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Tag: iab-cancer

  • Chris Evert Fast Facts | CNN

    Chris Evert Fast Facts | CNN

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    CNN
     — 

    Here is a look at the life of tennis great Chris Evert, who won at least one Grand Slam singles championship 13 years in a row (1974-1986).

    Birth date: December 21, 1954

    Birth place: Fort Lauderdale, Florida

    Birth name: Christine Marie Evert

    Father: James “Jimmy” Evert, pro tennis instructor

    Mother: Colette (Thompson) Evert

    Marriages: Greg Norman (2008-2009, divorced); Andy Mill (1988-2006, divorced); John Lloyd (1979-1987, divorced)

    Children: with Andy Mill: Colton, Nicholas and Alexander

    By age 14, she was the number one nationally ranked player in the Girls’ 14-under Division.

    At 15, she beat the number one ranked player in the world at the time, Margaret Court.

    Holds the highest winning percentage, male or female, in “Open Era” tennis history (.900).

    Her rivalry with Martina Navratilova began in 1973 and lasted until 1988, and has been called the greatest in sports history. They faced each other in 14 major finals.

    Ranked number one in the world for seven years: 1974-1978, 1980 and 1981.

    Holds 157 singles titles.

    In 52 of 56 Grand Slam tournaments over the course of her career, she reached at least the semifinals.

    Holds 18 Grand Slam singles titles and three Grand Slam doubles titles, two of which are with Navratilova.

    1971 – At 16 she reaches the US Open semifinals, losing to Billie Jean King.

    December 21, 1972 – Turns professional on her eighteenth birthday.

    1973 – Announces her engagement to men’s tennis star Jimmy Connors. They end their engagement in 1974.

    March 22, 1973 – Faces Navratilova on the court for the first time, beginning a long lived professional rivalry and personal friendship. Evert defeats Navratilova (7-6, 6-3).

    1974 – Wins the French Open, her first Grand Slam title.

    November 1975 – Signs with the World Team Tennis (WTT) Phoenix Racquets.

    1976 – Sports Illustrated names her “Sportswoman of the Year.”

    1976 – Becomes the first female athlete to earn $1 million in career prize money.

    January 1980 – Announces she will take an indefinite leave after fulfilling her upcoming tennis commitments, and plans to travel with her husband, John Lloyd.

    May 7, 1980 – Five months after announcing her plans to take a break from tennis, she competes in the first round of the Italian Open. Evert defeats unseeded Adriana Vilagran of Argentina 6-0, 6-1.

    1982 – Simon and Schuster publishes her autobiography “Chrissie: My Own Story.”

    1983-1991 – President of Women’s Tennis Association (WTA).

    April 1985 – The Women’s Sports Foundation names her the “Greatest Woman Athlete in the Last 25 Years.”

    1988 – Member of the US Olympic team.

    September 1989 – Retires from professional tennis after the US Open tournament after her defeat in the quarterfinals by Zina Garrison.

    November 11, 1989 – Becomes the first female athlete ever to host “Saturday Night Live.”

    1989 – Launches Chris Evert Charities, Inc. to fight substance abuse and children born into drug addiction.

    1990-2003 – Analyst with NBC Sports.

    January 1991 – President George H.W. Bush appoints her to serve as a board member of the President’s Council on Physical Fitness and Sports.

    July 16, 1995 – Becomes a member of the International Tennis Hall of Fame. She is only the fourth player to be elected unanimously.

    1996 – Opens the Evert Tennis Academy with her father, Jimmy, and brother, John.

    1999 – ESPN honors her as one of the “Top 50 Athletes of the 20th Century.”

    March 2001-2013Publisher of Tennis magazine.

    2011-present – Commentator and analyst for ESPN.

    November 2014 – Launches her tennis wear line, “Chrissie by Tail.”

    July 11, 2015 – Stars as herself in the HBO tennis mockumentary, “7 Days in Hell.”

    January 8, 2019 – The United States Tennis Association announces Evert has been appointed Chairwoman of the USTA Foundation’s Board of Directors.

    January 14, 2022 – Announces she has been diagnosed with stage 1 ovarian cancer.

    May 9, 2022 – Announces that she has completed her sixth and final chemotherapy session to treat stage 1 ovarian cancer.

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  • YouTube to prohibit false claims about cancer treatments under its medical misinformation policy | CNN Business

    YouTube to prohibit false claims about cancer treatments under its medical misinformation policy | CNN Business

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    New York
    CNN
     — 

    YouTube announced Tuesday that it will start removing false claims about cancer treatments as part of an ongoing effort to build out its medical misinformation policy.

    Under the updated policy, YouTube will prohibit “content that promotes cancer treatments proven to be harmful or ineffective, or content that discourages viewers from seeking professional medical treatment,” Dr. Garth Graham, head of YouTube Health, said in a blog post Tuesday.

    “This includes content that promotes unproven treatments in place of approved care or as a guaranteed cure, and treatments that have been specifically deemed harmful by health authorities,” he said, such as the misleading claim that patients should “take vitamin C instead of radiation therapy.”

    The update is just one of several steps YouTube has made in recent years to build out its medical misinformation policy, which also prohibits false claims about vaccines and abortions, as well as content that promotes or glorifies eating disorders.

    As part of the announcement, YouTube is rolling out a broader updated medical misinformation policy framework that will consider content in three categories: prevention, treatment and denial.

    “To determine if a condition, treatment or substance is in scope of our medical misinformation policies, we’ll evaluate whether it’s associated with a high public health risk, publicly available guidance from health authorities around the world, and whether it’s generally prone to misinformation,” Graham said. He added that YouTube will take action on content that falls into that framework and “contradicts local health authorities or the World Health Organization.”

    Graham said the policy is designed to preserve “the important balance of removing egregiously harmful content while ensuring space for debate and discussion.”

    Cancer treatment fits YouTube’s updated medical misinformation framework because the disease poses a high public health risk and is a topic prone to frequent misinformation, and because there is “stable consensus about safe cancer treatments from local and global health authorities,” Graham said.

    As with many social media policies, however, the challenge often isn’t introducing it but enforcing it. YouTube says its restrictions on cancer treatment misinformation will go into effect on Tuesday and enforcement will ramp up in the coming weeks. The company has previously said it uses both human and automated moderation to review videos and their context.

    YouTube also plans to promote cancer-related content from the Mayo Clinic and other authoritative sources.

