Each year, approximately 380 North Dakotans are diagnosed with colorectal cancer and 140 people will die annually from this disease. Colorectal cancer, commonly referred to as colon cancer, is the third most common cancer diagnosed in men and women in North Dakota as well as the U.S., and is the third leading cause of cancer death. It's preventable, treatable and beatable, though, and Trinity Health has a way to offer colon cancer screenings for free for North Dakotans who meet eligibility requirements.
The 2013-2015 North Dakota Colorectal Cancer Screening Initiative focuses on North Dakotans who are ages 50 through 64, low income, uninsured or underinsured who have never been screened or are past due for colorectal cancer screening. The goal is to screen 250 people statewide during the two years of this initiative. The program will run through June 2015 or will end earlier if the goal is met.
The screening procedure for this initiative is colonoscopy, provided at no-cost for those who are eligible, to be done at Trinity Health in Minot. If colon polyps are found during the procedure, they can be removed at that time. While treatment costs are not provided with the initiative funds, participants who are diagnosed with colorectal cancer through this program will be provided with available resources to assist with covering the cost of treatment.
Jodi Smith, Trinity Health Foundation director, left, and Dr. Shane Jordan, Trinity Health Cancer Care Center director, study the eligibility requirements of the 2013-2015 North Dakota Colorectal Cancer Screening Initiative, a program that focuses on screening North Dakotans for colorectal cancer. March is Colorectal Cancer Awareness Month and people are encouraged to get screened for colon cancer, the third most common cancer diagnosed in men and women in North Dakota.
The cost of getting screened, fear and lack of awareness for the need to screen for colon cancer are the most reported reasons people give for not getting screened. This program works to address those concerns.
According to Dr. Shane Jordan, Cancer Care Director at Trinity Health, four people have signed up for the program so far. Bismarck isn't participating in the program, so he anticipates getting a number of people from the Bismarck/Mandan area.
"I didn't realize the disproportionate number of North Dakotans diagnosed with colorectal cancer in relation to other states in the nation," said Jodi Smith, Trinity Foundation director. "I'm not sure why, but we can make assumptions, like cost, so the (initiative) may help with this."
Important notes about colon cancer
Age: About 90 percent of people are diagnosed with colon cancer are older than 50; African-American race; history of colorectal cancer or polyps; inflammatory intestinal conditions; family history of colon cancer and colon polyps; low-fiber, high-fat diet; sedentary lifestyle; diabetes; obesity; smoking; alcohol.
A change in bowel habits, such as diarrhea, constipation or narrowing of the stool, that lasts for more than a few days; a feeling that you need to have a bowel movement that is not relieved by doing so; rectal bleeding, dark stools, or blood in the stool (often, though, the stool will look normal); cramping or abdominal pain; weakness and fatigue; unintended weight loss.
Eat a variety of fruits, vegetables and whole grains; drink alcohol in moderation, if at all; stop smoking; exercise most days of the week; maintain a healthy weight.
The hope with the screening initiative is to make it simpler for people to get screened. "The point is to simplify the process and make it more accessible to people," Jordan said. One way the screening has been simplified is that the preparation solution for it will be available at the health care clinic instead of at the pharmacy like it typically is. They worked with the pharmacy company and they will supply the prep solution, he said, and that will save patients from having to go to the pharmacy.
Eligibility requirements to enroll in the program include age, residency, income, health insurance status, having no health conditions that exclude enrollment, and being due or past due for colorectal cancer screening. People must be in the 50 to 64 year age range, reside in North Dakota with a North Dakota address and meet a designated household income level. There are also insurance guidelines, but Jordan said having insurance does not exclude people from the program. Health conditions that would exclude enrollment a person would be a previous diagnosis of colon or rectal cancer, Crohn's disease, ulcerative colitis or genetic colon disease with multiple polyps.
In 2007, the N.D. Legislative assembly first appropriated funds for a colorectal cancer screening pilot program for the 2007-2009 biennium. The initial intent of this project was to focus screening efforts in a rural area of North Dakota where screening rates are lowest. Due to the success from the first two years of this project, the 2009 Legislative assembly appropriated funds for the 2009-2011 biennium to continue the rural project. Support from the Legislature will continue into 2015 and has increased the funding to include the program in six health care facilities. Those facilities include Heart of America Medical Center, Rugby; Sanford Health, Fargo; Altru Health System, Grand Forks; First Care Health Center, Park River; McKenzie Healthcare System Inc., Watford City; and Trinity Health, Minot.
To date, 465 North Dakotans have received colorectal cancer screening with the colon cancer screening initiative. There have also been 115 people who have had pre-cancerous colon polyps removed, while five people have had cancer diagnosed and treated. Smith said if there is a greater need for screening, there will be opportunity to gain more funding and the state has been open to doing so.
"It's important to get the word out about this," Jordan said. "Screening is important." The screening for colon cancer is easy, he continued, with some prep the day before, but the effects outweigh the alternative. Even people who don't meet the guidelines in the initiative are still encouraged to get screened. "It's a good reminder for people to get screened," Jordan said. "These are things that are preventable."
Colorectal cancer is one that can be treated effectively if detected early. According to the American Cancer Society, 90 percent of people whose colorectal cancer is found at an early stage are alive five years after the diagnosis. If spread to a distant part of the body, however, the five-year survival rate drops to 10 percent.
For people who are wondering if they should get screened if they have a family history of colorectal cancer, Jordan said to take a look at how many of your family members have had it, how many family members had been diagnosed with it under the age of 60 and how many family members had polyps. "It all goes back to genetics," he added.
Smith said not getting diagnosed early makes colon cancer harder to treat. "This initiative is set up to save lives. Colon cancer is one of the most preventable and treatable cancers out there and it's heartbreaking to lose someone when it could've been prevented."
People who are interested in enrolling in the program or have questions can call Trinity Cancer Care Center at 857-3535.