Colorectal Cancer In New Jersey
1979-1997

Appendix I
Information And Recommendations
Regarding Screening For Colorectal Cancer(10-12, 17)


Screening = Prevention + Early Detection

  • Prevention (polyp removal
  • -> decreased incidence
  • Early detection
  • -> decreased mortality

    The risk of colorectal cancer increases sharply with age, and 90 percent of colorectal cancer cases occur in people over 50. As a result, regular colorectal cancer screening is strongly recommended for persons 50 years of age and older. The Centers for Disease Control and Prevention (CDC) estimate that more than one-third of all colorectal cancer deaths could be prevented by regular screening.

    Table 15
    Centers For Disease Control And Prevention
    Colorectal Cancer Screening Options For People Over 50*


    TEST TYPE PERIODICITY BENEFITS SHORTCOMINGS
    FOBT+ Every Year 33% mortality reduction Performed at home and subject to patient error; test not specific for colorectal cancers
    Flex Sig# 5 years 60% mortality reduction from distal colon/rectal cancers. No reduction in deaths from proximal colon cancers.
    Colonoscopy 10 years 66% reduction of new cancers. Most accurate test for detecting polyps. Not recommended for patients with advanced age.
    DCBE++ 5-10 years Provides view of the entire colon. Lower sensitivity to detecting polyps than colonoscopy.
    *From A Call to Action: Prevention and Early Detection of Colorectal Cancer (CRC). Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, 2000.
    +Fecal occult blood test
    #Flexible Sigmoidoscopy
    ++Double contrast barium enema

    According to the American Cancer Society (ACS) guidelines for screening, men and women over the age of 50 should follow one of the following screening options:

    • Yearly fecal occult blood test (FOBT) + flexible sigmoidoscopy every 5 years, or
    • Colonoscopy every 10 years, or
    • Double contrast barium enema every 5-10 years.

    A digital rectal examination (DRE) should also be performed at the time of each sigmoidoscopy, colonoscopy, or barium enema examination.

    For individuals exhibiting any of the following colorectal cancer risk factors, screening should begin at an earlier age and be performed more often:

    • A strong family history of colorectal cancer or polyps (cancer or polyps in a first degree relative younger than 60 or in two first-degree relatives of any age); or
    • A family with hereditary colorectal cancer syndromes (familial adenomatous polyposis and hereditary non-polyposis colon cancer); or
    • A personal history of colorectal cancer or adenomatous polyps; or
    • A personal history of chronic inflammatory bowel disease.

    New Jersey Cancer Education and Early Detection Screening Services (NJCEED)

    The New Jersey Cancer Education and Early Detection Services (NJCEED), New Jersey Department of Health and Senior Services, provides free screening for colorectal cancer, as well as breast, cervical, and prostate cancers, for uninsured or low-income individuals over the age of 40. NJCEED contracts with an agency in 20 of New Jersey's 21 counties to provide these services. The phone number of the program office in each county are listed below:

    Atlantic 609-653-3484   Middlesex 732-745-3100x3115
    Bergen 201-599-6114 Morris 1-800-447-3337
    Burlington 609-267-1950 Monmouth 732-933-3989
    Camden 856-968-7315 Ocean 1-800-621-0096
    Cape May 609-465-1047 Passaic 973-754-2778
    Cumberland/Salem 856-825-3344 Salem (call NJCEED directly at 609-292-8540)
    Essex 973-972-2777
    Gloucester 856-845-0100x2786 Somerset 908-526-2335
    Hudson 201-946-6459 Sussex 973-702-2740
    Hunterdon 908-788-6514 Union 908-226-4900
    Mercer 609-394-4045 Warren 908-859-6757

    Each county also has an Office on Aging that can be reached at the number listed below:

    Atlantic 609-645-7700x4700 Mercer 609-989-6662
    Bergen 201-646-2625 Middlesex 732-745-3293/3295
    Burlington 609-265-5069
    1-800-564-4656
    Monmouth 732-431-7450
    Morris 973-285-6848
    Camden 856-858-3220 Ocean 732-929-2091
    Cape May 609-886-2784/2785 Passaic 973-881-4950/4952
    Cumberland 856-453-2220/2221 Salem 856-935-7510x8622
    Essex 973-395-8375 Somerset 908-704-6346
    Gloucester 856-232-4646 Sussex 973-579-0555
    Hudson 201-271-4322 Union 908-527-4870/4872
    Hunterdon 908-788-1361 Warren 908-475-6591

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