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  • Breast density changes over time could be linked to breast cancer risk, study finds | CNN

    Breast density changes over time could be linked to breast cancer risk, study finds | CNN

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    CNN
     — 

    Breast density is known to naturally decrease as a woman ages, and now a study suggests that the more time it takes for breast density to decline, the more likely it is that the woman could develop breast cancer.

    Researchers have long known that women with dense breasts have a higher risk of breast cancer. But according to the study, published last week in the journal JAMA Oncology, the rate of breast density changes over time also appears to be associated with the risk of cancer being diagnosed in that breast.

    “We know that invasive breast cancer is rarely diagnosed simultaneously in both breasts, thus it is not a surprise that we have observed a much slower decline in the breast that eventually developed breast cancer compared to the natural decline in density with age,” Shu Jiang, an associate professor of surgery at Washington University School of Medicine in St. Louis and first author of the new study, wrote in an email.

    Breast density refers to the amount of fibrous and glandular tissue in a person’s breasts compared with the amount of fatty tissue in the breasts – and breast density can be seen on a mammogram.

    “Because women have their mammograms taken annually or biennially, the change of breast density over time is naturally available,” Jiang said in the email. “We should make full use of this dynamic information to better inform risk stratification and guide more individualized screening and prevention approaches.”

    The researchers, from Washington University School of Medicine in St. Louis and Brigham and Women’s Hospital in Boston, analyzed health data over the course of 10 years among 947 women in the St. Louis region who completed routine mammograms. A mammogram is an X-ray picture of the breast that doctors use to look for early signs of breast cancer.

    The women in the study were recruited from November 2008 to April 2012, and they had gotten mammograms through October 2020. The average age of the participants was around 57.

    Among the women, there were 289 cases of breast cancer diagnosed, and the researchers found that breast density was higher at the start of the study for the women who later developed breast cancer compared with those who remained cancer-free.

    The researchers also found that there was a significant decrease in breast density among all the women over the course of 10 years, regardless of whether they later developed breast cancer, but the rate of density decreasing over time was significantly slower among breasts in which cancer was later diagnosed.

    “This study found that evaluating longitudinal changes in breast density from digital mammograms may offer an additional tool for assessing risk of breast cancer and subsequent risk reduction strategies,” the researchers wrote.

    Not only is breast density a known risk factor for breast cancer, dense breast tissue can make mammograms more difficult to read.

    “There are two issues here. First, breast density can make it more difficult to fully ‘see through’ the breast on a mammogram, like looking through a frosted glass. Thus, it can be harder to detect a breast cancer,” Dr. Hal Burstein, clinical investigator in the Breast Oncology Center at Dana-Farber Cancer Institute, who was not involved in the new study, said in an email. “Secondly, breast density is often thought to reflect the estrogen exposure or estrogen levels in women, and the greater the estrogen exposure, the greater the risk of developing breast cancer.”

    In March, the US Food and Drug Administration published updates to its mammography regulations, requiring mammography facilities to notify patients about the density of their breasts.

    “Breast density can have a masking effect on mammography, where it can be more difficult to find a breast cancer within an area of dense breast tissue,” Jiang wrote in her email.

    “Even when you take away the issue of finding it, breast density is an independent risk factor for developing breast cancer. Although there is lots of data that tell us dense breast tissue is a risk factor, the reason for this is not clear,” she said. “It may be that development of dense tissue and cancer are related to the same biological processes or hormonal influences.”

    The findings of the new study demonstrate that breast density serves as a risk factor for breast cancer – but women should be aware of their other risk factors too, said Dr. Maxine Jochelson, chief of the breast imaging service at Memorial Sloan Kettering Cancer Center in New York, who was not involved in the study.

    “It makes sense to some extent that the longer your breast stays dense, theoretically, the more likely it is to develop cancer. And so basically, it expands on the data that dense breasts are a risk,” Jochelson said, adding that women with dense breasts should ask for supplemental imaging when they get mammograms.

    But other factors that can raise the risk of breast cancer include having a family history of cancer, drinking too much alcohol, having a high-risk lesion biopsied from the breast or having a certain genetic mutation.

    For instance, women should know that “density may not affect their risk so much if they have the breast cancer BRCA 1 or 2 mutation because their risk is so high that it may not make it much higher,” Jochelson said.

    Some ways to reduce the risk of breast cancer include keeping a healthy weight, being physically active, drinking alcohol in moderation or not at all and, for some people, taking medications such as tamoxifen and breastfeeding your children, if possible.

    “Breast density is a modest risk factor. The ‘average’ woman in the US has a 1 in 8 lifetime chance of developing breast cancer. Women with dense breasts have a slightly greater risk, about 1 in 6, or 1 in 7. So the lifetime risk goes up from 12% to 15%. That still means that most women with dense breasts will not develop breast cancer,” Burstein said in his email.

    “Sometimes radiologists will recommend additional breast imaging to women with dense breast tissue on mammograms,” he added.

    The US Preventive Services Task Force – a group of independent medical experts whose recommendations help guide doctors’ decisions – recommends biennial screening for women starting at age 50. The task force says that a decision to start screening earlier “should be an individual one.” Many medical groups, including the American Cancer Society and Mayo Clinic, emphasize that women have the option to start screening with a mammogram every year starting at age 40.

    “It’s also very clear that breast density tends to be highest in younger women, premenopausal women, and for almost all women, it tends to go down with age. However, the risk of breast cancer goes up with age. So these two things are a little bit at odds with each other,” said Dr. Freya Schnabel, director of breast surgery at NYU Langone’s Perlmutter Cancer Center and professor of surgery at NYU Grossman School of Medicine in New York, who was not involved in the new study.

    “So if you’re a 40-year-old woman and your breasts are dense, you could think about that as just being really kind of age-appropriate,” she said. “The take-home message that’s very, very practical and pragmatic right now is that if you have dense breasts, whatever your age is, even if you’re postmenopausal – maybe even specifically, if you are postmenopausal – and your breasts are not getting less dense the way the average woman’s does, that it really is a reason to seek out adjunctive imaging in addition to just mammography, to use additional diagnostic tools, like ultrasound or maybe even MRI, if there are other risk factors.”

