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Consider the Alternative

Prostate and colorectal cancer each kill approximately 30,000 men in the U.S. every year. However, colorectal cancer accounts for a larger majority of premature deaths, and regarding screening for the two cancers, only colorectal cancer screening has been clearly proven through thorough research to reduce the risk of death, according to a recent study appearing in the Journal of the American Medical Association. If medical practice guidelines are based on research, colorectal cancer screening should be much more common than screening for prostate cancer.

Utilizing a 2001 annual health survey of adults in all 50 states conducted by the Centers for Disease Control and Prevention, information was gathered on 50,000 men age 40 or older. Researchers focused on the percentage of men screened for prostate cancer using PSA (prostate-specific antigen) testing and colorectal cancer using fecal occult blood testing (FOBT), colonoscopy or sigmoidoscopy.

Men were more likely to have ever been screened for prostate cancer than colorectal cancer (75% vs. 63% of subjects, respectively) in those age 50 or older. Subjects of all ages also more commonly had received PSA screening in the past year than FOBT in the past year or colonoscopy/sigmoidoscopy in the last five years. Men were significantly more likely to be up-to-date on prostate-cancer testing than colorectal-cancer testing in 27 states, compared to being more up-to-date on colorectal screening in only one state.

Men may be more willing to submit to a simple PSA blood test because it is less convenient and more invasive than testing required to detect colorectal cancer. Men also may perceive their risk of death from prostate cancer to be higher because they know others suffering from the condition. Consider the alternative to avoiding colorectal cancer screening, however: You may be allowing a cancer to develop until it is no longer treatable. Talk to your doctor for more information about the importance of screening for bowel cancers.


Sirovich BE, Schwartz LM, Woloshin S. Screening men for prostate and colorectal cancer in the United States: Does practice reflect the evidence? Journal of the American Medical Association 2003:289(11), pp. 1414-1420.

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