COLON CANCER IN KENTUCKY Presented by Name Kentucky

COLON CANCER IN KENTUCKY Presented by: {Name} Kentucky Cancer Program University of Louisville

Colon cancer accounts for 1 out of every 10 cancer deaths every year.

Colorectal Cancer Screening in Kentucky 75. 0% 69. 6% 70. 0% Screening Rate 65. 0% 60. 0% 63. 7% 2008 2010 65. 7% 58. 6% 55. 0% 47. 2% 50. 0% 43. 9% 45. 0% 40. 0% 35. 0% 34. 7% 30. 0% 2000 49 th 2002 2004 Source: http: //cdc. gov/brfss, Accessed June 2016 2006 Year 23 rd 2012 2014

Colorectal Cancer Incidence in Kentucky Age-Adjusted Incidence Rate per 100, 000 72. 0 70. 0 68. 0 66. 6 66. 0 68. 1 68. 8 65. 4 65. 2 64. 1 64. 0 62. 0 61. 3 60. 0 59. 3 59. 5 58. 1 58. 0 57. 2 R 2=0. 9647 56. 0 54. 6 53. 4 54. 0 54. 2 53. 3 52. 9 51. 3 52. 0 50. 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Year P<. 05 Source: http: //www. kcr. uky. edu, Accessed April 2018

Colorectal Cancer Mortality in Kentucky Age-Adjusted Incidence Rate per 100, 000 25. 0 24. 2 23. 6 23. 0 21. 0 22. 6 22. 5 23. 0 20. 6 20. 5 19. 6 19. 1 19. 0 R 2=0. 9146 17. 4 17. 5 16. 9 16. 6 16. 8 16. 4 17. 0 15. 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Year P<. 05 Source: http: //www. kcr. uky. edu, Accessed April 2018

Colon and Rectum Cancer by Area Development District in KY, 2011 -2015 Area Development District High School Education, 2011 -2015 Colonoscopy Rate, 2012, 2014 Late Stage Incidence (%) Percent Rank Cumberland Valley 72. 1 2 61. 2 4 60. 2 Big Sandy 74. 0 3 59. 5 3 55. 2 Buffalo Trace 79. 2 6 62. 4 5 61. 2 Kentucky River 70. 8 1 57. 0 1 47. 7 Gateway 78. 8 5 57. 2 2 52. 8 Lake Cumberland 76. 9 4 63. 1 6 53. 9 Barren River 81. 8 8 64. 8 8 55. 2 Northern Kentucky 88. 9 15 64. 7 7 61. 4 Lincoln Trail 85. 2 11 68. 6 10 54. 1 Fivco 84. 0 10 68. 0 9 50. 9 Green River 85. 3 12 73. 0 14 56. 6 Pennyrile 83. 2 9 69. 5 11 50. 2 Bluegrass 81. 3 7 71. 1 12 49. 2 Kipda 88. 6 14 71. 3 13 51. 0 Purchase 85. 6 13 74. 1 15 43. 6 Percent Overall Rank 3 5 2 14 9 8 6 1 7 11 4 12 13 10 15 9 11 13 16 16 18 22 23 28 30 30 32 32 37 43

Colon Cancer 101 Facts Ø Colorectal cancer is the second leading cause of death from cancer in the United States. Ø The majority of these cancers and deaths could be prevented by increasing awareness and screening according to recommended guidelines.

Colon Cancer Also called “Colorectal cancer” Ø Uncontrolled, abnormal cell growth which starts in the colon or rectum Ø These abnormal cells can form a mass of tissue Ø Usually begins as a noncancerous polyp, that can, over time, become a cancerous tumor. Polyp: A polyp is a growth that shouldn’t be there. Most colon polyps are harmless. But over time, some colon polyps can develop into colon cancer, which could be fatal if it is found in a late stage.

Polyp Growth to Cancer: An Opportunity for Intervention

Digestive System & Polyps Image Source: National Cancer Institute

Risk Factors for Colon Cancer Ø Different cancers have different risk factors Ø Having a risk factor(s) does not mean you will get cancer Ø Certain risk factors increase a person’s chance of developing a polyp(s) or colorectal cancer Risk Factor: Anything that affects your chance of getting a disease such as cancer.