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  • Democratic congressman has surgery to remove cancerous tumor in his tonsil | CNN Politics

    Democratic congressman has surgery to remove cancerous tumor in his tonsil | CNN Politics

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    CNN
     — 

    Democratic Rep. Dan Kildee of Michigan had surgery Monday to remove a small cancerous tumor in his tonsil, his office said.

    Kildee, who announced last month that he’d been diagnosed with squamous cell carcinoma, will stay at George Washington University Hospital “for the next several days as part of the normal recovery process,” his chief of staff, Mitchell Rivard, said in a statement, adding that he’d continue his recovery at home later in the week.

    Kildee will miss House votes while he recovers. “During this time, the Congressman will be submitting written statements for the record to the House Clerk for any missed recorded votes, to keep his constituents updated on his positions,” Rivard said.

    In announcing his diagnosis, Kildee said he’d scheduled what he had thought would be a “preventative scan for a swollen lymph node.” Following additional testing, however, he received his diagnosis. “Thankfully, I caught it very early,” he said.

    “The prognosis after surgery and treatment is excellent,” Kildee said at the time. “I am going to get through this. I’m going to beat cancer.”

    First elected to congress in 2012, Kildee currently represents Michigan’s 8th Congressional District and is co-chair of the Democratic Steering and Policy Committee.

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  • A Florida woman spent her life savings on her daughter’s cancer treatment — then she won millions in the lottery | CNN

    A Florida woman spent her life savings on her daughter’s cancer treatment — then she won millions in the lottery | CNN

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    CNN
     — 

    A Florida mother won $2 million in the lottery, just days after she finished paying off her daughter’s cancer treatment.

    Geraldine Gimblet, a resident of Lakeland, Florida, won $2 million from a $10 scratch-off lottery ticket, according to a news release from the Florida Lottery. She claimed her winnings as a one-time lump-sum payment of $1,645,000 last Friday, the April 7th news release says.

    Gimblet told the Florida Lottery she bought the last lottery ticket at her local gas station.

    “At first, the gas station clerk thought there were no tickets left,” she recalled, according to the news release. “But I asked him to double check because I like the crossword games the best. He found the last one!”

    Her daughter, who isn’t identified in the news release, spoke about the significance of her mother’s win through tears, the lottery said. Her mother paid for her treatment for breast cancer, she said.

    “The day before my mom bought this ticket, I rang the bell and walked out of the hospital after completing my last treatment for breast cancer,” said Gimblet’s daughter in the release. “My mom had taken out her life savings to take care of me when I was sick. I’m just so happy for her!”

    Gimblet purchased her lucky ticket at Pipkin Road Beverage Castle in Lakeland, according to the release. The retailer will also receive a $2,000 commission for selling the ticket.

    The chances of winning the $2 million prize in the “Bonus Cashword” game are just 1 in 3,921,270, according to the Florida Lottery’s website.

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  • Democratic congressman announces he has ‘serious but curable form of cancer’ | CNN Politics

    Democratic congressman announces he has ‘serious but curable form of cancer’ | CNN Politics

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    CNN
     — 

    Democratic Rep. Dan Kildee of Michigan announced in a statement on Friday that he has been “diagnosed with squamous cell carcinoma, a serious but curable form of cancer.”

    The congressman went on to say, “In a few weeks, I will have surgery to remove the cancer. The prognosis after surgery and treatment is excellent. My doctors have advised me it will take a few weeks to recover after the surgery. I’m eager to have this chapter behind me and get back to work. But in the meantime, I’ll be away from the office for a period of time. My congressional office will remain open to serve the people of Michigan’s Eighth Congressional District.”

    This story is breaking and will be updated.

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  • Federal judge says insurers no longer have to provide some preventive care services, including cancer and heart screenings, at no cost | CNN Politics

    Federal judge says insurers no longer have to provide some preventive care services, including cancer and heart screenings, at no cost | CNN Politics

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    CNN
     — 

    A federal judge in Texas said Thursday that some Affordable Care Act mandates cannot be enforced nationwide, including those that require insurers to cover a wide array of preventive care services at no cost to the patient, including some cancer, heart and STD screenings, and tobacco programs.

    In the new ruling, US District Judge Reed O’Connor struck down the recommendations that have been issued by the US Preventive Services Task Force, which is tasked with determining some of the preventive care treatments that Obamacare requires to be covered.

    The decision applies to task force recommendations issued on or after March 23, 2010 – the day the Affordable Care Act was signed into law. While the group had recommended various preventive services prior to that date, nearly all have since been updated or expanded.

    O’Connor’s ruling comes after the judge had already said that the task force’s recommendations violated the Constitution’s Appointments Clause. The judge also deemed unlawful the ACA requirement that insurers and employers offer plans that cover HIV-prevention measures such as PrEP for free.

    Other preventive care mandates under the ACA remain in effect.

    The full extent of the ruling’s impact and when its effects could be felt are unclear.

    It is likely the case will be appealed, and the Justice Department has the option to ask that O’Connor’s ruling be put on pause while the appeal is litigated.

    The Justice Department did not immediately respond to a CNN request for comment, nor did the US Department of Health and Human Services.

    White House spokesperson Karine Jean-Pierre called the case “yet another attack on the Affordable Care Act” and said that DOJ and HHS were reviewing Thursday’s ruling.

    The decision, in a case brought by employers and individuals in Texas, represents the latest legal affront to the landmark 2010 health care law. It is unclear what immediate practical effect O’Connor’s new ruling will have for those with job-based and Affordable Care Act policies because insurance companies will likely continue no-cost coverage for the remainder of the contracts even though the Obamacare requirements in question have been blocked. Contracts often last one calendar year.

    O’Connor’s Thursday ruling is expected to kick off a new phase of the legal battle over Obamacare’s preventive care measures. The judge rejected other claims that the ACA’s foes brought against the law – including challenges to the entities that determine no-cost coverage mandates for vaccines, an assortment of women’s health preventive care treatments, and services for infants and children. It’s possible that the plaintiffs appeal those aspects of O’Connor’s handling of the case, which could put at risk coverage requirements for additional preventive services at no cost.

    A lawyer for the challengers did not respond to CNN’s inquiry about Thursday’s decision.

    O’Connor is a George W. Bush-appointee who sits in the Northern District of Texas and who has issued anti-Obamacare rulings in major challenges to the law in the past. An appeal of the current case would head to the 5th US Circuit Court of Appeals, perhaps the most conservative federal appeals court in the country.

