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Notice to Readers: National Colorectal Cancer Awareness Month --- March 2005

March is National Colorectal Cancer Awareness Month, a health observance created to increase awareness about the importance of regular screening for colorectal cancer (i.e., cancer of the colon or rectum), the second leading cause of cancer-related death in the United States (1). During 2005, approximately 56,290 Americans will die from colorectal cancer, and an additional 145,290 new cases will be diagnosed (1). Colorectal cancer screening rates in the United States remain low, even though regular screening for colorectal cancer has been shown to reduce the incidence and the number of deaths from this disease (2,3).

Regular screening beginning at age 50 years is considered the key to preventing colorectal cancer (4). CDC and other public health agencies encourage all persons aged >50 years to discuss screening with their health-care providers. According to current screening guidelines, including those from the U.S. Preventive Services Task Force, persons aged >50 years should be screened for colorectal cancer with one or more of the following tests:

  • Annual fecal occult blood test (FOBT), which should be performed at home;
  • Flexible sigmoidoscopy every 5 years;
  • Colonoscopy every 10 years; and
  • Double-contrast barium enema every 5 years.

Health-care professionals can help control colorectal cancer by recommending regular and appropriate colorectal cancer screening to all patients aged >50 years (5). An estimated 50%--60% of colorectal cancer deaths could be prevented if all persons aged >50 years were routinely screened (6).

Despite the established effectiveness of screening, findings from CDC's 2000 National Health Interview Survey indicate that only 45% of men and 41% of women aged >50 years in the United States had undergone a flexible sigmoidoscopy or colonoscopy within the previous 10 years or had used a FOBT home test kit within the preceding year (7). Furthermore, findings from CDC's national Survey of Endoscopic Capacity demonstrate that approximately 41.8 million average-risk persons aged >50 years have not been screened for colorectal cancer according to national guidelines (8). An immediate capacity exists to screen the unscreened population with annual FOBT followed by a diagnostic colonoscopy for those with a positive FOBT result (9).

The public can learn more about preventing colorectal cancer through CDC's Screen for Life: National Colorectal Cancer Action Campaign, which promotes colorectal cancer screening among adults aged >50 years by using several communication strategies, including patient education materials, public service announcements, airport dioramas, and Internet advertising. Additional information is available at Information about CDC's colorectal cancer--control efforts is available at


  1. American Cancer Society. Cancer facts and figures, 2005. Atlanta, GA: American Cancer Society; 2005. Publication no. 5008.05.
  2. Mandel JS, Church TR, Bond JH, et al. The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med 2000;343:1603--7.
  3. Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 1993;328:1365--71.
  4. Pignone M, Rich M, Teutsch SM, Berg AO, Lohr KN. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;137: 132--41.
  5. Nadel MR, Shapiro JA, Klabunde CN, et al. National survey of primary care physicians' methods for screening for fecal occult blood. Ann Intern Med 2005;142:86--94.
  6. Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS. A case control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 1992;326:653--7.
  7. Swan J, Breen N, Coates RJ, Rimer BK, Lee NC. Progress in cancer screening practices in the United States: results from the National Health Interview Survey. Cancer 2003;97:1528--40.
  8. Seeff LC, Manninen DL, Dong FB, et al. Is there endoscopic capacity to provide colorectal cancer screening to the unscreened population of the United States? Gastroenterol 2004;127:1661--9.
  9. Seeff LC, Richards TB, Shapiro JA, et al. How many endoscopies are performed for colorectal cancer screening? Results from CDC's Survey of Endoscopic Capacity. Gastroenterol 2004;127:1670--7.

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