Many people who are otherwise conscientious about their health seem to practice a "see-no-evil, hear-no-evil" approach when it comes to protecting themselves against colorectal cancer, according to a Duke University Medical Center specialist.

"As a result, only a fraction of the people who could benefit from colorectal screening actually receive it," said Dr. Malcolm Stanley Branch, of the Duke Division of Gastroenterology. "But the prevalence of this malignancy - and the relative ease with which it can be diagnosed and treated in its early stages - offer compelling reasons to get past the reticence."

Colorectal cancer kills more than 55,000 Americans each year and is this country's second-leading cause of cancer deaths. Some 135,000 new cases of colorectal cancer are diagnosed each year, and it is the fourth most common cancer in the U.S.

"When caught early - colorectal cancer is among the most treatable of all types of cancer," Dr. Branch explained. "Unlike many other cancers that can appear suddenly and grow quickly, colon cancer has a long precancerous phase as growths or polyps, which often exist for several years before becoming cancerous."

If the growths are discovered and removed promptly, colon cancer can be prevented, said Dr. Branch. Even after colorectal cancer has developed, it's 90 percent curable when found early, he said.

"New surgical techniques and drug therapies are improving outcomes, extending lives, and enhancing quality of life for colon cancer patients," said Dr. Branch. But, as with any type of cancer, an ounce of prevention is worth the proverbial pound of cure.

To minimize your risk of developing full-blown colorectal cancer, consider the following tips:

• Follow a healthful diet. More and more biomedical studies indicate a relationship between a diet rich in fruits and vegetables - especially bright-colored vegetables rich in beta carotene and leafy greens - and a lower risk of all types of cancer, including colorectal cancer. Fiber alone won't do the job; a range of healthful, nutritious, low-fat foods is your best bet.

• Get regular exercise. This recommendation, too, is becoming a touchstone for the prevention ofmany serious health conditions, including colorectal cancer. Recent studies show that regular moderate exercise can reduce the risk of developing colon cancer by almost 50 percent.

• Just say no - or not much. Abundant research confirms that smoking may significantly increase your risk for not only lung cancer, but many other cancers, including colorectal cancer. As for alcohol consumption, while a small amount may be healthful to your heart, too much can also be a risk factor for colon cancer - so, if you drink, do so in moderation.

• Start a screening program. The American Society of Colon and Rectal Surgeons recommends that, from the age of 40 on, people at average risk for colorectal cancer receive a digital rectal exam and a stool-sample test annually. If you're 50 or over, the society recommends that, in addition to the above screenings, you also undergo direct imaging of the colon every five to 10 years. This is typically accomplished via either flexible sigmoidoscopy (which uses a tiny camera to visually examine the lower third of the colon) or, for higher-risk patients or follow-up testing, colonoscopy (which looks at the entire colon).

• Know your risk factors. Risk factors for colorectal cancer include a family history of colorectal cancer or a personal history of other cancers or colon diseases. Should you have one or more of such risk factors, your doctor will probably suggest that you begin flexible sigmoidoscopy or colonoscopy screenings before the age of 50.

• Be alert for symptoms. Symptoms of colorectal cancer include blood in the stool, a change in bowel habits, and abdominal pain. The optimum approach, however, is not to wait for symptoms to appear (a sign that the cancer, if diagnosed, has been growing for some time) but to catch colorectal cancer before it becomes symptomatic.

In his practice, Dr. Branch said, "we frequently treat colorectal cancer patients whom we wish we could have seen earlier."

As Whittier said, "For of all sad words of tongue or pen, The saddest are these: 'It might have been.'" While colorectal cancer is a serious disease, if it is found and treated early, the prognosis is excellent. So, to avoid regrets later, take steps to prevent colorectal cancer now.

Source: Duke Health, Duke University Medical Center, www.dukehealth.org.

Copyright 2004 Health Resources Publishing