¶ … Health Care (PHC) and Colorectal Cancer Authorities around the world have expressed the need for development of an incorporated health care system with augmented emphasis on primary health care, and integration of principles and practices of health promotion. Primary health can be defined as the care provided at the first point of contact with the health care system, the point at which health services are assembled and synchronized to promote health, prevent illness, care for common illness, and manage health problems. This definition includes a focus on a primary care model, typically provided by family physicians, and a broader notion that includes a range of health and social services offered by way of multidisciplinary teams. Primary health care is the natural entry-point to reorient a health system towards health promotion. Health promotion is the procedure of facilitating people to amplify control over, and to advance, their health and well being (Frankish, Moulton, Rootman, Cole & Gray, 2006).

Health promotion is made up of multiple, interrelated concepts that need to be included into the daily practice of primary health care. People working in primary care or health promotion share common culturally transmitted values in regards to health and health services. These values are primary in affecting which health issues are tackled, and the approaches that are used. Values and norms inside an organization are frequently understood and may be overlooked or go unnoticed in thinking of health promotion (Frankish, Moulton, Rootman, Cole & Gray, 2006).

Health is predisposed by more than just provision of health care. Health promotion subscribes to an affirmative, multidimensional view of health that centers on the whole, physical, mental and social person or the community. It distinguishes the role of extensive determinants like income, social support, education, employment or working conditions, housing, food security, social environments, physical environments, health practices, coping skills, child development, gender, culture, genetics, health services in creating and maintaining health and quality of life. These determinants may each interact with one another. To better add in health promotion values, the practice of primary care must address causal conditions, not just treatment (Frankish, Moulton, Rootman, Cole & Gray, 2006).

Health is more than the nonexistence of disease or disability; it includes susceptibility to disease and disability. Health promotion is concerned with health problems prior to their development or worsening, not only after they become visible. Health promotion aims to decrease differences in health status and vulnerability, and to make sure equal opportunities and resources to facilitate all people to attain their fullest health potential and quality of life (Frankish, Moulton, Rootman, Cole & Gray, 2006).

Colorectal cancer (CRC) is a large health problem in developed countries, both because of its high occurrence and because it is accompanied by high mortality (Ramos, Llagostera, Esteva, Cabeza, Cantero, Segarra, Martin-Rabadan, Artigues, Torrent, Taltavull, Vanrell, Marzo, & Llobera, 2011). There have been roughly fifty thousand deaths from colorectal cancer in the United States in 2011 (Colon and Rectal Cancer, 2011). Colon cancer and cancer of the rectum typically begin as a small polyp. While most colon polyps are benign, some do become cancerous. Colon cancer symptoms may consist of a change in bowel habits or bleeding, but typically colon cancer strikes without indication. That's why it's so important to get a colon cancer screening test, such as a colonoscopy. If the cancer is found early, the doctor can use surgery, radiation, and chemotherapy for successful treatment. About a quarter of all adults in the U.S. over the age of fifty will have at least one colorectal polyp in their lifetime. Most colorectal cancers develop from polyps that are present in glandular tissue of the intestinal lining (Colorectal Cancer Health Center, 2011).

CRC is one of the few kinds of cancer for which both primary and secondary prevention are possible. "With respect to secondary prevention, the evidence strongly indicates that population-based screening using the fecal occult blood test (FOBT), and colonoscopy if FOBT results are positive, reduces both the incidence of and mortality from CRC. Participation of a large proportion (more than 50%) of the population in testing is crucial for the success of screening programs" (Ramos, et al., 2011).

Cancers of the colon and rectum are the third most common cancer in the U.S., with approximately one hundred and fifty thousand cases diagnosed each year. Like a lot of cancers, colorectal cancer is of particular concern for people older than age fifty. Even though diagnosis is frequently possible at an early stage, a lot of people...

Risk increases considerably after age fifty and continues to go up with age (Colorectal Cancer Health Center, 2011).
People with an average risk of colon cancer should consider screening beginning at age fifty. But people with an increased risk, such as those with a family history of colon cancer, should consider screening much sooner. African-Americans and American Indians should start colon cancer screening at age forty-five. Numerous screening options exist today, each with its own benefits and drawbacks. One should talk to their doctor about their options and together decide which tests are appropriate. Options may include:

yearly fecal occult blood testing flexible sigmoidoscopy done every five years colonoscopy every ten years

virtual colonoscopy (CT colonography) done every five years stool DNA testing -- since this is a new screening approach it's not clear how frequently it should be repeated (Colon Cancer, 2011).

There are also things that a person can do to decrease their risk of colon cancer. These include making changes in ones everyday life to:

consume an assortment of fruits, vegetables and whole grains. Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which are thought to play a role in cancer prevention. A person should choose a variety of fruits and vegetables so that they get an array of vitamins and nutrients.

drink alcohol in moderation, if at all - if one chooses to drink alcohol, they should limit the amount to no more than one drink a day for women and two for men.

stop smoking -- one should talk to their doctor about ways to quit exercise most days of the week -- one should try to get at least thirty minutes of exercise on most days. If one has been inactive, they should start slowly and build up slowly to thirty minutes.

maintain a healthy weight - if one has a healthy weight, they should work to maintain their weight by combining a healthy diet with daily exercise. If a person needs to lose weight, they should ask their doctor about healthy ways to attain their goal (Colon Cancer, 2011).

A screening test is used to look for a disease when a person is not experiencing any symptoms. Cancer screening tests, including those for colorectal cancer, are successful when they can detect disease early. Detecting disease early can lead to more effective treatment. In some cases, screening tests can detect something that shouldn't be there, such as a polyp in the colon or rectum, before it has a chance to turn into cancer. Eliminating polyps in the colon and rectum prevents colorectal cancer from developing. A diagnostic test differs from a screening test because it is used when a person has symptoms. A diagnostic test is used to find the cause of the symptoms (Colorectal Cancer Screening, 2011).

The World Health Organization recognizes that early discovery of cancer greatly increases the chances for successful treatment. While identification of early warning signs and symptoms of cancer may add to early detection, it is screening that offers the occasion to diagnose the disease at an asymptomatic or even premalignant stage of aetiology (Integrated Primary Care & Cancer Services Model of Care, 2008).

Modern cancer prevention initiatives are frequently presenting in the context of a broader chronic disease prevention approach in that many cancer risk factors are also risk factors for other chronic diseases. "Tobacco control, programs promoting healthy weight, healthy diet, physical activity, sun protection, lower levels of alcohol consumption and the like require a comprehensive multi-faceted approach which includes community education, the influence of social norms through policy and legislation, specifically targeted interventions for higher risk groups and structural reforms to the environment, both built and natural and more" (Integrated Primary Care & Cancer Services Model of Care, 2008).

When CRC is diagnosed at the early localized stage, the five-year survival rate is ninety percent. When it is not diagnosed until the late distant stage, the five-year survival rate is only ten percent. CRC can be prevented by way of the early identification and removal of pre-cancerous polyps detectable only through screenings. It is critical, consequently, that barriers to screening be removed and that screening rates for the average-risk population, those people over the age of fifty, be increased (Colorectal Cancer Screening & Treatment for the uninsured, 2011).

Despite the fact that CRC screenings have proven to decrease cancer mortality only half of men and women in the U.S. get screened. This problem is made worse for people who lack health insurance or whose health…