Risk Factors for Colon Cancer: Lifestyle Factors Ø Diet § High in red meats (beef, pork, lamb, or liver) and processed meats § Cooking meats at high temperatures (frying, broiling, or grilling) Ø Physical inactivity Ø Obesity (Being very overweight) Ø Smoking Ø Heavy alcohol use

Other Risk Factors Ø Age (over 50) Ø Personal history of colorectal cancer or polyps Ø Personal history of Inflammatory Bowel Disease (IBD) Ø Family history of colorectal cancer or polyps Ø Inherited syndromes Ø Racial & Ethnic Backgrounds: ü African-Americans ü Jewish persons of Eastern European descent Ø Type 2 Diabetes

Signs & Symptoms Early colon cancer may have NO symptoms. If symptoms are present, they may include: Ø A change in bowel habits Ø A feeling of needing a bowel movement Ø Rectal bleeding Ø Blood in the stool which may make it look dark Ø Cramping or abdominal (belly) pain Ø Weakness & fatigue Ø Unintended weight loss Schedule an appointment to talk to your health care provider if you have any of these symptoms.

Screening is Important Ø Ø Colon cancer is PREVENTABLE! Early diagnosis means a better chance at successful treatment. Obtain regular colon cancer screenings Find any polyps or abnormal growths early & remove them Prevent colon cancer or find it in its early stage when it is more treatable

Who should be screened? People at Average Risk Ø ALL people ages 50 -75 who are “average risk” Ø After age 75, discuss with your doctor if screening needs to be continued Ø Includes men and women People at High Risk Ø Have one or more risk factors for developing colon cancer Ø Must be screened more often & regularly Ø This includes persons with a personal or family history of polyps or colon/rectal cancer The American College of Gastroenterology, a professional medical organization, recommends African-Americans begin colon cancer screening at age 45.

Colorectal Cancer Screenings Types of Colon Cancer Screening Tests Description of the Test Screening Schedule for AVERAGE RISK PERSONS Fecal/Stool blood tests (FIT, FOBT, or g. FOBT) Samples of stool are checked for blood Every year Stool DNA Test Samples of stool are checked for blood as well as DNA changes Every 3 years Colonoscopy A flexible, lighted tube is used to look at the entire colon & rectum Every 10 years Sigmoidoscopy A flexible, lighted tube is used to look at the rectum & lower colon Every 5 years when combined with FIT or FOBT; every 3 yrs when done alone.

Colonoscopy Screening and Insurance Coverage In the past, some people have had additional out-of-pocket costs when: Ø they had a positive: FIT, DNA test or FOBT test that required a colonoscopy Ø they had a “screening colonoscopy” (meaning they had no symptoms) which was later coded as a “diagnostic colonoscopy” if a polyp was removed

Colonoscopy Screening and Insurance Coverage Ø Ø In March 2015, the Kentucky General Assembly passed legislation that requires that all “screening colonoscopies” be covered without a co-pay or deductible. Health benefit plans that are renewed on or after January 1, 2016 will no longer be able to impose a deductible or co-pay for patients who have a “screening colonoscopy” that results in a polyp removal or have a positive FIT/Fecal DNA test (including Cologuard)/FOBT test that requires a followup colonoscopy.

PROGRESS IN KENTUCKY

Data Source: Kentucky Cancer Registry; KY BRFFS

2016 Colorectal Cancer Screening Rates by Area Development District, Ky. BRFS Purchase ADD achieved 80% by 2018! And many ADDs increased their screening rates by over 30% in the past 10 years. Purchase- 83% Green River- 78% Bluegrass- 77% Barren River- 72% Northern Kentucky- 74% FIVCO- 74% KIPDA- 72% Pennyrile- 71% Lincoln Trail- 71% Buffalo Trace- 67% Kentucky River- 64% Gateway- 63% Cumberland Valley- 63% Lake Cumberland- 62% Big Sandy- 60%

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