    While the case does not pose the existential threat to the Affordable Care Act that previous legal challenges did, legal experts say that O’Connor’s ruling nonetheless puts in jeopardy the access some Americans will have to a whole host of preventive treatments.

    “We lose a huge chunk of preventive services because health plans can now impose costs,” said Andrew Twinamatsiko, associate director of the O’Neill Institute for National and Global Health Law at Georgetown University. “People who are sensitive to cost will go without, mostly poor people and marginalized communities.”

    Thursday’s ruling, if left standing, could have significant consequences for Americans nationwide by limiting access to key preventive services aimed at early detection of diseases, including lung and colorectal cancer, depression and hypertension.

    Some of the US Preventive Services Task Force’s recommendations – including lung and skin cancer screenings, the use of statins to prevent cardiovascular disease and the offer of PrEP for those at high risk of HIV – were issued after the ACA’s enactment.

    Certain older recommendations have been updated with new provisions, such as screening adults ages 45 to 49 for colorectal cancer.

    “It would effectively lock in place coverage of evidence-based prevention with no cost sharing from 13 years ago,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.

    Some of the cost-sharing for these preventive services can be substantial. PrEP, for instance, can cost up to $20,000 a year, plus lab and provider charges, according to Kaiser.

    In an earlier ruling, the judge upheld certain free preventive services for children, such as autism and vision screenings and well-baby visits, and for women, such as mammograms, well-woman visits and breastfeeding support programs.

    O’Connor also upheld the mandate that provides immunizations at no charge for the flu, hepatitis, measles, shingles and chickenpox.

    These services are recommended by the Health Resources and Services Administration and the Advisory Committee on Immunization Practices.

    Insurers will have to continue to cover preventive and wellness services since they are one of the Affordable Care Act’s required essential health benefits. But under O’Connor’s ruling, they could require patients to pick up part of the tab.

    Insurers’ trade associations stressed there would be no immediate disruption to coverage.

    “It is vitally important for patients to know that their care and coverage will not change because of today’s court decision,” said David Merritt, senior vice president of policy and advocacy for the Blue Cross Blue Shield Association. “Blue Cross and Blue Shield companies strongly encourage their members to continue to access these services to promote their continued well-being. We will continue to monitor further developments in the courts.”

    More than 150 million people with private insurance can receive preventive services without cost-sharing under the Affordable Care Act, according to a 2022 report published by HHS.

    Overall, about 60% of the 173 million people enrolled in private health coverage used at least one of the ACA’s no-cost preventive services in 2018 prior to the Covid-19 pandemic, according to a recent Kaiser analysis. These include some services that will continue to be available at no charge under the judge’s ruling.

    The most commonly received preventive care includes vaccinations, not including Covid-19 vaccines, well-woman and well-child visits, and screenings for heart disease, cervical cancer, diabetes and breast cancer, according to Kaiser. The most commonly used preventive services will continue to be covered at no cost.

    Studies have shown the Obamacare mandate prompted an uptake in preventive services and narrowed care disparities in communities of color.

    “There’s plenty of evidence that people responded to this incentive and started using preventive care more often,” said Paul Shafer, assistant professor of health policy at Boston University.

    This story has been updated with additional details.

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  • Opinion: I was diagnosed with colon cancer at a young age. We’re seeing a lot more cases like mine | CNN

    Opinion: I was diagnosed with colon cancer at a young age. We’re seeing a lot more cases like mine | CNN

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    Editor’s Note: Sara Stewart is a film and culture writer who lives in western Pennsylvania. The views expressed here are solely the author’s own. View more opinion articles on CNN.



    CNN
     — 

    If I could pick one refrain I heard the most from doctors and nurses during my months of treatment for colon cancer in 2018, it’d be this: “You’re so young!” Often, they would follow this up by telling me they were seeing more and more people my age, and younger, being similarly diagnosed. Their distress has been confirmed in a new report released last week, at the start of Colorectal Cancer Awareness Month.

    “(T)he proportion of colorectal cancer cases among adults younger than 55 increased from 11% in 1995 to 20% in 2019. There also appears to be an overall shift to more diagnoses of advanced stages of cancer. In 2019, 60% of all new colorectal cases among all ages were advanced,” CNN noted from the report.

    I was 45 the year I received my shocking diagnosis: stage-3 colon cancer. It was just a few months after the American Cancer Society changed its recommendation for the age at which people should get routine colonoscopies, revising it downward from age 50 to, wouldn’t you know it, 45.

    Because I’m a relentlessly inquisitive patient — sometimes to the annoyance of my doctors — I would always ask their thoughts on the reason for this trend of younger colorectal cancer diagnoses. And always the answer would be the same: some variation of “well, it’s hard to say.”

    While I recognize medical professionals find it difficult to speculate, and might be in legal jeopardy if they do, I also find it infuriating that there isn’t more open discussion about the link between industrially-produced toxins and colorectal cancer. The National Cancer Institute reported in 2020 on scientists “examining factors in the environment as potential causes of early-onset colorectal cancer. Such factors include things like air and water pollution, chemicals in soil and food, and pesticide use.”

    A Spanish study concluded that same year that “residing in the proximity of industries may be a risk factor for colorectal cancer.” But there have been scant studies since then focusing on connecting colorectal cancer and environmental toxins. Considering it’s the fourth most commonly-diagnosed cancer in this country and the second leading cause of cancer deaths, it stands to reason there ought to be substantially more studies dedicated exclusively to it.

    There is a tendency, when one experiences the terror of a potentially fatal disease, to want to deal with it and then, if you’re very lucky, put it behind you. But as the years go on in the wake of my treatment — I’ll be at my five-year mark of no evidence of disease this summer — I find myself increasingly frustrated with a lack of systematic investigation of possible environmental causes.

    In the category of “risk factors” for younger colorectal cancer patients, there are a few regular culprits, grouped under “lifestyle”: certain diets, lack of exercise, excessive weight. For what it’s worth: I am a healthy eater, a thin person and a fitness fanatic with no genetic conditions that would favor colorectal cancer. I’m not arguing that these conditions aren’t contributors, but given the scope of the increase in diagnoses, it seems worth considering that something else could be at play.

