Colorectal Cancer

Once assessment and planning have been completed, including analysis of the collected data, the next step is implementing the strategies and interventions that will comprise the workplace health program. The intervention descriptions for colorectal cancer include the public health evidence-base for each intervention, details on designing interventions for colorectal cancer screening, and links to examples and resources.

Multi-component interventions that include communications/media, education, reduction of barriers, and enhanced access to care will increase employees’ awareness of and participation in screening, prevention, and treatment.

Before implementing any interventions, the evaluation plan should also be developed. Potential baseline, process, health outcomes, and organizational change measures for these programs are listed under evaluation of colorectal cancer screening programs.

Of cancers affecting both men and women, colorectal cancer is the second most common cause of cancer deaths in the U.S. population.

  • The estimated annual national expenditure for colorectal cancer treatment is $5.5-$6.5 billion; inpatient hospital care accounts for 80% of this cost1
  • Because colorectal cancer is a disease of middle and old age, the costs related to colorectal cancer treatment are likely to increase as the population ages2
  • In 2007, 142,672 people were diagnosed with colorectal cancer, and 53,219 people died from it2

Risk factors for colorectal cancer include being 50 years of age or older, having a family history of colorectal cancer, having a personal history of inflammatory bowel disease, being overweight or obese, being physically inactive, having certain genetic conditions, and (possibly) consuming inadequate amounts of fruits and vegetables (nutrition).3

The United States Preventive Services Task Forceexternal icon strongly recommends that screening begin at age 50 and continue to age 75, and include:

  • colonoscopy (an inspection of the complete colon using a scope inserted into the rectum) every 10 years or
  • flexible sigmoidoscopy (inspection of the lower colon using a scope inserted into the rectum) every 5 years or
  • high-sensitivity fecal occult blood test (testing feces for digested blood) every 1 year

In Rankings of Preventive Services for the U.S. Populationexternal icon, the Partnership for Prevention provides an approach to ranking preventive services according to their clinically preventable burden (CPB) and cost effectiveness (CE). CPB is the disease, injury and premature death that would be prevented if the service were delivered to all people in the target population. With this approach, colorectal cancer screening received a ranking of 8 on a scale of 1-10, with 10 the highest ranking.

When colorectal cancer is found early and treated, the 5-year relative survival rate is 90%. Screening can also prevent colorectal cancer by allowing clinicians to identify and remove precancerous polyps before they develop into cancer.

References

1.  Seifeldin R, Hantsch JJ. The economic burden associated with colon cancer in the United States. Clinical Therapeutics. 1999; 21(8): 1370-1379.

2.  U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2007 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2010. Available at: https://www.cdc.gov/uscs.

3.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.