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The Test No One Wants to Talk About

HAP's Dr. Bolton Sheds Light on the Number Two Cancer Killer

DETROIT – March 4, 2010 – Cancer of the colon or rectum is one of the most curable cancers when diagnosed early. But about 40 percent of adults aged 50 or older have not been screened appropriately, according to the Centers for Disease Control and Prevention.
Despite being the second-leading cause of cancer-related deaths in Michigan, many people are too embarrassed to talk about colorectal cancer and the tests used to detect it.

"Colorectal health can be an uncomfortable topic, but we can't let embarrassment get in the way of saving lives," said Mary Beth Bolton, MD, FACP, chief health officer at Health Alliance Plan (HAP), who answers three common questions about colorectal cancer.

Men and women age 50 or older are at routine risk for colorectal cancer. You may be at higher risk if you have a family history of colorectal cancer (especially if the cancer started before age 50) or a history of ulcerative colitis; endometrial, ovarian, or breast cancer; or adenomatous polyps in the colon. African Americans and people of Jewish and of Eastern European descent (Ashkenazi) are more likely to get colorectal cancer than members of other population groups.

Some risk factors – what you eat, how much you weigh, whether you smoke, how much you drink, and how often you exercise – are factors you can control. Colorectal cancer can develop without any noticeable symptoms; therefore, regular screening is important.  Screening can find precancerous polyps that can be removed before they turn into cancer. It can also find colorectal cancer early, when treatment works best.


There are several screening tests available to detect colorectal cancer:

  • A colonoscopy examines the inside of the entire colon using a flexible, lighted tube. This test allows the physician to remove most polyps and some cancers. Sedation is provided to decrease any discomfort.        
  • A Fecal Occult Blood Test (FOBT) is done at home using a special kit. The test checks for blood in the stool, which can be a sign of cancer.
  • During a flexible sigmoidoscopy, a physician inspects the rectum and lower colon with a flexible, lighted tube. This test detects polyps in the rectum and lower third of the colon.

For adults age 50 and older who do not fall into one of the high-risk categories above, the Michigan Quality Improvement Consortium (MQIC) recommends colonoscopy every 10 years, or a Fecal Occult Blood Test annually and/or flexible sigmoidoscopy every five years. Adults at higher risk should talk to their physician about screening options.

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