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Sunday, May 02, 2010

An Important Measure for Prevention

Years ago when I started on this journey in public health I learned that prevention was one of the most important factors in getting to good public health.

Since that time, about 40-45 years, this caveat seems to have fallen far from the path.

My father took a specialty in proctology in 1929.  He did this because one of his sisters was misdiagnosed and died from colon cancer.  One of his brother's also developed  colon cancer and he asked my father to do his surgery.  This was the time when my father developed the flat stoma where the colostomy collection pouch is placed on the body.

People as a rule don't generally like colonoscopies and don't seem to like the simple home test either.

Here's a newer option that seems to have the ability to prevent thousands of deaths for 5 minutes of your time.

Five minute test could save thousands

A news study suggests a five-minute colon cancer test could reduce the number of deaths from the disease by about 40 percent.
Of the 170,000 people followed for about 11 years by the British researchers, more than 40,000 had a "flexi-scope" test, an exam that removes polyps, small growths that could become cancerous.
Researchers used the test, where a pen-sized tube is inserted into the colon, on people in their 50s. They also said patients only needed this test once in their lives. In the U.K., government-funded colon cancer screening doesn't start until age 60.
Dr. Wendy Atkin, a professor of surgery and cancer at Imperial College London led the research and said the flexi-scope test only needed to be performed once because polyps that grow in the bowel appear before the age of 60, so the possibility of cancer could be caught of the test was done on people in their fifties.
However, the test only works on the lower bowel, so other exams, like the fecal blood test, would still be necessary.
In the U.K. a fecal blood test it done bi-annually on people aged 60 to 74, and in the U.S. colonoscopies are most commonly test used to scan the entire colon.
Researchers compared those results to more than 113,000 people who were not screened. They found the flexi-scope test reduced peoples' chances of getting colon cancer by one third. It also cut their chances of dying by 43 percent. Worldwide, the disease causes 1 million cases and 600,000 deaths every year.
Some experts said they believe the findings have the potential to make some authorities reconsider their practices for finding and diagnosing colon cancer.
The American Cancer Society recommends several options for people over 50 to find polyps or to detect cancer early: a flexi-scope test, double-contrast barium enema or virtual colonoscopy every five years or a colonoscopy every 10 years.
"It's not for me to tell governments what to do," Atkin said. "But this is a very big effect, with a very quick and a very cheap test."
Dr. Durado Brooks, director of prostate and colorectal cancer at the American Cancer Society, said the study results would not change their colon cancer screening guidelines.
"We have long included (flexi-scope) tests as one of our preferred tests to prevent disease," he said. "I would hope clinicians look at this information and recognize there is some value in this test."
Dr. David Ransohoff of the departments of medicine and epidemiology, University of North Carolina at Chapel Hill, North Carolina, said the claim that the test only needed to be done once in a person's lifetime was "striking" and further follow-up was necessary to see just how long this protective effect lasts.
The results of the study were published online in the medical journal, Lancet.

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