Resources
Cancer Plan: Colorectal Cancer
Colorectal cancer is the second leading cause of both new cancer cases and cancer deaths in Maine.63 Maine has the 10th highest colorectal cancer mortality rate in the country, which is slightly higher than the United States. Despite the availability of proven screening methods, Maine’s colorectal cancer incidence and mortality rates have remained relatively stable over the past 10 years (Figures 24 & 25).
Figure 24: Age-Adjusted Colorectal Cancer Incidence Rates, 1995-2002
Source: Surveillance, Epidemiology and End Results Program and the Maine Cancer Registry Program
Figure 25: Age-Adjusted Colorectal Cancer Mortality Rates, 1995-2002
Source: National Center for Health Statistics
The primary risk factor for colorectal cancer is age, with more than 90% of cases diagnosed in individuals older than 50. Risk is also increased by a personal or family history of colorectal cancer and/or polyps, as well as smoking, alcohol consumption, physical inactivity, poor nutrition, and being overweight. Both men and women are at increased risk for colorectal cancer. Additionally, the death rate for colorectal cancer among African Americans is almost 30% higher than among whites and more than two times higher than for Hispanics, Native Americans, Asian Americans, and Pacific Islanders.
Routine screening can reduce the number of people who die of colorectal cancer by as much as 60% or more.65 Several national organizations recommend colorectal screening for average risk adults age 50 and over (Appendix D). There are several approved screening methods, including fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. In 2002, a Medical Advisory Committee of the Maine Cancer Consortium’s Colorectal Cancer Task Force developed a consensus statement on colorectal screening, which stated that any form of colorectal cancer screening is preferable to no screening (Appendix D).
While colorectal screening has been proven to be effective in preventing and detecting cancer early, only half of Maine adults over 50 are getting screened regularly. Compared with other cancer detection tests, colorectal cancer screening rates in Maine are significantly lower. Reasons for this could include the lack of a statewide, free screening program (similar to the Maine Breast and Cervical Health Program), lack of a mandated insurance benefit, confusion over the screening options, lack of understanding about risk, and discomfort with the screening tests and preparation.
Goal: To promote, increase, and optimize the utilization of high-quality colorectal cancer screening and follow-up services.
Objective 1: Increase the proportion of adults aged 50 and older who have ever received a screening colonoscopy or sigmoidoscopy to 75% by 2010.
Baseline: 59.1% colonoscopy/sigmoidoscopy, BRFSS, 2004.
Strategies
- Inventory the number of professionals regionally who perform colonoscopies.
- Sustain the Maine Comprehensive Cancer Control Program’s colorectal cancer social marketing campaign.
- Provide at least four continuing education programs about colorectal screening guidelines and procedures annually for health care professionals.
- Work with health professional training programs to teach students state-of-the-art techniques for colorectal cancer screening exams.
Objective 2: Increase access to colorectal cancer screening by reducing financial barriers by 2010.
Strategies
- Work with health insurers to provide coverage for colorectal cancer screening, specifically colonoscopy, as a benefit.
- Identify and seek grant funding opportunities for colorectal screening for under and uninsured Maine residents.
« Back to Cancer Plan