Though cancer death rates continue to decline across the state, cancer remains a leading cause of death in Iowa, according to the "Cancer in Iowa: 2011" report released March 14 by the State Health Registry of Iowa, based in the UI College of Public Health. The latest report estimates 6,300 Iowans will die from cancer and 16,500 new cancers will be diagnosed this year.
"Year to year we don't see much change in the numbers. What is more telling are the trends," said Charles Lynch, MD, PhD, UI professor of epidemiology and medical director of the registry.
Colorectal cancer is one of the state's "big four" cancers in addition to breast, lung and prostate cancers. The "big four" account for half of all cancer deaths in Iowa.
With March serving as Colorectal Cancer Awareness Month, UI experts emphasized an important reminder about colorectal cancer--one of the keys to reducing death from colorectal cancer is detection at an early stage. When diagnosed at an early stage, the five-year relative survival rate for colorectal cancer is more than 95 percent.
Colorectal cancer usually begins with small growths, or polyps. As they grow, these polyps may become cancerous. Screening can lead to detection and removal of polyps.
"Colorectal cancer is unique in that screening can find pre-malignant polyps, which when removed can prevent cancer from ever developing," said George Weiner, MD, director of Holden Comprehensive Cancer Center at the UI.
The goal is to increase screening participation and decrease perceived barriers, he said.
"One of the issues we have with colorectal cancer is we are in a similar place as we were with breast cancer 20 years ago--people are afraid to talk about it," Weiner said. "We need to get to a comfort level with colorectal cancer screening in the same way women view the importance of mammograms and pap smears--they may not like it, but they do it because it is the right thing to do."
The U.S. Preventive Services Task Force recommends screening for colorectal cancer in adults at average risk between age 50 and 75 by any of the following methods: annual sensitive fecal occult blood tests; flexible sigmoidoscopy every five years combined with fecal occult blood testing every three years; or screening colonoscopy every 10 years. Screening should be considered earlier for people who have certain risk factors, such as family history.
According to the report, colorectal cancer incidence has been declining for the past two decades. Compared to the 1980s, colorectal cancer incidence rates have declined 18 percent and death rates have declined more than 30 percent. In addition in recent years, an increasing number of Iowans report ever having had a sigmoidoscopy or colonoscopy, but there are still significant numbers of Iowans who have not been screened at recommended intervals, according to the report.
"Screening may help explain recent declines in colorectal cancer diagnosis and death, but we can do better," Lynch said. "Colorectal cancer is highly preventable and treatable, and screening is the key.
"This is an important issue. This is an area where we can improve, and the tools are there. We need to get more Iowans to follow the screening guidelines," he added.
The State Health Registry of Iowa has been gathering cancer incidence and follow-up data for the state since 1973. The report includes county-by-county statistics, summaries of new research projects and a special section on colorectal cancer.