Monday, August 24, 2009

Cancer Screening Resolution

As a Member of the Lenoir County Board of Health I submitted this Resolution for discuss and possible vote at our next meeting August 26, 2009.

Resolution proposing Expansion of the Breast and Cervical Cancer Control and Prevention Program to include Prostate Cancer, Lung Cancer, Skin Cancer and Colon & Rectum Cancer and changing the name to the “Lenoir County Cancer Control and Prevention Program”.

There is a great need for Free Cancer Screening in Lenoir County. We have a higher Prostate Incidence Rate than the rest of the state. We have a higher Breast Cancer Incidence rate than the rest of the state. Our Colon Cancer Death rate is higher than the states. The Lung Cancer Rate in Lenoir County is higher than the state. We have a serious problem that I don’t feel is being properly addressed. By providing Free Cancer Screenings we will at least be providing preventative measures that will decrease the death rates from these diseases.

Cancer (malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors which are self-limited, and do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.

Cancer may affect people at all ages, even fetuses, but the risk for most varieties increases with age. Cancer causes about 13% of all human deaths. According to the American Cancer Society, 7.6 million people died from cancer in the world during 2007. Cancers can affect all animals.

Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers are usually affected by complex interactions between carcinogens and the host's genome. New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly recognized as important.

Lung Cancer

More people die from Lung Cancer than from any other type of cancer. This is true for both Males and Females. In 2005 (The most recent year for which statistics are available) lung cancer accounted for more deaths than did breast, prostate and colorectal cancers combined. In 2005, 90,139 men and 69,078 women in the United States died o lung cancer. That same year, 107,416 men and 89,271 women were diagnosed with lung cancer.

Risk Reduction
Tobacco use is the major cause of lung cancer in the United States. About 90% of lung cancer deaths in men and almost 80% of lung cancer deaths in women in this country have been attributed to smoking. Experts agree on the importance of preventing adolescents from starting to smoke, helping smokers to quit and reducing the exposures to environmental tobacco smoke and other substances known to cause lung cancer.

Prostate Cancer


Prostate cancer is the most common form of cancer (other than some forms of skin cancer) and the second leading cause of cancer deaths among men in the United States after Lung Cancer. About 62% of all clinically diagnosed prostate cancers occur in men over age 65. According to the CDC Division of Cancer Prevention and Control.

According to the Division of Cancer Prevention and Control African American men experience higher rates of Prostate Cancer than White men.

Screening
The two most common test used by physicians to detect prostate cancer are the digital rectal examination (DRE) and the prostate specific antigen (PSA) test. For the DRE, the doctor inserts a gloved and lubricated finger into the rectum. This allows the doctor to feel the back portion of the prostate (where most prostate cancers begin) for size and irregularities. The PSA Test is a Blood test that measures prostate specific antigen, an enzyme produced only by the prostate. The doctor may use this test to see if the PSA level is within normal limits and to check for any changes in PSA levels compared to previous PSA tests. All information sourced from the Center for Disease Control.

Colon & Rectum

Colorectal cancer is cancer that occurs in the colon or rectum. Sometimes it is called Colon Cancer, for short. The colon is the large intestine or large bowel. The Rectum is the passageway that connects the colon to the anus.

Colorectal cancer affects both men and women of all racial and ethnic groups, and is most often found in people aged 50 years or older. For Men, colorectal cancer is the third most common cancer. For women colorectal cancer is the second most common cancer among Asian and Hispanic Women, and the third most common cancer among white, black and Native American women.

Colorectal cancer is the second leading cancer killer in the United States, but it doesn’t have to be. If everybody aged 50 or older had regular screening test as many as 60% of deaths from colorectal cancer could be prevented.

Colorectal Cancer screening saves lives. Screening can find precancerous polyps—abnormal growths in the colon or rectum—so that they can be removed before turning into cancer. Screening also helps find colorectal cancer at an early stage, when treatment often leads to a cure.

Screening Test

Several test are used to screen for Colorectal Cancer. The U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), and an interdisciplinary task force convened by the Agency for Health Care Policy and Research, or AHCPR all have developed guide lines related to Colorectal Cancer screening.
USPSTF – Annual fecal occult blood test (FOBT) and or periodic Sigmoidoscopy.
ACS – Annual and flexible Sigmoidoscopy every 5 years or total colonic examination with colonoscopy every 10 years or DCBE every 5-10 years.
AHCPR – Annual FOBT and or flexible sigmoidoscopy every 5 years or total colonic examination with colonoscopy every 10 years or double contrast barium enema (DCBE) every 5-10 years.

Strong scientific evidence shows that when people have either FOBT once a year or flexible sigmoidoscopy every 5 years, there is a reduction in deaths from Colorectal Cancer.

Skin Cancer

Skin cancer is likely the most common form of cancer in the United States. The two most common types of skin Cancer-basal cell and squamous cell carcinomas are highly curable. However, melanoma, the third most common skin cancer, is more dangerous, especially among young people. Approximately 65% --90% of melanomas are caused by exposure to ultraviolet (UV) light or sunlight.

The best way to prevent skin cancer is to protect oneself from the sun. When used consistently, sun protective practices can reduce a person’s risk of developing skin cancer.

The U.S. Preventive Services Task Force (USPSTF) has concluded there is not enough evidence to recommend for or against routine screening. However, the USPSTF recommends that clinicians be aware that fair skinned men and women aged 65 years or older, and people with atypical moles or more than 50 moles, are at greater risk for developing melanoma and remain alert of skin abnormalities when conducting physical examinations for other purposes.

Center for Disease Control (CDC) Top 5 Cancer Death Rates Male and Female in NC

1. Lung & Bronchus……………….59.8
2. Prostate………………………….25.2
3. Female Breast…………………...25
4. Colon & Rectum………………...16.8
5. Pancreas…………………………10.9
Note: Rates per 100,000

Center for Disease Control (CDC) Top 5 Cancer Incidence Rates Male and Female in NC

1. Prostate………………………….146.7
2. Female Breast…………………...118.5
3. Lung & Bronchus……………….75.6
4. Colon & Rectum………………...48.3
5. Corpus & Uterus, NOS………….20.2
Note: Rates per 100,000

Center for Disease Control (CDC) Top 5 Cancer Incidence Rates for Males in NC
1. Prostate…………………………..146.7
2. Lung & Bronchus………………..101.1
3. Colon & Rectum…………………57.4
4. Urinary Bladder………………….34.3
5. Melanomas of the Skin…………..24
Note: Rates per 100,000

Center for Disease Control (CDC) Top 5 Cancer Incidence Rates for Females in NC
1. Breast…………………………….118.5
2. Lung & Bronchus………………...57.2
3. Colon & Rectum………………….41.3
4. Corpus & Uterus, NOS…………...20.2
5. Melanomas of the Skin…………...16.1