Four Reasons to Talk to Your Employees About Colorectal Cancer

Need a topic for your team’s next safety discussion or wellness meeting? Consider colorectal cancer. Here are four compelling reasons to talk with your employees right away:

1. Colorectal cancer is affecting more working-age people. While the overall numbers of cases and deaths have declined steadily since the early 1960s, colorectal cancer is on the rise in adults under age 50.¹
2. Colorectal cancer is highly relevant to the workplace. Although commonly linked to diet, lifestyle, and family history or genetic conditions², research studies are now finding an association between increased risk of colorectal cancer and certain occupational exposures to chemicals.³
3. With early detection, the chances of survival are far superior. According to the American Cancer Society, when the cancer is found early and has not spread, the five-year survival rate for colorectal cancer is 90 percent. This means that five years after diagnosis or the start of treatment, 90 out of 100 people who had colorectal cancer are alive. If the cancer is detected later, after it has spread to nearby tissues, only 71 of 100 people are alive after five years. If colorectal cancer has spread to distant parts of the body, the five-year survival rate plunges to 14 percent (see Table 8).⁴
4. Escalating expense of treatment significantly increases the cost burden of cancer on commercial health plans, workers’ compensation (when cancer is found to be work-related), and on the individuals affected, particularly when cancer has spread (this is called metastatic cancer).^5,6

Even though early detection can mean a better survival rate and lower cost burden, many adults are reluctant to get a colonoscopy, the traditional method of colorectal cancer screening.⁷ It is invasive and requires advance preparation, including dietary restriction.⁸ Perforation of the colon during a colonoscopy – although rare, occurring in only 0.03 to 0.8 percent of colonoscopies – is the most feared complication, with a mortality rate as high as 25 percent.⁹ Concentra offers a solution to this dilemma.

Colorectal cancer, a growing occupational concern

Scientific understanding of occupational exposures and the risk of colorectal cancer is still developing. Researchers conducted a meta-analysis of 83 studies from 1976 through 2012. A meta-analysis is a type of analysis that enables researchers to formally and systematically pool together all relevant research on a particular subject to clarify findings and form conclusions based on all information that is currently available. In the analysis, they found evidence of increased malignancy among employees in some industrial occupations but, so far, without any clearly defined, homogeneous pattern. They did find a higher risk of colorectal cancer among the following occupations:¹⁰

• Employees exposed to chemicals in textiles; the automobile industry; leather, plastic, and rubber production; and various industries/occupations with exposures to asbestos, dioxin, wood dust, and organic solvents
• Iron and steel employees operating furnaces or copper smelters, exposed to iron and coal dust, and working with grinding materials and agents
• Dockyard employees with likely exposure to carcinogenic agents including asbestos, polycyclic aromatic hydrocarbons, and welding smoke
• Employees in fur production who were exposed to tanning, cleaning, and dying chemicals.

The National Colorectal Cancer Roundtable (NCCRT), a coalition working to reduce colorectal cancer incidence and mortality, acknowledges that the American Cancer Society recommends high-sensitivity FIT fecal occult blood testing for colorectal cancer screening, citing evidence of its effectiveness in randomized controlled trials.¹¹

Preventing the high cost of colorectal cancer treatment

So what do we know about the cost of cancer treatment? In 2017, the estimated national expenditure for all cancer care was $147.4 billion.¹² In 2018, it was $150.8 billion. “As cancer survival rates rise, so do the price tags of life-saving treatments. Monthly drug costs may reach $100,000,” according to one cancer website.¹³

Researchers in Germany, Australia, and the United States have conducted separate studies into the cost of colorectal cancer treatment. The German study followed 21,851 people discharged from a hospital with a colorectal cancer diagnosis from 2007 to 2010 (12,792 in the initial stage of the disease, 5,280 in the intermediate stage, and 3,779 in late stage). Compared against control cases matching in age and gender, and taking into consideration in-patient, out-patient, and drug costs, the study showed annualized stage-specific costs increase significantly from the early to late stages. This research supports the financial wisdom of early detection to eliminate the need for treatment or enable effective treatment more quickly.¹⁴

In Australia, researchers said that newer therapies, while improving the treatment of late-stage colorectal cancer, are adding significantly to the financial cost burden of the health care system and the people it serves. “The increased costs of managing later stages of the disease make an investment in prevention and early detection even more attractive,” they concluded.¹⁵

An American study reached similar conclusions about new therapies that “have revolutionized treatment” of metastatic colorectal cancer while increasing the cost burden.¹⁶

Concentra provides a solution to ease concerns

Concentra® is prepared to work with you in two ways, first, through medical surveillance exams to identify health effects early to allow timely medical treatment and, second, to resolve the tendency to “fear and avoid” colorectal cancer screening that can contribute to a higher cost burden of cancer treatment by offering an effective, non-invasive screening method.

