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Date: Tuesday, March 25, 1997 FOR IMMEDIATE RELEASE Contact: National Institutes of Health, NCI Press Office (301)496-6641,
Cancers of the Colon and Rectum
Cancers of the colon and rectum are some of the most common cancers
in both men and women in the United States, with more than 131,000
new cases expected to be diagnosed in 1997. These cancers kill
nearly 55,000 Americans each year, making them the second leading
cause of cancer death.
Between 1973 and 1992, the annual rate of new colorectal cancer
cases for all races dropped by 1 percent, and the death rate fell
by 17 percent. The trend continued into the 1990s, with deaths
falling 5.4 percent between 1991 and 1995.
Advances
Understanding Risk. Studies have shown that lifestyle factors
may cause colon and rectum cancers. A diet high in fruits and
vegetables and fiber and low in fat appears to reduce the risk
of getting colorectal cancer. Exercise may also lower a person's risk for the disease.
Prevention. Increased use of flexible sigmoidoscopy and
colonoscopy, procedures that use lighted tools that doctors insert
into the rectum to look at the inside of the intestine, has made
it simpler for doctors to remove abnormal growths before they
turn into cancer.
Early Detection. Routine use of annual fecal occult blood
tests has proven useful in identifying people who should have
further tests to rule out colon cancer and other diseases.
New Drugs. Doctors have found new drugs that work with
fluorouracil (5FU) to treat colorectal cancer better than
5FU alone. Until the mid1970s, 5FU was the mainstay
of drug treatment for colorectal cancer patients.
Drugs With Surgery. After surgery, drug treatment has been
found to improve the cure rate of certain patients at high risk
by about onethird.
Quality of Life. New surgical techniques have reduced to
a small fraction the number of colorectal cancer patients needing
permanent colostomy bags.
Genetics. The discovery of four genes involved in hereditary
nonpolyposis colon cancer (HNPCC) has provided crucial clues to
the role of DNA repair in the development of colon and other cancers.
Scientists have also identified genes involved in the more common,
noninherited form of colon cancer.
Opportunities
Diet. Scientists continue to pursue leads on how certain
foods may cause colorectal cancer and how other foods may prevent
it.
Early Detection. The National Cancer Institute's
Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
may show whether screening tests can reduce deaths from cancers
of the colon and rectum.
Genetics. Scientists are studying genes to find better
ways of diagnosing and treating colon cancer. For example, a new
gene test could eventually allow doctors to detect tumors by looking
at stool samples rather than tissue removed through surgery.
Vaccines and Antibodies. Scientists are working on new
vaccines and monoclonal antibodies that may improve the way patients'
immune systems respond to cancers of the colon and rectum.
Computer Technologies. Researchers are working to develop
"virtual colonoscopy,"
in which doctors use threedimensional computer graphics
to view the entire colon in less than two minutes without the
need for inserting a sigmoidoscope or colonoscope.
Additional Reading
Cohen A.M., Minsky B.D., Schilsky R.L. "Colon
Cancer," Cancer: Principles
and Practice of Oncology; 4th ed., edited by Vincent T. DeVita,
Jr., Samuel Hellman, and Steven A. Rosenberg. Philadelphia: J.B.
Lippincott, 1993, pp. 929977.
Greenwald P. "Colon
Cancer Overview," Cancer (Supplement), 1992; 70(5), pp. 1206S1215S.
Statistics are from the National Cancer Institute's
Surveillance, Epidemiology, and End Results (SEER) database (January
1997) and from the American Cancer Society's
Cancer Facts and Figures: 1997, which contains estimates based on SEER data.
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