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‘Everyone over 50 needs their colon checked’

An estimated 145,000 people in the United States will be diagnosed with colorectal cancer this year.
/ Source: TODAY

An estimated 145,000 people in this country will be diagnosed with colorectal cancer this year alone, and about 57,000 people will die from the disease.  When detected early, this kind of cancer can be fully cured more than 90 percent of the time, so getting the word out is absolutely critical. Dr. Julie Gerberding, the director of the Centers for Disease Control and Prevention, talked with “Today” host Katie Couric in this special series called Confronting Colon Cancer.

Katie Couric:  You know, it's about the same number of people who died during the entire Vietnam War who are taken by this disease every single year, and yet not enough people are getting screened — only 44 percent of men and 41 percent of women 50 and over have been screened for this disease. What’s keeping them from doing it?

Dr. Julie Gerberding:  Well, I think there are two main things. One is that people just don't know that you can have colon cancer and be completely asymptomatic and healthy.  I think the other thing is not enough doctors are making the recommendation to their patients.  So we've got a knowledge gap and also the connection between the knowledge and the actual steps.

Couric:  It's still a part of our body that people don't feel completely comfortable discussing. We were saying how, even from an early age, you're taught to refer to your body euphemistically, you know, this part of your body.  As you say, everybody's got a colon, right?

Gerberding: Absolutely. Everybody has a colon. Everyone over 50 needs to get their colon checked.

Couric:  Just like you want to check other parts of your body, that needs to be healthy as well. We joined forces — the National Colorectal Research Alliance, which I co-founded with the Entertainment Industry Foundation, has joined forces with the Centers for Disease Control [and] we're doing sort of a multimedia campaign to get the word out, starting with print ads featuring yours truly, right?

Gerberding:  Exactly.

Couric:  Tell me a little bit about this campaign.  These will be appearing in magazines, right?

Gerberding:  The screen for life campaign is really designed to get people out and aware of the fact that they need to be screened. We’re putting it out in the print media – there'll be ads on television and the radio. You'll probably see them in airports the next time you're passing through one of the major airports, because we have these dioramas up with these posters.

Couric:  I was teasing Matt and Al about the fact that every year I become this nagging fishwife with a rolling pin. If you don't continue to pound the message then people really put this on the back burner because I know that screening went up after President Reagan was diagnosed, or they found a cancerous polyp in him and then it kind of declined after that, right?

Gerberding:  Well, it did. But, Katie, you've done a lot, too, and we really thank you because you have caused what we call “The Couric Effect,” which is many more people did get screened after you brought attention to this, and we know how important that is. But we've got a long way to go.

Couric:  I was going to say, a 20 percent increase, but, still, those numbers I told you earlier show a huge gap in the number of people who are not getting screened for this highly preventable disease.  Now, Morgan Freeman is participating in this campaign, which is terrific for a lot of reasons. We want to say thank you to Morgan Freeman.  He’s such a beloved actor and one of his friends, Debra Hill, a Hollywood producer, actually died from colon cancer last week, and I know that was the impetus for him getting involved in our campaign.  Also, this has been a catalyst for him. He plans to get screened as well for this disease. It's also very important, because African Americans have a much higher mortality rate, don't they, Dr. Gerberding? I understand that their mortality rate is 40 percent higher than that of white men and women.

Gerberding: That's right. Part of that is because they're not getting screened early.

Couric: I was going to say, is it access  to good screening and health care or is there something biological going on?

Gerberding:  Well, it certainly is access to care in the majority. If there are genetic factors or other issues, we haven't been able to detect them yet.  So I think the main thing is that all of us need to be screened, but African Americans and women in particular.

Couric:  You brought up women, because the American Cancer Society has a very cute public service announcement out right now that shows a woman literally on her husband's back.  Well, we think they may be actors.  But basically, you know, staying on someone's back to make sure they get screened for colon cancer.  I'm so happy that the American Cancer Society has made colon cancer a top priority.  On the other hand, maybe they need to do another one with a man on a woman's back, right?

Gerberding:  Absolutely.

Couric:  Because a lot of women think this is a man's disease, and that is definitely not the case. It’s projected in 2005, 73,470 women will be diagnosed and 71,820 men.

Gerberding:  More women than men.

Couric: That's right. So women really need to pay attention. Why do you think they don't get screened? Is it because they're taking care of everyone else except themselves?

Gerberding:  Dr. Mom is often out there worrying about the kids or the spouse or the parents and doesn't take the time to take care of herself.

Couric:  But they are getting pap smears, they are getting mammograms.  I think 82 percent of women 25 [years-old] and older say they've had a pap smear during the previous three years.  Women over [age] 40, 70 percent have had mammograms over the past two years.  So this needs to be considered a critical test, just a no-brainer for women over 50, right?

Gerberding:  Absolutely. It should just be bundled together with the other kinds of prevention screening that women routinely have.

Couric:  I know that you were screened because your gynecologist, right said, “Julie, you need to look at this.” You have a family history, right?

Gerberding:  I do, my uncle had colon cancer. I was so lucky because my gynecologist said, “You know, you're 49, you're close to the screening age anyway, I think you should have this done,” and it turned out I had 10 polyps.

Couric:  You can't predict which polyps might become cancerous.

Gerberding:  Absolutely.

Couric:  That's why you have to nip it in the bud, or the butt, A-S-A-P right, Julie?

Gerberding:  Absolutely.

Couric:  Finally, there are a lot of new tests that are being researched, like a DNA stool test, for example, a virtual colonoscopy. Do you still consider a colonoscopy the gold standard?

Gerberding:  Well, there are four screening tests, including colonoscopy and some of these new tests are promising, but they're not yet approved.

Couric: We have colonoscopy, flexible sigmoidoscopy, fecal occult blood test and double contrast barium enema. More doctors need to go into gastroenterology, don't they, to deal with the demand for screening.

Gerberding:  I hope so.  I mean, I think we know we can do more screening now with what resources we have, but we will need to scale up if we're really going to get this national.

Couric:  Well, thanks so much, Julie Gerberding, for joining forces with us.

Gerberding:  I’m delighted to be a part of this.

Couric:  Thank everyone at the CDC. We so appreciate it.

Gerberding: Thank you.