February 25, 2012 2:00 AM
By Roger M. Epstein
Colorectal cancer is the third most common cancer in this country and the second leading cause of cancer-related death.
The average citizen of this country has a 5 percent lifetime risk of developing colorectal cancer. This week, on the eve of Colon Cancer Awareness Month, The New England Journal of Medicine published follow-up data from the National Polyp Study demonstrating a 50 percent decrease in colon cancer deaths in people who had undergone colonoscopy and polyp removal, compared to the general population. Current screening rates are 60 to 70 percent of those 50 to 75 years old, the population at greatest risk.
We can do better.
The N.H. Comprehensive Cancer Collaboration has set a goal of increasing statewide screening rates for colorectal cancer. The Affordable Health Care Act mandates all private insurers offer full coverage for colon cancer screening, with no out-of-pocket expense, co-pay or deductible to the patient. This mandate, partially implemented as of last year, will be fully implemented by 2014 for all plans and does not specify needing to go to any specific location to have the procedure done.
We are once again offering a free colon cancer screening clinic for uninsured individuals who cannot afford a colonoscopy. This is being done in cooperation with Families First, Portsmouth Regional Hospital, Converge Labs and Atlantic Pathology.
As cost is removed as an obstacle to screening, this leaves fear of the exam as the most common reason to avoid a colonoscopy. With current sedation techniques and skilled providers, the risk is low and comfort level high. Alternative screening strategies exist for those who can't go through a colonoscopy and can be discussed with your doctor.
High-risk individuals, such as those with inflammatory bowel disease and first-degree relatives with colon cancer before age 60, should commence their screening before age 50. For average-risk individuals, a colonoscopy can be performed every 10 years and provide protection from developing advanced colon cancer.
There is nothing more tragic to a (health care) provider than identifying a disease such as colon cancer in an advanced stage, which could have been prevented entirely had the appropriate test been done a few years earlier. This coming March is another opportunity to educate the public and save lives.
Roger M. Epstein, M.D., is a Portsmouth resident.
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Source: http://www.seacoastonline.com/articles/20120225-OPINION-202250307
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