Concentra performs a wide range of medical surveillance exams to provide insight into the effectiveness of current chemical exposure-control efforts. Medical surveillance exams can reveal changes in health status before an employee is likely to seek medical attention. Concentra clinicians will review with you the medical surveillance services and exam components that meet your state and federal requirements.

To ease the fear of invasive colorectal cancer screening and the associated cost burden, Concentra in August will begin offering the latest and most advanced non-invasive fecal occult blood test to promote early detection of colorectal cancer and pre-cancerous polyps in the lower bowel. It is a fecal immunochemical test (FIT) called Hemoccult ICT. (“Occult blood” cannot be detected visually but only under a microscope or by the chemicals used in a fecal occult blood test.)

Last year, a Concentra article (“Fecal Immunochemical Test Interest in Manufacturing and Other Industries”) explained the differences between a FIT colorectal cancer screening and the more traditional colonoscopy, with FIT having the following advantages:

• Non-invasive because it involves a home test kit for private stool sample collection and assessment
• No advance preparation or dietary restriction ahead of time and no sedation
• No need for a colonoscopy unless there is a positive result. A colonoscopy is done only when there is likelihood cancer or polyps may be present, based on the high sensitivity and reliability of the two-day Hemoccult ICT test used by Concentra
• Recommended frequency of once per year enables earlier detection

You value your workforce, so providing employees the non-invasive, two-day Hemoccult ICT screening makes sense. It is also less expensive than a colonoscopy and much less expensive than cancer treatment.

Conclusion: Get ahead of these trends

If you protect the health of your employees and avoid any amount of the escalating costs of colorectal cancer treatment by implementing enterprise-wide colorectal cancer screening with the two-day Hemoccult ICT screen used by Concentra, isn’t that worth a conversation to explore?

Also, consider how a conversation with Concentra might improve your position as these trends progress:

• Research findings on the connection between occupational chemical exposures and colorectal cancer
• Introduction of new treatment therapies that increase the overall cancer cost burden
• Colorectal cancer mortality increasing among adults younger than 50

Through medical surveillance exams and the non-invasive two-day Hemoccult ICT screen, Concentra helps workforces battle the second leading cause of cancer death for men and women combined in the United States.¹⁷

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Notes

1 “Colorectal Cancer Rates Rise in Younger Adults,” American Cancer Society. March 5, 2020.
2 Jasperson KW, Tuohy TM, Neklason DW, Burt RW. Hereditary and Familial Colon Cancer. Gastroenterology. March 15, 2011.
3 “Occupational exposures and colorectal cancers: A quantitative overview of epidemiological evidence” World Journal of Gastroenterology, September 21, 2014; 20(35): 12431-12444. Accessed September 14, 2019
4 Cancer Facts and Figures 2020. American Cancer Society. January 8, 2020. 
5 Zadio J. Cost-Effectiveness of New and Emerging Treatment Options for the Treatment of Metastatic Colorectal Cancer. American Journal of Managed Care. April 25, 2018.
6 Paramore LC, Thomas SK, Knopf KB, Cragin LS, Fraeman KH. Estimating Costs of Care for Patients With Newly Diagnosed Metastatic Colorectal Cancer. Clinical Colorectal Cancer. 2006; 6(1): 52-58.
7 “Quick Facts: Colorectal Screening in the United States: Behavioral Risk Factor Surveillance System 2016,” U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Accessed September 14, 2019.
8 “Colorectal Cancer Screening Tests,” American Cancer Society.
9 Tiwari A, Sharma H, Qamar K, Sodeman T, Nawras A. Recognition of Extraperitoneal Colonic Perforation following Colonoscopy: A Review of the Literature. Case Reports in Gastroenterology. 2017; 11: 256-264.
10 Oddone E, Modonesi C, and Gatta G. “Occupational exposures and colorectal cancers: A quantitative overview of epidemiological evidence” World Journal of Gastroenterology, September 21, 2014; 20(35): 12431-12444. September 14, 2019
11 Clinician’s Reference: Fecal Occult Blood Testing for Colorectal Cancer Screening. National Colorectal Cancer Roundtable and the American Cancer Society.
12 Cancer Statistics, National Cancer Institute. April 27, 2018.
13 High Cost of Cancer Treatment. Asbestos.com and the Mesothelioma Center. 
14 Haug U, Engel S, Verheyey F, Linder R. “Estimating Colorectal Cancer Treatment Costs: A Pragmatic Approach Exemplified by Health Insurance Data from Germany.” PLoS One, 2014; 9(2): e88407
15 Ananda S, Kosmider S, Tran B, Field K, Jones I, Skinner I, Guerrieri M, Chapman M, Gibbs P. “The rapidly escalating cost of treating colorectal cancer in Australia.” Asian Pacific Journal of Clinical Oncology. April 2015.
16 Zadio J. Cost-Effectiveness of New and Emerging Treatment Options for the Treatment of Metastatic Colorectal Cancer. American Journal of Managed Care. April 2018.
17 Colorectal Cancer: Statistics. Cancer.net. January 2020.