Benefits of fecal test outweigh ‘ick factor’

Incidence and death rates for most cancers have stabilized or fallen, Canadian statistics show, but officials are stepping up a call for the 50-plus crowd to test for one form of cancer in particular in the privacy of their own bathrooms

Margaret Starns

Margaret Starns

Incidence and death rates for most cancers have stabilized or fallen, Canadian statistics show, but officials are stepping up a call for the 50-plus crowd to test for one form of cancer in particular in the privacy of their own bathrooms.

An estimated 177,800 new cancer cases will be diagnosed in Canada this year, and an estimated 75,000 people will die from the disease, according to Canadian Cancer Statistics 2011, released Wednesday.

The Canadian Cancer Society said it’s highlighting colorectal cancer because it’s the second leading cause of cancer death in Canada, and early detection is possible.

“We’re starting to win the war with colorectal cancer,” said Dr. Jeff Sisler, a family doctor working at Cancer Care Manitoba in Winnipeg.

“To me, the good news in the stats is that the survival from colorectal cancer is improving over the last several years and the uptake of screening in the population is also on the rise, particularly in provinces that have implemented screening,” he said in an interview.

The key is to get more Canadians talking about it with their doctor or nurse, and completing a home test for screening, Sisler said.

The fecal occult blood test and the fecal immunochemical test involve sending a tiny sample of stool to a lab, where technicians can detect trace amounts of blood — a possible sign of colorectal cancer.

Sisler acknowledged the “ick factor” but said the test only needs to be done once every two years, and is not onerous.

“I think given the possible benefits in terms of colon cancer being detected early, it’s good for the public and for doctors to remind them that the ick factor’s a pretty small factor given the possible benefits.”

An estimated 22,200 new cases of colorectal cancer are expected in Canada in 2011, and an estimated 8,900 people will die from the disease.

“We know that with good participation in screening, we’re going to see the rates drop much more quickly in the coming decade,” Sisler said.

Margaret Starns of Toronto said everyone should have the test done because prevention is better than having to take action once cancer is discovered.

She had never had a fecal test or a colonoscopy — a procedure to view the inside of the colon —when she had her first symptoms of colorectal cancer at age 65.

“I went to England to visit relatives and on the plane coming back I had a very dull ache in my left groin which at the time, I thought, maybe tight underwear, maybe just sitting,” said Starns, now age 72.

She was diagnosed with cancer, and went through surgery, followed by chemotherapy and radiation.

“They removed a small piece and they resection it, they stitch it together, I understand. It’s amazing. I was extremely lucky,” she said, adding that through her treatments, she managed to keep working at her job as a supervising editor for a legal publishing company.

Risk factors for colorectal cancer include being overweight, a diet high in red or processed meat, physical inactivity, smoking and a family history of the disease.

Prithwish De, an epidemiologist for the cancer society, said colorectal cancer poses a major burden of illness in Canada, and screening could make a difference.

“If 80 per cent of Canadians who are aged 50 and over were screened appropriately over the next 10 years, up to 15,000 deaths could be avoided, and that’s a huge impact,” he said.

In terms of the overall cancer numbers, De said the decline in death rates and better survival is a reflection of more effective treatment, more screening and better patient care.

The new statistics estimate 167 deaths per 100,000 population this year, compared to an estimated 170 deaths per 100,000 population in 2010.

In 2007, there were about 749,000 cancer survivors or people undergoing cancer treatment in Canada who had been diagnosed in the previous decade.

De noted that two cancers — liver and thyroid — have been increasing in incidence from 1998 to 2007, and health officials need to pay attention.

Part of the increase in liver cancer incidence — 3.6 per cent a year in men and 2.3 per cent in women — is attributable to rising immigration from parts of the world where hepatitis B is prevalent, he said. Other risk factors for the “highly fatal” cancer are hepatitis C and excessive alcohol use, De said.

The jump in thyroid cancer cases diagnosed over the same period — 6.8 per cent per year in men and 8.8 per cent per year in women — could be due to better diagnostic imaging techniques for detection and-or greater exposure to medical imaging, he hypothesized.

But the good news is survival is quite high, at 98 per cent.