    A couple of recently-interviewed experts seem to agree. Dr. Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at the Dana Farber Cancer Institute, told NBC News that “it isn’t just diet and lifestyle, there is something else. We see so many young patients with colorectal cancer who follow very healthy lifestyles and diets.” And Dr. Folasade P. May, an associate professor of medicine in the University of California, Los Angeles Vatche and Tamar Manoukian Division of Digestive Diseases, says that “when something is affecting people who have their birth years in common, then we know it’s something in the environment that has led this whole group of people to have higher rates.”

    Yes! Finally!

    There are an alarming number of reports linking cases of cancer, including colon cancer, to environmental toxins. Industrial toxins and heightened colon cancer rates (often, among other cancers) have been linked in Pompton Lakes, New Jersey; Merrimack, New Hampshire; Satellite Beach, Florida; Akron, Ohio; a school near Ground Zero; Rikers Island, a jail in New York; Juliette, Georgia; and Peterborough, Ontario – the latter being the former site of a General Electric plant.

    Of course, as the Satellite Beach story acknowledges, “The complex interplay of genes and infectious and chemical agents obscure cancer’s many causes. Relatively small numbers of cases to work with, limited available data on occupational risks, lifestyle and demographic factors also complicate cluster investigations.” I’m aware that it’s rare for cancer cluster investigations to find an increase in cancer rates because cancer is so common, and it’s rarer still to find a clear cause for the cancer.

    But I don’t think anyone could reasonably argue there isn’t a large-scale problem with carcinogens in our environment. We are at a global tipping point where, as The Guardian reported last year, “the cocktail of chemical pollution that pervades the planet now threatens the stability of global ecosystems upon which humanity depends.” A study released just last month found that “at least 330 species are contaminated with cancer-causing ‘forever chemicals.’” Those chemicals, known as PFAS and present in widely-used items such as nonstick pans and firefighting foam, are only just now under consideration by the Environmental Protection Agency (EPA) to restrict their presence in drinking water in this country.

    The sheer scale of the problem seems completely overwhelming. So we need to do the things that are within our power, prevention-wise: making healthy choices and being more open in talking to doctors about worrying symptoms, even if it’s embarrassing (it is). Colonoscopies should be available, maybe even recommended, for people in their 30s and early 40s. Perhaps even in their 20s.

    For prevention on an environmental level, I’d like to suggest a model I found here in western Pennsylvania, when I wrote about a tiny town called Grant Township. The people here were fighting an oil and gas company’s attempt to install a fracking waste well that could potentially poison their groundwater with cancer-causing chemicals. As the residents in this coal-centric region know all too well, the only way to prevent toxic pollution is to stop it from happening in the first place. Once it’s in the ground, or air, or water, deep-pocketed companies can and will obfuscate and litigate for years while regular people get sick and die. (I’m still regularly freaked out by the sight of neon-orange streams and rivers in this part of the country, visible proof of the dangers of mine runoff.)

    Six years after my story ran, I’m thrilled Grant is still free from toxic dumping – and has garnered some major attention for its efforts. Jon Perry, a then-township supervisor in Grant, asks in a New Republic story: “Should a polluting corporation have the right to inject toxic waste, or should a community have the right to protect itself?” Their case is currently in front of the state supreme court, so we will soon know Pennsylvania’s stance. (The oil and gas company, for its part, has said in federal district court that Grant’s pushback “is deliberate, arbitrary, and irrational, exceeds the limits of governmental authority, amounts to an abuse of official power, and shocks the conscience.”)

    As we watch colorectal cancer numbers ticking disturbingly upward in the young, maybe it’s time to start asking that kind of question more often and more loudly. Is it easy? No. Is it worth it? Ask anyone who’s survived the hell of chemotherapy, and you’ll have your answer.

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  • Opinion: Women don’t have to die from cervical cancer | CNN

    Opinion: Women don’t have to die from cervical cancer | CNN

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    Editor’s Note: Dr. Eloise Chapman-Davis is director of gynecologic oncology at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. Dr. Denise Howard is chief of obstetrics and gynecology at NewYork-Presbyterian Brooklyn Methodist Hospital and a vice chair of obstetrics and gynecology at Weill Cornell Medicine. The views expressed in this commentary are their own. Read more opinion on CNN.



    CNN
     — 

    As doctors who specialize in women’s reproductive health, we are on the front lines of a preventable crisis. Imagine treating a woman with advanced cancer who has a five-year survival rate of 17%, knowing that she should have never developed the deadly disease in the first place.

    This is what we are facing with cervical cancer. Yet we have the clinical tools not only to lower but also eliminate nearly all the roughly 14,000 new cases and 4,300 deaths from cervical cancer each year.

    Denise Howard

    We have effective screenings: the traditional Pap smear and the HPV test. If these screening tests are abnormal, additional tests can determine who needs further treatment to prevent the development of cancer. Importantly, we have the HPV vaccine, which protects against high-risk human papillomavirus (HPV) types that cause the majority of cervical cancer cases and is nearly 100% effective, according to the National Cancer Institute.

    A report published earlier this month shows the vaccine’s tremendous impact. The US saw a 65% drop in cervical cancer rates from 2012 through 2019 among women ages 20-24, the first to have received the vaccine. The vaccine, combined with screening, could wipe out cervical cancer and make it a disease of the past.

    But the percentage of women overdue for their cervical cancer screening is growing, and, alarmingly, late-stage cases are on the rise.

    We have had the heartbreaking experience of seeing mothers in the prime of life die from this avoidable disease, leaving small children behind — even women who had an abnormal screening but never received follow-up care. It’s devastating to see an otherwise healthy person slowly die from a preventable cancer.

    Simply put, cervical cancer should never occur. This Cervical Cancer Awareness Month, we should commit to making that a reality. Here is what needs to happen.

    Eliminating cervical cancer requires commitment at multiple levels, from public awareness campaigns with culturally appropriate messaging that broadcasts the power of the vaccine and screenings to prevent cancer to resources that ensure all women have easy access to routine health exams.

    Timely screening reminders and systems to prioritize follow-up care are essential. Too many women with abnormal screenings don’t receive their results, reminders or follow-up instructions they understand and, therefore don’t receive the proper treatment. Barriers also include logistical challenges like transportation and language issues. Studies suggest that 13% to 40% of cervical cancer diagnoses result from lack of follow-up among women with an abnormal screening test.

    Gynecology and primary care practices should be vigilant about reaching and monitoring patients with suspicious test findings. Large health systems can leverage the power of the electronic health record to track abnormal tests and ensure these women receive the proper follow-up.

