Washington, DC -- In recognition of Colorectal Cancer Awareness Month, ob-gyns are encouraged to remind all of their patients age 50 and older to be screened for colorectal cancer. Because ob-gyns are the only physicians many women see on a regular basis, they can help increase colorectal cancer screening rates and, thereby, help reduce deaths from one of the most preventable and treatable types of cancer.

"Despite the promising decline in colorectal cancer deaths in the US, many women are still not getting screened for colorectal cancer," says Douglas W. Laube, MD, MEd, president of The American College of Obstetricians and Gynecologists (ACOG). "Ob-gyns can really help by making sure that all eligible patients leave their office with screening recommendations. ACOG encourages its members to educate women about the importance of routine colorectal cancer screening."

Colon and rectal cancer (colorectal cancer) affects the large intestine and rectum. It is the third leading cause of cancer death among women in the US and the second leading cause of cancer deaths overall for all adults. In most cases, colorectal cancer develops slowly over time. It often begins as a tissue growth, called a polyp, in the colon or rectum. Routine screening helps detect these polyps so that they can be removed before they turn into cancer. In many cases, colorectal cancer has no symptoms. The following symptoms, however, may indicate colorectal cancer: a change in bowel habits, bleeding from the rectum, blood in the stool, stools that are more narrow than usual, abdominal discomfort (bloating, cramps, or frequent gas pains), loss of appetite, and weakness and feeling tired.

ACOG recommends that all women age 50 and older be screened for colorectal cancer by one of the following methods:

• Annual patient-collected fecal occult blood test (FOBT) or fecal immunochemical test (FIT)
• Flexible sigmoidoscopy once every five years
• Annual patient-collected FOBT or FIT plus a flexible sigmoidoscopy once every five years
• Double-contrast barium enema once every five years
• Colonoscopy once every 10 years

Some women may need to be screened for colorectal cancer before age 50 if they:

• Have a first-degree relative younger than age 60 with colorectal cancer or colon polyps
• Have two or more first-degree relatives of any age with colorectal cancer or colon polyps
• Have had colorectal cancer
• Have had colon polyps
• Have had inflammatory bowel disease (IBS), chronic ulcerative colitis, or Crohn's disease
• Have a family history of familial adenomatosis polyposis or hereditary nonpolyposis colon cancer

In early 2006, the National Colorectal Cancer Roundtable, of which ACOG is a member, published an evidence-based guide, How to Increase Colorectal Cancer Screening Rates in Practice. It is available free to physicians at www.nccrt.org/documents/general/
increasecolorectalcancerscreeningrates.pdf. The guide offers current screening guidelines and features checklists, chart prompts, tracking sheets, and other tools that physicians can use in their practice.

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