Here's Something to Dog Your Doctor About

If the cancers of the world threw a party, the colorectal variety would surely arrive in a small Toyota and wearing a JC Penney suit. Although it ranks second only to its lung-borne cousin in the lineup of lethal cancers, lack of publicity and education means that only one third of Americans most at risk for colorectal cancer ever get the full battery of tests for the disease, warns a new study in the Journal of the National Cancer Institute, Although the American Cancer Society recommends annual screenings for people older than 50, several factors conspire to discourage follow-up tests. Partly to blame: embarrassment colorectal cancer doesn't make for great dinner party conversation. It also doesn't help that the tests involved all too often sound like scenes from dubious horror movies: something called a positive fecal occult screening (to examine a stool sample for blood) should be followed by a flexible sigmoidoscopy in which instruments are inserted into the colon to check for cancer and a barium enema X-ray examination. None of the procedures are particularly pleasant-sounding, but as any doctor will tell you, undergoing a few moments of mild discomfort certainly beats joining the 56,000 Americans who will die from colorectal cancer this year.

Adding to the problem is the fact that colorectal cancer is a "quiet disease" usually heralded only by seemingly innocuous gastrointestinal problems the presence of which is often detected after it is too late for treatment. "Doctors need to do a better job of education and of convincing patients that the tests are important, and that whatever preconceptions they have about the tests are probably false," says TIME medical contributor Dr. Ian Smith. With education clearly the key to prevention, the attention brought to the disease in recent times by several celebrities will highlight the need for complete testing. Media coverage skyrocketed with the diagnosis and treatment in September of Supreme Court Justice Ruth Bader Ginsburg, as well as that of New York Yankee Darryl Strawberry last year. Perhaps most important to the cause is "Today" show host Katie Couric, whose husband, Jay Monahan, died of the disease in early 1998 at the age of 42. Couric, who cofounded the National Colorectal Cancer Research Alliance after her husband's death, apparently recognizes a great truth in the wars against modern disease: A famous face may save more lives than a million brochures ever could.