    Pediatricians should encourage parents of children 9 and older to get the HPV vaccine and stress its safety. About 60% of teenagers are up to date on their HPV vaccines, according to the US Centers for Disease Control and Prevention. Physicians not recommending the vaccine and parents’ rising concerns about its safety, despite more than 15 years of evidence that it is safe and effective, have been cited as top reasons why more children aren’t receiving this lifesaving vaccine.

    College campuses should do large-scale, catch-up vaccination outreach. These students are at high risk for contracting HPV, yet only half report having received the full HPV vaccine series. This service should be provided at no cost to students.

    Stark racial disparities also must be addressed. As Black women physicians, we are frustrated that Black women continue to be more likely to die from the disease than any other race, according to the American Cancer Society. The system failures contributing to this tragedy range from Black women receiving less aggressive treatment to barriers around access to affordable routine health care and the high-quality, specialized treatment needed to treat cancer. Everyone deserves access to quality care.

    Older patients should be told that approval of the HPV vaccine has been extended up to age 45 and to discuss with their doctor whether it’s right for them. Insurance providers should cover the cost of the vaccine for these older ages.

    Women should see a gynecologist on a regular basis well into their older years. We see patients with cervical cancer in their 60s and 70s who haven’t been screened in 20 years. Many people stop seeing a gynecologist after childbearing or menopause, but this shouldn’t be the case. Getting quality gynecological exams throughout a woman’s life is critical to preserving it.

    We also need to empower women to be their own advocates through health education. Women should receive their screening result with an explanation of what it means and any next steps clearly delineated. No news after a screening is not good news. In an ideal world, women would see their HPV status as essential information with the power to save their lives.

    Education makes a difference. At NewYork-Presbyterian and Weill Cornell Medicine, we produced a series of easy-to-understand, publicly available videos on cervical cancer and the HPV vaccine. We showed several of the vaccine videos to more than 100 parents in one of our pediatric practices that serves mostly low-income families as part of a pilot study. Their knowledge scores on a questionnaire about the vaccine and HPV that they completed before and after watching the videos increased nearly 80%, and roughly 40% of the unvaccinated children received the HPV vaccine within one month. We aim to expand this effort.

    We have the tools to prevent cervical cancer but fail to use them effectively. It’s unacceptable, and we can no longer ignore the problem. It’s time for a full-scale offensive focused on all fronts to make cervical cancer a disease of the past.

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  • Lesion on Jill Biden’s left eyelid determined to be ‘non-cancerous growth’ | CNN Politics

    Lesion on Jill Biden’s left eyelid determined to be ‘non-cancerous growth’ | CNN Politics

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    CNN
     — 

    White House physician Dr. Kevin O’Connor on Thursday provided an update on first lady Dr. Jill Biden’s recent Mohs surgery, saying a lesion found on her left eyelid was determined to be “a very common, totally harmless, non-cancerous growth.”

    Biden spent several hours at Walter Reed National Military Medical Center last week, undergoing an outpatient procedure to remove two cancerous lesions – one on her chest and another her right eye. During that procedure, a third lesion was found on her left eyelid.

    “This (lesion) was sent out for traditional biopsy. Results are consistent with seborrheic keratosis,” O’Connor wrote in a letter dated Wednesday. “Seborrheic keratosis is a very common, totally harmless, non-cancerous growth. No further treatment is required.”

    “Dr. Biden is recovering nicely from her procedures,” O’Connor writes. “She experienced some anticipated mild bruising and swelling, but feels very well.”

    In his letter last week, O’Connor wrote that “all cancerous tissue was successfully removed, and the margins were clear of any residual skin cancer cells.” That letter also noted that basal cell carcinoma lesions “do not tend to ‘spread’ or metastasize, as some more serious skin cancers such as melanoma or squamous cell carcinoma are known to do.”

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  • A lot of people hide their cancer diagnosis from their bosses. These companies aim to change that | CNN Business

    A lot of people hide their cancer diagnosis from their bosses. These companies aim to change that | CNN Business

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    CNN
     — 

    After having surgery to remove a small cancerous tumor from his neck last year, Publicis Groupe CEO Arthur Sadoun decided to tell his employees, clients and shareholders of his condition. He still needed to undergo radiation and chemotherapy, and explained to them what that would mean for his work schedule.

    While deciding to go public was difficult for Sadoun because it meant showing vulnerability both as a person and as a leader of one of the world’s largest advertising agencies, he said he received thousands of compassionate responses from both inside and outside Publicis after doing so.

    What shocked him most, he said, was how many people told him they hid their own cancer diagnosis from their employers for fear of losing their job or being perceived as weak. Instead, they took vacation days for treatments or scheduled very early morning procedures so they could work the same day, Sadoun told CNN. Some even hid their children’s cancer treatments from their boss, he added.

    “That is crazy,” Sadoun said. “I started 2022 with cancer and left it with a mission.”

    That mission is to create a worldwide campaign to encourage employers to eradicate the stigma and anxiety of having cancer at work.

    The initiative — called the #WorkingWithCancer Pledge — launched Tuesday at the 2023 World Economic Forum in Davos, Switzerland.

    Many of the world’s best-known companies have agreed to the pledge already. They include Bank of America, Citi, Disney, Google, L’Oréal, Marriott, McDonald’s, Meta, Microsoft, Nestlé, PepsiCo, Toyota, Unilever and Walmart.

    Employers who take the pledge promise “to abolish job fear and insecurity that exist for cancer sufferers in the workplace.”

    Signatories also pledge to do a better job publicizing to their workforces the benefits they already have in place for employees with cancer and for employees taking care of a family member with cancer. They will also consider ways to do more.

    Walmart, for instance, notes on the #WorkingWithCancer Pledge site that it currently offers access to high-quality care in the United States through its Centers for Excellence Program, and that the care is often free for employees, including travel and lodging if necessary for both the employee and their caregiver. The company also said it provides free counseling with a licensed therapist, educational resources and experts on cancer, as well as leave-of-absence programs.

    In terms of forward-looking pledges, Publicis is committing to its employees worldwide that it will:

    • Secure the job and salary of any employee suffering from cancer for at least 1 year so they can focus on their health treatment
    • Offer career support to any affected employee after they return to work to help them assess whether they wish to do the same job or try something different, depending on their capacities after treatment
    • Provide affected employees with an internal community of trained volunteers who can offer support “so that our employees don’t feel alone at a challenging time”
    • Offer custom support to employees serving as caregivers to a family member with cancer so they can get what they need in terms of flexibility and time to both “maintain their energy at work and as a caregiver.”

