Health: Katie’s Cure

It’s never easy to talk to patients about getting their colon probed from the inside by a 5-ft.-long tube, but it’s a lot easier than it used to be, thanks to NBC host Katie Couric. After she lost her husband Jay Monahan, 42, to colon cancer in 1998, she launched a campaign to raise awareness of the importance of regular screenings–a campaign that may have done more than any doctor could to get people to make that crucial appointment. After Couric bravely had her colon screened on national television in 2000, researchers at the University of Michigan reported a 20% increase in the number of scheduled colonoscopies. It came to be known as the Couric effect. So when I heard the news last week about the risk of colon cancer for smokers and drinkers, one of my first calls was to Couric. A study of more than 160,000 colon-cancer patients published in the Archives of Internal Medicine found that the cancers of patients who smoked tobacco or drank alcohol were diagnosed an average of 5.2 years earlier than were those of other patients. If you smoke as well as drink, the study suggests, your cancer is likely to be diagnosed almost eight years earlier.

Those are findings that ought to get people in bars across America thinking twice about their bad habits, because the implication is that smokers and drinkers should be getting screened earlier than ever for colorectal cancer. Doctors usually recommend that patients schedule their first exam on or near their 50th birthday. If you get a colonoscopy–considered the gold standard of screenings because it allows doctors to examine the whole length of the lower intestine and snip off any precancerous polyps they find–you may not need to be screened again for 10 years. If you use one of the less definitive tests– a flexible sigmoidoscopy, barium enema or simple stool analysis–you should get tested more frequently.

Couric was on vacation last week, but she got right back to me by e-mail. “Fear and embarrassment are major obstacles,” she wrote, “but educated, well-informed people who want to have long lives should force themselves to get over those feelings. The time to be screened for colon cancer is when you are feeling well and not having symptoms.”

She’s right, of course. Colorectal cancer remains one of the top three causes of cancer deaths in the U.S. (after lung and breast cancer), but it doesn’t have to be; 90% of cases detected early can be cured.

Meanwhile, there are plenty of steps you can take to improve your odds. Exercise is good for both your heart and your colon. You should also try to eat less red meat (which stresses the digestive system) and more vegetables, fruit and–above all–fiber. Obviously, given the news last week, you need to think about cutting back on your drinking– and, for goodness’ sake, stop smoking (or, if you’ve never started, keep up the good work).

Nobody, not even Couric, likes to talk about getting their backside probed, but, as she puts it, “having a colonoscopy is a heck of a lot easier than facing a diagnosis of colon cancer.” > Sanjay Gupta is a neurosurgeon and CNN medical correspondent

5 years How much earlier colon cancers were diagnosed in patients who smoked or drank alcohol

8 years How much earlier such cancers were diagnosed in patients who smoked and drank alcohol

After Couric had her colon screened on TV, the number of scheduled colonoscopies rose 20%