Prevent suffering and death from colon cancer by increasing access to on-time information
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Call to action with the Policy for On Time Information (POTI - pronounced “potty”)
The Colon Cancer Prevention Project recommends a radical change in both thinking and action to address the longstanding, self-imposed embargo on evidence based, time sensitive information regarding colorectal cancer to those under the age of 50.
This is what we know now and what we should disclose to the public now.
- We know there is an alarming increase in colon and especially rectal cancers in the under age 50 group. Soon 20% of all rectal cancers will occur under the age of 50.
- We know that to better tailor screening age, the accurate family history needs to be identified long before the age of 50 (preferably before but certainly by age 40) in order to deliver screenings to those most at risk due to genetic or familial factors.
- We know that due to a timely lack of awareness and understanding, most sporadic (non-genetic) cases of colon and rectal cancer occurring under the age of 50 have a significant delay in notification of the provider and then an additional delay in appropriate timely diagnosis once in the system. Patients and physicians are generally not aware of the dramatic increases. Many occurrences of colorectal cancer in people under the age of 50 are misdiagnosed.
- We know that just over half of asymptomatic, normal risk individuals are screened anytime during their fifth decade because they know too little about the entire issue until they are or just after 50. This means that only half of those individuals are screened in their fifties – the other half wait.
- We know that there are disease modifying behaviors that, if implemented, can reduce the risk of ever developing colorectal cancer, which also promote general good health BUT only when implemented early enough to count. Smoking cessation, dietary changes like avoiding red or processed meats, regular exercise, maintaining a healthy weight are but a few powerful, evidence-based risk reduction recommendations.
Given these facts, we recommend the following, immediate policy development and implementation into the existing resources for the American Cancer Society (ACS) and National Colorectal Cancer Roundtable (NCCRT), supported by a vigorous marketing program targeted at primary care providers, providers of screening services, and patients to expand our target message in the following way.
"By age 40, but preferably earlier, both patients and providers should engage in the initial discussion regarding individualized CRC prevention and early detection. The intervention should include four parts:
- a review of pertinent family history regarding colorectal cancer or other relevant cancers, inflammatory bowel disease (such as Crohn’s and Ulcerative Colitis), or polyps which might necessitate screening for colorectal cancer earlier than age 50;
- a review of the signs and symptoms of colorectal cancer, emphasizing the extreme importance of prompt evaluation to reduce the instance of misdiagnosis or delayed diagnosis;
- a review of the importance of on-time screening for normal risk individuals at age 50 and discussion of the menu of screening options available; and
- emphasis on promoting evidence-based lifestyle modifications to reduce the risk of colon cancer, including weight loss, smoking cessation, increased exercise and dietary changes."
Current efforts focus primarily on screening individuals at the presently recognized recommended screening age of 50.
We believe this narrow focus to be short-sighted. In order to reach and screen more of those asymptomatic, normal risk individuals in the fifth decade, we need to begin the conversation earlier, say in the forties.
For those individuals who are at risk, either due to family history, risk behaviors, or other potential cause, we need to begin the conversation MUCH earlier.
The evidence is clear – colorectal cancer is on the rise in individuals under 50 and we are doing them an immense disservice by not fighting to change the standards.
We need to talk about colorectal cancer well before the age of 50. We need to talk to emphasize the importance of knowing a complete family history as well as understanding personal risk factors. By amending the guidelines for screening and shifting the focus to include a broader scope, we believe that we can prevent unnecessary death and suffering from colorectal cancer.
Join us and our movement to create change on a national level with our proposal for the Policy for On Time Information (POTI - pronounced “potty”). Together, we can do this. We can save lives.
Please sign our petition and be a part of this important change.
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