    Leading cancer institutions, including Memorial Sloan Kettering, are backing Sadoun’s initiative.

    His hope is that if the world’s biggest companies go public with what they are doing both to help employees with cancer and to make it easier to talk about it at work, smaller companies may follow their lead.

    Given how prevalent cancer diagnoses are — and how, thanks to improved treatments and early detection, it can be more of a chronic disease than a death sentence in many instances — “Not only will we have to live with [cancer],” Sadoun said, “we will have to work with it.”

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  • Jill Biden to undergo procedure for skin lesion | CNN Politics

    Jill Biden to undergo procedure for skin lesion | CNN Politics

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    CNN
     — 

    First lady Jill Biden will undergo a procedure next week to remove a lesion that was found during a routine skin cancer screening, her press secretary Vanessa Valdivia told CNN on Wednesday.

    “During a routine skin cancer screening, a small lesion was found above the First Lady’s right eye,” White House physician Kevin O’Connor said in a memo released by the first lady’s office. “In an abundance of caution, doctors have recommended that it be removed.”

    Biden will have the outpatient procedure known as Mohs surgery on January 11 at Walter Reed National Military Medical Center in Bethesda, Maryland.

    Mohs Surgery is typically an outpatient procedure that cuts away thin layers of skin to look for signs of the most common types of skin cancer as well as other less-common skin cancers. Care is taken to remove cancerous tissue while leaving healthy tissue in place.

    The first lady, 71, is the oldest sitting first lady in modern American history, though she exercises several times a week, taking classes at local barre gyms.

    The Bidens returned this week from a holiday vacation in St. Croix, US Virgin Islands, where President Joe Biden had said he would discuss the possibility of running for a second term with his family. Many Democrats close to Biden say they are convinced he will run again, and there appears to be little dissent within his family.

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  • Modest Mouse drummer Jeremiah Green dead at 45 | CNN

    Modest Mouse drummer Jeremiah Green dead at 45 | CNN

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    CNN
     — 

    Just days after his cancer diagnosis was publicly announced, Jeremiah Green – the drummer for the rock band Modest Mouse – has died, according to statements from his mother and bandmates.

    He was 45 years old.

    “It is with a very heavy heart that the Green and Namatame families announce the passing of their husband, father, son and brother, Jeremiah Green,” his mother Carol Namatame posted on Facebook.

    “Jeremiah, drummer and founding member of the Issaquah based band Modest Mouse, lost his courageous battle with cancer on December 31. He went peacefully in his sleep,” the post read.

    “Jeremiah was a light to so many. At this time the family is requesting privacy. More information will be forthcoming including a Celebration of Life for friends and fans in the coming months. Jeremiah’s loved ones would like to thank everyone for their continued well wishes and support.”

    Modest Mouse announced Green’s passing in an Instagram post Saturday.

    “Today we lost our dear friend Jeremiah. He laid down to rest and simply faded out,” the post read. “I’d like to say a bunch of pretty words right now, but it just isn’t the time. These will come later, and from many people.”

    Modest Mouse, famous for the song “Float On,” was formed in the 1990s and released its debut album in 1996.

    Modest Mouse has released eight albums, including “The Golden Casket” in 2021.

    Last week, band frontman Isaac Brock announced Green had been recently diagnosed with cancer but did not specify what kind of cancer.

    Radio DJ Marco Collins tweeted last week that Green had pulled out of a tour because he had stage 4 cancer and was undergoing chemotherapy treatment.

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  • Henrietta Lacks statue will replace Robert E. Lee monument in Roanoke, Virginia | CNN

    Henrietta Lacks statue will replace Robert E. Lee monument in Roanoke, Virginia | CNN

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    CNN
     — 

    A statue of Henrietta Lacks, whose cells were used without her consent in crucial medical research, will replace a monument to Confederate general Robert E. Lee in Roanoke, Virginia.

    Lacks, a Black mother of five receiving treatment for cervical cancer at John Hopkins Hospital, was undergoing radium treatments in 1951 when tissue from her cancer was removed and sent to another doctor’s lab without her consent. Cancer researcher George Gey used Lack’s tissue to cultivate a line of cells that are still used in medical research today. The hospital says on its website that while “the collection and use of Henrietta Lacks’ cells in research was an acceptable and legal practice in the 1950s, such a practice would not happen today without the patient’s consent.”

    Lacks died later that year from her cancer at age 31.

    A statue dedicated to Lacks and her contribution to science will be erected in Roanoke, Lacks’ hometown, in fall of 2023, according to the city’s Facebook page. The plaza, previously known as Lee Plaza, has also been renamed to Lacks Plaza in her honor.

    The city started the legal process to remove the Robert E. Lee statue, erected in 1960, in June of 2020. In July of that year, the statue was found knocked over and broken into two pieces, according to CNN affiliate WDBJ.

    In a December 19th press conference, city officials unveiled a preliminary sketch for the statue and celebrated Lacks’ life.

    “In the past, we commemorated a lot of men with statues that divided us,” said Ben Crump, a prominent civil rights attorney who has represented Lacks’ estate, at the press conference. “Here in Roanoke, Virginia, we will have a statue of a Black woman who brings us all together.”

    Trish White-Boyd, the city’s vice mayor, said that the Roanoke City Council had voted unanimously to rename the plaza.

    “We want to honor her, and to celebrate her,” White-Boyd said of Lacks.

    The city exceeded its goal of fundraising $160,000 for the statue, she added.

    The cell line produced from Lacks’ cells, called HeLa cells, allowed scientists to experiment and create life-saving medicine, including the polio vaccine, in-vitro fertilization, and gene mapping. They’ve also helped advance cancer and AIDS research.

    Ron Lacks, Henrietta’s grandson, said “it was an honor just to come down here” at the conference. He lauded Roanoke for actually working with Lacks’ family and estate to design the statue.

    And Lawrence Lacks, Henrietta’s only surviving child, said the statue of his mother would make him “the happiest person in the world.”

    Artist Bryce Cobbs crafted a sketch of Lacks that will be used as inspiration for the statue. Creating the sketch was “a humbling experience,” said Cobbs at the press conference. “Just being involved with something like this, that has so much historical impact, is a huge humbling moment. I couldn’t imagine being surrounded by more supportive people.”

