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University of Iowa News Release

March 4, 2003

(Photo: Charles Lynch, M.D., Ph.D., UI professor of epidemiology and medical director of the State Health Registry of Iowa)

State Health Registry Issues 'Cancer in Iowa: 2003'

In 2003, the state of Iowa will see an estimated 14,700 new cancer cases and 6,400 deaths due to cancer, according to "Cancer in Iowa: 2003," the annual report issued by the State Health Registry of Iowa, based at the University of Iowa College of Public Health.

The projections are based on data from the Iowa Department of Public Health and the Iowa Cancer Registry and are reflective of cancer rates seen at the national level, said Charles Lynch, M.D., Ph.D., UI professor of epidemiology and medical director of the registry.

"As in years past, we are seeing stability in the number of newly diagnosed cases and deaths," Lynch said. "However, cancer remains the second leading cause of death in Iowa."

The top three types of projected cancer deaths for men and for women remain unchanged from previous years. For men, the leading cancer deaths will be due to lung, prostate and colon and rectum, or colorectal, cancer. For women, leading cancer deaths will be lung, breast and colorectal cancer. Lung cancer alone will account for one of every four cancer deaths.

Projected new cancer cases in females will be breast (30 percent of total new cases in women), colorectal (approximately 15 percent) and lung (nearly 12 percent). The new cancer cases in males will be prostate (nearly 30 percent of total new cases in men), lung (nearly 16 percent) and colorectal (13.5 percent).

In addition to providing overall information on cancer in Iowa, this year's report includes a special focus on colorectal cancer. This type of cancer is projected this year to be diagnosed in Iowa in 1,100 women and 1,000 men and be the cause of 390 deaths in women and 350 deaths in men. Iowans were diagnosed with 58,783 colorectal cancers between 1973 and 2000, and 23,527 Iowans died from the disease during those years.

Screening is a key to reducing the mortality rate from colorectal cancer, Lynch said. The American Cancer Society recommends that screening for the disease begin at age 50 for both men and women. People with a family history of colorectal cancer or certain colorectal diseases, such as familial polyposis, should be screened earlier.

"Nearly 95 percent of all colorectal cancers in Iowa are diagnosed after age 50, so if you have no increased risk factors for the disease, age 50 is a good time to start," Lynch said. "However, as of 1999, 65 percent of Iowans ages 50 to 59 reported never having had a sigmoidoscopy or colonoscopy."

Lynch added that in 1999 about half of all Iowans age 60 and older reported never having had these types of colorectal cancer screening.

"Screening is so important because it can detect pre-malignant colorectal cancer, which takes the form of polyps," Lynch said. "When you remove these polyps, you can prevent a person from being diagnosed with colorectal cancer."

The five-year survival rate is nearly 98 percent for people with cancer confined to a polyp and 94 percent for those with stage 1 colorectal cancer, which is cancer that has invaded the superficial layers of the bowel. However, this survival rate falls to 6 percent if the disease is diagnosed when it already has spread (metastasized) to other organs such as the liver. Once symptoms of colorectal cancer develop, such as pencil-thin stools and unexplained weight loss, the disease often is advanced and may have spread to other organs.

Colorectal cancer screening can take several forms:

* a fecal occult blood test every year, which involves an easy-to-use at-home kit;
* flexible sigmoidoscopy every five years, which allows examination of the area of the colon and rectum where the majority of cancers occur;
* fecal occult blood test plus flexible sigmoidoscopy every five years;
* double-contrast barium enema every five to 10 years, which provides a radiologic visualization of the entire large bowel; and
* colonoscopy every 10 years, which provides an examination of the entire large bowel.

Iowans have reacted differently to the screening test for breast cancer, mammography, compared to the screening tests available for colorectal cancers. This is reflected in the fact that nearly seven of every 10 breast cancer cases in Iowa were diagnosed at an early stage throughout the 1990s, however, only four to five of every 10 colorectal cancer cases were diagnosed at an early stage for the same time period.

"Women are getting out and getting mammograms. Thus, we see a significant number of early stage breast cancers, which are more treatable than those at the later stages," Lynch said. "However, for colorectal cancers, there seems to be less acceptance and understanding among both men and women of the screening procedures."

Individuals age 50 and older should talk with their family physician about which colorectal cancer screening method is best for them.

More than 150 hospitals, clinics and medical laboratories across Iowa, as well as referral facilities in neighboring states, contribute data to the State Health Registry. Lynch said this participation is essential to providing a thorough tracking of the cancer experience of Iowans. The registry is one of 14 registries nationwide that are currently funded to provide data to the National Cancer Institute.

The State Health Registry has been gathering cancer incidence and follow-up data for the state since 1973 and includes projected numbers of new cancer diagnoses and cancer deaths for each county. Links to the "Cancer in Iowa: 2003" report and reports from previous years are available at http://www.shri.us/. People may also request a copy of the report by calling the State Health Registry of Iowa at (319) 335-8609.

STORY SOURCE: University of Iowa Health Science Relations, 5137 Westlawn, Iowa City, Iowa 5224-1178

CONTACTS: (media) Becky Soglin, 319 335-6660 becky-soglin@uiowa.edu. State Health Registry: Michele West, (319) 335-7497, michele-west@uiowa.edu