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Many cancer doctors refer their patients to palliative care only very late in the disease process, a study from Canada shows. The study was based on a survey of 603 oncologists. Most of the doctors practiced in hospitals that had access to palliative care. This is a type of care that focuses on pain relief and the overall well-being of patients and their families. It may include psychological, social and sometimes spiritual care. About one-third of oncologists said they referred patients for this type of care when they found that a cancer had spread. Such cancers often can be treated but not cured. Another one-third of the doctors said they waited to refer to palliative care until chemotherapy was stopped. This often occurred just a few weeks or months from death. Palliative care is designed to benefit patients throughout treatment, not just at the end.

A new study suggests that more use of colonoscopy has helped to reduce U.S. rates of colorectal cancer. Colonoscopy looks at the upper and lower colon. It uses an instrument that can remove as well as find cancers. It also can snip out polyps before they turn into cancers. In 2001, Medicare began to pay for people to get a screening colonoscopy every 10 years. Colonoscopies greatly increased after this decision. Surgeries for cancer in the upper colon were steady until 2002. Then they dropped 3.1% a year through 2009. Colonoscopy is the only test that looks at the upper colon from the inside. Surgeries for cancer in the lower colon also fell faster after 1999. In the next decade, they dropped by 3.8% per year. Researchers said the increase in colonoscopies may be one cause. Taking out polyps may have prevented many cancers, especially in the upper colon.