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8/2/2019 Chinese American Colon CAGroup
http://slidepdf.com/reader/full/chinese-american-colon-cagroup 1/26
Colon Cancer in Chinese
Americans
50 Years Old or Older?
Get Tested Regularly!
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What is colon cancer?
Cancer of the colon or rectum
Your colon:
is another name for your large intestine.
is about 6 feet long.
turns food you eat into waste matter or a bowel
movement as it passes through the colon.
Your rectum: is the last 8-10 inches of the large intestine.
bowel movements travel through the rectum and
pass out of the body through the anus.
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Your Colon and Rectum
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Chinese American Colorectal
Cancer Disparities What is a disparity?
³«. a population-specific difference in the
presence of disease, health outcomes, or
access to care.´ (Health Resources and
Services Administration, 2000)
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Chinese American Colorectal
Cancer Disparities What is the prevalence of Colorectal cancer
in Chinese Americans?
52 out of 100,000 Chinese Men get colorectal
cancer yearly (Clin, 2007).
42 out of 100,000 Chinese women get
colorectal cancer yearly (Clin, 2007).
Clin, J., (2007). CA Cancer , 57: 190 -205
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How long does it take cancer to develop,
and what are your chances?
In most people, colorectal cancers develop
slowly over a period of several years. 10 to 20 years (Clin, 2007).
Clin, J., (2007). CA Cancer , 57: 190 -205
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Why does it develop?
Colorectal cancer usually begins as a non-
cancerous (or benign) polyp.
A polyp
is a growth inside the colon or rectum that is
not normal.
can be several types.
is not always cancerous.
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When Cancer Forms in a Polyp
It can eventually grow through the lining and
into the wall of the colon or rectum.
95 percent of colorectal cancers grow from
cancerous polyps and move into the inside
layer of the wall of the colon and rectum
(Winawer, 1993).
Winawer, B., (1993). Colorectal Cancer, New
England J Med., 329(27):2028-9
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Personal History Risk Factors for
Colorectal Cancer
Personal History of Cancer
If you¶ve already been treated for colorectal cancer, you¶reat an increased risk for developing it again.
Personal History of Polyps
If you have had a polyp removed
You are no longer at risk of that particular polypdeveloping into cancer.
If you have had an adenomatous polyp removed, you aremore likely to have other polyps in the future.
Adenomatous polyps are groups of polyps with abnormalcells that multiply and may eventually become cancerous.
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Family History and the Role of
Genetics
You have a higher risk of developing
colorectal cancer if:
One or more immediate family members were
diagnosed with colorectal, uterine, or stomachcancer
Immediate family members include:
Parent
Sibling
Child
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Lower Your Risk of Developing
Colorectal Cancer by:
Increasing physical activity
Exercise at least 30 minutes a day on the majority of days.
Not smoking - long-time smokers are more likely than
non-smokers to get colorectal cancer (American Cancer Society).
Improving your diet
Limit your alcohol use.
Limit high-fat diets. Limit red, charred, or processed meat.
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Importance of Screening and
Early Detection
Once a non-cancerous (benign) polyp isremoved, it will never have the chance todevelop into cancer.
Regular screenings for colorectal cancer andremoval of polyps
Reduce a person¶s lifetime risk of dying.
When colorectal cancer is detected early
It is highly curable!
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Early Detection Makes a Difference
The most effective way to reduce your risk of colorectal cancer is to get screened routinely.
Start at age 50.
Start earlier if you are at higher risk. Personal health history
Family health history
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USPSTF Screening Guidelines
Age: 50-75 years and no screening from 76-
85.
Screening Methods
1. FOBT: every year
2. Flex Sig: every 5 years
3. Colonoscopy: every 10 years
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Why should Chinese Americans
get screened?
Chinese Americans screening rates are
significantly lower in Chinese Americans, who
get screened only 46% compared to
Caucasians 60%, and African Americans
55%. (CDC).
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Don¶t want to get screened?
Embarrassed?
Doctors need to know about changes in your
bowel habits or rectal bleeding.
Everyone has ³private parts,´ and it¶simportant to keep them healthy!
Don¶t want bad news?
Getting screened can find bad things early,
which increases the amount of time you can
spend with your family. They need you!
Doctor didn¶t say you need to get tested?
Bring it up with him or her ± it¶s important!
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What test do I take to get screened?
There are several tests to screen
for colorectal cancer.
Some tests are used alone, while
others are used in combinationwith other tests.
Talk to your doctor about which
type of test is best for you!
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What if something is found?
If you have polyps
They can be removed before they turn
into cancer.
Finding and removing adenomatouspolyps can decrease colorectal cancers
by 60-90 percent. (Winawer, 1993)
If cancer is found
It is often curable in its early stages.
Winawer, B., (1993). Colorectal Cancer,
New England J Med., 329(27):2028-9
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Fecal Occult Blood Test (FOBT)
Recommended to be done yearly
Checks for hidden blood in the stool
Your doctor gives you a test kit
At home, you place a small amount of your stool from 3bowel movements on test cards.
You then return the cards to your doctor¶s office or a
lab where the stool samples are tested for hidden
blood.
If blood is found, a colonoscopy will be needed.
A disadvantage of this test
Sometimes the test is negative in people who have
adenomatous polyps and colorectal cancer. So a better
method might be need to evaluate you further.
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Flexible Sigmoidoscopy (Flex Sig)
Recommended every 5 years
Examines the lining of your rectum and lower part of your colon
Uses a thin, flexible, lighted tube called a sigmoidoscope
It is inserted into your rectum and lower part of your colon. If polyps or lesions are found, a follow-up test is needed.
Some of the disadvantages of the Flex Sig are: You may feel some discomfort ± but not painful
If a polyp is found, it needs to be followed by a colonoscopyto remove the polyp at a later time.
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Combination FOBT and Flex Sig
Some experts recommend using both of
these tests to increase the chance of finding
polyps and cancers.
It is recommended every 5 years.
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Colonoscopy
Similar to the Flexible Sigmoidoscopy except:
It allows the doctor to look at the lining of your rectum andentire colon.
You will NOT be under general anesthesia.
The Doctor will use a thin, flexible, lighted tube called acolonoscope that is inserted into your rectum and colon tovisualize and remove any polyps if needed.
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Colonoscopy (continued) «
Procedure takes 15±30 minutes.
If the polyps are removed, it might take a little
longer..
A wire loop is passed through the scope to cut the
polyp from the lining of the colon using an electrical
current.
Polyps are collected and
sent to the lab for
evaluation.
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Worried about How Much It Will Cost?
If you are 50 years old or older and haveMedicare
You are eligible for colorectal screenings!
For more information, call or visit:
1-800-MEDIC ARE (1-800-633-4277)
http://medicare.gov/Health/ColonCancer.asp
If you have private insurance
Most insurers are now paying for some form of colorectal screening
Often including screening colonoscopy
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Think about the future
Your family needs you.
If you¶re 50 years old or older
Get screened!
You have the power to determine your future!
Any questions?