002 and 2004, death rates dropped by an average of 2.1 percent a year. That may not sound like much, but between 1993 and 2001, deaths rates dropped on average 1.1 percent a year.

The big change was a two-pronged gain against colorectal cancer. It remains the nation’s No. 2 cancer killer, deaths are dropping faster for colorectal cancer than for any other malignancy — by almost 5 percent a year among men and 4.5 percent among women.

UPDATE:
Colorectal cancer fact sheet

The following table outlines some of the advantages and disadvantages of the colorectal cancer screening tests described in this fact sheet.

Table: Advantages and Disadvantages of Colorectal Cancer Screening Tests
Test AdvantagesDisadvantages
Fecal Occult Blood Test (FOBT)

  • No preparation of the colon is necessary.
  • Samples can be collected at home.
  • Cost is low compared to other colorectal cancer screening tests.
  • Studies have proven that this test, when performed every 1 to 2 years in people ages 50 to 80, reduces the number of deaths due to colorectal cancer by as much as 30 percent.li>
  • FOBT does not cause bleeding or tears in the lining of the colon.
  • This test fails to detect most polyps and some cancers.
  • False positive results are possible. (“False positive” means the test suggests an abnormality when none is present.)
  • Dietary and other limitations, such as increasing fiber intake and avoiding meat, certain vegetables, vitamin C, iron, and aspirin, are often recommended for several days before the test.
  • Additional procedures, such as colonoscopy, may be necessary if the test indicates an abnormality.
Sigmoidoscopy
  • The test is usually quick, with few complications.
  • Discomfort is minimal.
  • In some cases, the doctor may be able to perform a biopsy (the removal of tissue for examination under a microscope by a pathologist) and remove polyps during the test, if necessary.
  • Less extensive preparation of the colon is necessary with this test than for a colonoscopy.

  • This test allows the doctor to view only the rectum and the lower part of the colon. Any polyps in the upper part of the colon will be missed.
  • There is a very small risk of bleeding or tears in the lining of the colon.
  • Additional procedures, such as colonoscopy, may be necessary if the test indicates an abnormality.
Colonoscopy
  • This test allows the doctor to view the rectum and the entire colon.
  • The doctor can perform a biopsy and remove polyps during the test, if necessary.

  • The test may not detect all small polyps and cancers, but it is the most sensitive test currently available.
  • Thorough preparation of the colon is necessary before the test.
  • Sedation is usually needed.
  • Although uncommon, complications such as bleeding and/or tears in the lining of the colon can occur.
Double Contrast Barium Enema(DCBE)
  • This test usually allows the doctor to view the rectum and the entire colon.
  • Complications are rare.
  • No sedation is necessary.
  • The test may not detect some small polyps and cancers.
  • Thorough preparation of the colon is necessary before the test.
  • False positive results are possible.
  • The doctor cannot perform a biopsy or remove polyps during the test.
  • Additional procedures are necessary if the test indicates an abnormality.
Digital Rectal Exam (DRE)
  • Often part of a routine physical examination.
  • No preparation of the colon is necessary.
  • The test is usually quick and painless.
  • The test can detect abnormalities only in the lower part of the rectum.
  • Additional procedures are necessary if the test indicates an normality.

New tests for colorectal cancer screening are under study. For example, virtual colonoscopy (also called computed tomographic colonography) is a procedure that uses special x-ray equipment to produce pictures of the colon. A computer then assembles these pictures into detailed images that can show polyps and other abnormalities. Because it is less invasive and does not require sedation, virtual colonoscopy may cause less discomfort and take less time than conventional colonoscopy. However, as with conventional colonoscopy and DCBE, thorough preparation of the colon is necessary before the test.

Genetic testing of stool samples is also under study as a possible way to screen for colorectal cancer. The lining of the colon is constantly shedding cells into the stool. Testing stool samples for genetic alterations that occur in colorectal cancer cells may help doctors find evidence of cancer or precancerous polyps. Research conducted thus far has shown that this test can detect colorectal cancer in people already diagnosed with this disease by other means. However, more studies are needed to determine whether the test can detect colorectal cancer or precancerous polyps in people who do not have symptoms.