    Larry Bechtel, the sculptor who will create the sculpture, called the project a “big deal” at the conference. “I’ve had a number of commissions, but this one is singular,” he said.

    Little was known about Lacks’ impact on modern medicine outside the medical community until author Rebecca Skloot’s 2010 book about her life, “The Immortal Life of Henrietta Lacks.”

    Since then, activists and institutions have worked to posthumously honor Lacks’ nonconsensual contributions and to raise awareness about the Black women’s often-unknown contributions to science. In 2018, the Smithsonian unveiled a portrait of Lacks at the National Portrait Gallery. And in 2021, the World Health Organization honored her with an award.

    “In honouring Henrietta Lacks, WHO acknowledges the importance of reckoning with past scientific injustices, and advancing racial equity in health and science,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement at the time.

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  • Kirstie Alley died of colon cancer. Here’s how to lower your risk | CNN

    Kirstie Alley died of colon cancer. Here’s how to lower your risk | CNN

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    CNN
     — 

    Colon cancer has claimed another life. Emmy Award and Golden Globe winner Kirstie Alley, best known for her roles in the television sitcoms “Cheers” and “Veronica’s Closet,” died Monday at age 71 after battling cancer that was “recently discovered,” according to a family statement.

    A representative for Alley confirmed to CNN via email on Tuesday that she had been diagnosed with colon cancer prior to her death.

    Colorectal cancer, which includes colon and rectal cancers, is the second most common cause of death from cancer in 2022, outranked only by lung and bronchus cancer, according to the National Cancer Institute Surveillance, Epidemiology and End Results Program.

    Regular checkups are the best way to keep colon cancer at bay, according to the US Preventive Services Task Force. The task force lowered the age to begin screening for colon and rectal cancer to 45 last year after a worrisome spike in cases of colorectal cancer in people younger than 50.

    The new recommendations apply to everyone ages 45 to 75, including people with no symptoms, no prior diagnosis, no family history of colon or rectal disease, and no personal history of polyps, which are all key risk factors. Polyps are bumps or tiny mushroom-like stalks that grow inside the colon or rectum.

    If these growths are not found and removed, they can turn cancerous.

    Adults ages 76 to 85 years can also be screened, depending on their overall health, prior screening history and personal preferences, the task force said.

    Colorectal cancer screening can occur in several ways, including simple mail-in tests that look for blood or cancer cells in a sample of stool collected by the patient. However, all stool tests can have false-positive test results, which would likely require a more invasive test to rule out cancer, according to the American Cancer Society.

    Stool tests: While a stool test is the least invasive option, it does have to be done at least once a year, the society said. No anti-inflammatory pain relievers can be taken for seven days prior to a stool test, while red meats such as beef, lamb or liver and any citrus or vitamin C supplements should be avoided for at least three days.

    If the test finds something of concern, “you will still need a colonoscopy to see if you have cancer,” according to ACS. However, hidden bleeding in the stool does not automatically signal cancer, as ulcers, hemorrhoids and other conditions can also cause rectal bleeding.

    DNA stool test: A DNA stool test is another option, the society said. Because colorectal cancer cells can have DNA mutations, the test can screen for those genetic abnormalities. This test only needs to be done once every three years, but an entire stool sample must be collected and mailed.

    Patients may have insurance coverage issues because the test is fairly new, ACS said. Again, if anything suspicious is found, a colonoscopy will still be required.

    For all of the following tests, the colon must be clean and free of stool matter, which requires at-home bowel prep. Ways to empty the bowels include pills, drinking a laxative solution or the use of an enema the night before the procedure.

    This process has become much easier over the years with the advent of new kits that don’t require as much liquid laxative, so talk to your doctor about your options, ACS suggested.

    Colonoscopy: One of the most widely used tests, this procedure allows a doctor access to the entire length of the colon and rectum with a colonoscope, a “flexible, lighted tube about the thickness of a finger with a small video camera on the end,” ACS said.

    Typically, the patient is under light sedation during the whole procedure, waking up with no knowledge of the process. Watching on video in real time as the scope moves through the intestine, the doctor can stop and insert small instruments into the scope to take a sample or even remove any suspicious polyps.

    Virtual colonscopy: This test uses computer programs that take X-rays and a computed tomography (CT) scan to make three-dimensional pictures of the inside of the colon and rectum.

    The test does not require sedation. However, it does require the same bowel prep as a regular colonoscopy. After the patient drinks a contrast dye, a small, flexible tube will be inserted into the rectum, followed by pumped air expand the rectum and colon for better pictures.

    As with all CT scans, this procedure exposes the patient to a small amount of radiation and can cause cramping until the air exits the body, the society said. If a suspicious mass is detected, a colonoscopy will still be needed to remove the mass.

    Flexible sigmoidoscopy: This test inserts the same flexible camera tube into the lower part of the colon. However, because the tube is only 2 feet (60 centimeters) long, this test only allows the doctor to examine the entire rectum and less than half of the colon — any polpys in the upper colon will be missed. This test is not often used in the United States, the society said.

    Many people avoid a colonoscopy, partly due to the preparation, so as a way of encouraging people to get screened, former “Today” host Katie Couric broadcast her entire procedure in 2000 — from prep the night before to a mildly sedated Couric watching the procedure as it unfolded.

    “I have a pretty little colon,” Couric said with a sleepy chuckle as she watched the video projection from the scope inside her colon. “You didn’t put the scope in yet, did you?” asked Couric, whose husband, Jay Monahan, had died from colon cancer at age 42 in 1998.

    “Yes! We’re doing the examination. We’re almost done,” said her physician, the late Dr. Kenneth Forde, who taught for nearly 40 years at Vagelos College of Physicians and Surgeons at Columbia University in New York City.

    More recently, actors Ryan Reynolds and Rob McElhenney videotaped parts of their colonoscopies to raise public awareness after Reynolds lost a bet.

    “Rob and I both, we turned 45 this year,” Reynolds said in the video. “And you know, part of being this age is getting a colonoscopy. It’s a simple step that could literally — and I mean, literally — save your life.”

    Doctors found both actors had polyps that were removed during the screening.

    “It’s not every day that you can raise awareness about something that will most definitely save lives. That’s enough motivation for me to let you in on a camera being shoved up my a–,” Reynolds said.

    READ MORE: Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.

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