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Nearly 40 percent of the 315,000 Montanans who should be screened for colorectal cancer either aren't doing so or aren't getting it done properly.

With that in mind, the Montana Department of Health and Human Services aims to cut that percentage in half.

DPHHS is pursuing an 80 percent screening rate for Montanans ages 50 to 75 by 2018, said Lisa Troyer, Cancer Control Section supervisor for the Montana Department of Public Health and Human Services.

Colorectal cancer is the second-leading cause of cancer deaths both nationally and in Montana, with an average of 490 Montanans diagnosed each year from 2009 to 2014. Over the same period, 172 died from it annually.

However, it often can be prevented with early and regular screening, and with proper measures it can be one of most preventable forms of cancer.

According to the American Cancer Society, it almost always starts with a small growth known as a polyp. If doctors find them early, polyps can be removed to stop the cancer before it develops.

"We can prevent the cancer from even starting if we catch it early enough," said Dr. Steven Hammond, a gastroenterologist at Billings Clinic. "It can be prevented by having an early screening."

If colorectal cancer is detected before it spreads beyond its starting point, it's more likely curable.

"The earlier it is found, the more likely that the treatment will be successful," said the National Institutes of Health in its information for seniors on colorectal cancer. "If colon cancer is detected in its early stages, it is up to 90 percent curable."

The most effective screening and, if necessary, polyp removal option is a colonoscopy, while other screening options involve collecting stool samples.

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Troyer said that while people might often be nervous about the procedures or uncomfortable talking about them, everybody should begin screening at the age of 50, since the chances of colorectal cancer increase at that age.

"Knowing what to expect is really important," Troyer said. "You can get (a colonoscopy) every 10 years if they don’t find any polyps. It’s a big test, but there are (other tests) that can be done on a yearly basis, too."

Hammond said that symptoms of the cancer don't usually show up until it begins to cause serious health problems and that a large amount — somewhere in the range of 80 percent — of people who haven't been screen avoided it because "they didn't think they needed it."

While average risk patients, which are most people, should start screening at 50, people with a family history of colorectal cancer or other risk factors should consult their health care provider earlier.

The statewide effort to get more Montanans screened includes PSAs featuring Carroll College football coach Mike Van Diest talking about the disease and printed materials designed to provide quick information on getting screened.

Troyer said that financial barriers to getting screened have been a hindrance to some people in the past, but that it is covered as preventative care by both Medicare and Medicaid. In addition, most health insurance plans under the Affordable Care Act also cover the screenings in the same way, as do many private insurance plans.

Nationwide, nearly 700 organizations have joined the efforts to increase screening numbers while working to make it easier to do so, including Blue Cross Blue Shield of Montana.

To get to that 80 percent screening rate, Hammond said, it's up to health care providers to encourage screening while educating patients on colorectal cancer. But patients, especially those who don't have a regular doctor or don't visit often, must also take the initiative and ask.

"Our message is just to go and talk to a doctor about getting screened and find out what is best for you," Troyer said.

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