Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Despite evidence and guidelines supporting the value of screening for this disease, rates of screening for colorectal cancer are consistently lower than those for other types of cancer, particularly breast and cervical. Although the screening rates in the target population of adults over age 50, have increased from 20-30 percent in 1997 to nearly 55 percent in 2008 – the rates are still too low. An NIH state-of-the-science panel was convened this week to identify ways to further increase the use and quality of colorectal cancer screening in the United States.

“We recognize that some may find colorectal cancer screening tests to be unpleasant and time-consuming. However, we also know that recommended screening strategies reduce colorectal cancer deaths,” said Dr. Donald Steinwachs, panel chair, and professor and director of the Health Services Research and Development Center at the Johns Hopkins University. “We need to find ways to encourage more people to get these important tests.”

The panel found that the most important factors associated with being screened are having insurance coverage and access to a regular health care provider. Their recommendations highlighted the need to remove out-of-pocket costs for screening tests.

Although colorectal cancer is the second leading cause of cancer-related deaths in the United States, screening for this disease is currently underutilized among eligible individuals. An NIH State-of-the-Science Conference on Enhancing Use and Quality of Colorectal Cancer Screening will be held February 2-4, 2010.

At the annual meeting of the American Association for Cancer Research (AACR) last month, researchers from GeneNews Corp. reported that the probability of colorectal cancer (CRC) in asymptomatic patients can be accurately stratified by RNA expression profiling of six genes in whole blood [1]. The company focuses on developing blood-based biomarker tests for the early detection of diseases and personalized health management.

A study published in the journal Cancer Research last month suggests that the principle treatment for advanced prostate cancer may actually encourage prostate cancer cells to metastasize [1]. Researchers at The Johns Hopkins University School of Medicine focused on a gene called Nestin, which encodes an intermediate filament protein. Intermediate filaments are cytoskeletal or scaffolding structures found in cells that, in addition to maintaining cell shape, control a variety of cellular processes including proliferation, migration and survival [2]. Nestin gene expression also distinguishes stem cells from differentiated cells and has been shown to be activated in pediatric brain tumors and rhabdomyosarcomas (cancers that develop from skeletal muscle), central nervous system tumors and gastrointestinal stromal tumors [3-6].

The goal of the annual National Colorectal Cancer Awareness Month is to make people aware of colorectal cancer and to encourage people to learn more about how to reduce their risk of colorectal cancer (CRC) through regular screening and a healthy lifestyle. The results of the National Health Interview Survey (NHIS) administered to 32,374 adults 18 years of age or older in 2000 showed that colorectal cancer screening is underused [1]. Just over 60% of adults had ever had colorectal cancer testing. Only 44% of men and 37% of women greater than 75 years of age were current for testing. Colorectal cancer screening is very important. If colorectal cancer is allowed to metastasize (meaning to spread to other parts of the body), the 5-year survival rate is less than 10%. However, if colorectal cancer is found early, the 5-year survival rate is greater than 90% [2].