Colorectal Cancer Prevention and Early Detection

We can estimate how many of the 56,300 people who die annually of colorectal cancer whose survival could have been lengthened if their disease had been prevented or detected early: more than 50 percent. Risk of colorectal cancer may be reduced by regular physical activity and appropriate diet, and it can be effectively treated when it is detected early.1 Only lung cancer, which is expected to take the lives of 156,900 American men and women in 2000, outpaces colorectal cancer in the potential impact prevention strategies could have.2 Increased screening and adenoma removal, which prevents progression to invasive cancer, have been credited with the 2.1 percent annual decline in incidence between 1992 and 1996.2 Early detection translates into a 91.4 percent 5-year relative survival rate for about 37 percent of all cases diagnosed.1 Another 37 percent are diagnosed when disease is regional, and the survival rate for these cases falls to 66.1 percent. For those remaining cases diagnosed when cancer has metastasized to a distant site, the survival rate is only 8.5 percent. In the United States, men have higher rates of colorectal cancer incidence and mortality than do women,3 but mortality rate graph lines tended to intertwine from 1930 to about 1960, when the mortality rate began to decline steadily and in women fell distinctly lower than in men.1 Cumulative lifetime risk for colorectal cancer is 6 percent.4 In the United States, a gap exists between overall survival rates by race: the rate for whites (63 percent) sur4