Katie Couric

Like most Americans, NBC “Today” show co-host Katie Couric had not given a lot of thought to the deadly consequences of colon cancer.

All that seemingly changed overnight in 1997, when her husband, television legal analyst Jay Monahan, was diagnosed with the disease. A fit, trim, healthy non-smoker in his early forties—with no family history of colon cancer—Monahan certainly did not give the appearance of a man at risk of contracting this lethal disease. Despite access to the best doctors and treatments available, however, Jay died of colon cancer at the age of 42, following a courageous but brutal nine-month battle against the disease. In addition to his wife, he left behind two young daughters, seven-year-old Ellie and two-year-old Carrie.

As Katie later noted in testimony before the US Senate Select Committee on Aging in March 2000, “During this terrible struggle, motivated by fear and desperation, I got a quick and painful education about this devastating disease. I learned that colon cancer is the second leading cancer killer: 130,000 people are diagnosed with it every year; 56,000 of them die. It kills more people than any other cancer, with the exception of lung cancer . . . Women get it—they are diagnosed at a rate slightly higher than men. Minorities get it—African-Americans are at a slightly higher risk. Young people get it—13,000 people under the age of 50 are diagnosed every year.

“But I also learned that it has a 90% or better cure rate if detected early. That means that colon cancer screening is a critical weapon in the fight against a disease no one needs to die from.”

Katie decided to honor her husband’s memory by launching her own crusade against colon cancer and using the power of her celebrity to educate the public about this deadly disease. In the same month that she testified before the Senate, Katie, along with anti-cancer activist Lilly Tartikoff and the Entertainment Industry Foundation, co-founded the National Colorectal Cancer Research Alliance (NCCRA, www.nccra.org). The alliance is dedicated to the eradication of colon cancer by promoting education about the importance of early medical screening and funding research to develop better tests, treatments, and, ultimately, a cure. Among its other activities, the NCCRA has placed millions of educational brochures in drugstores across the country, and has sponsored public service announcements featuring noted celebrities.

Katie quickly learned that one of the largest obstacles to educating people about colon cancer is the very squeamishness that the subject provokes in many. As she noted in her Senate testimony, “A lot of people don’t want to talk about it. Colons. Rectums. Bowels. Not exactly the stuff of cocktail party conversation . . . But if you recall, not that long ago people felt uncomfortable talking about breast cancer . . . and men rarely discussed their prostates. Now those cancers are routinely discussed with family, friends . . . and most importantly, doctors. We have to do the same for colon cancer.”

Katie Couric with NBC’s “Today” show co-host Matt Lauer.

All the talk in the world, however, is not going to prevent a single case of colon cancer. While education and proper nutrition are important elements in preventing colon cancer, the real bottom line is screening for the disease. As Katie told the Senate, “People need to not only talk the talk, they need to walk the walk. And walking the walk means getting tested. According to the [Centers for Disease Control and Prevention], a whopping 60% of people who should be screened never have been. Some people find the procedures, like stool tests, flexible signoidoscopies, and colonoscopies, unappealing. I can tell you they are all much more appealing than dying of this disease.”

For Katie, “walking the walk” not only meant getting tested herself, but doing so in a way that would most powerfully spread her message of prevention. Therefore, in March 2000, before a nationwide audience of millions, Katie underwent a colonoscopy live on the “Today” show. Her impact on screening rates for colon cancer in the program’s aftermath was so profound that medical researchers dubbed the phenomenon the “Couric Effect.” Test rates shot up more than 20% nationwide and remained elevated for at least nine months, the period during which researchers tracked them.

“Considering that fewer than half of Americans currently get appropriate screening for colon cancer, the second leading cause of cancer deaths, Ms. Couric’s efforts are especially significant,” noted researcher Peter Cram, MD. In a study reported in the July 13, 2003, edition of the Archives of Internal Medicine, researchers examined the number of colonoscopies performed each month by 400 specialists in 22 states, starting 20 months before Katie’s on-air colonoscopy and continuing until nine months afterward. In that time, the average number of colonoscopies performed each month by each specialist jumped from 15 to 18.

Today, Katie remains active in the NCCRA and continues to spread her message of education and hope. As she noted in her Senate testimony, “I know all too well . . . about the lives shattered and the families devastated by these three words: ‘you have cancer’ . . . We have a unique opportunity to change that . . . Nobody needs to die of embarrassment. Every person screened is a potential life saved. Knowledge is power.”

IN HER OWN WORDS In previously published interviews excerpted below, Katie Couric has answered many of the questions most asked by her viewers about her efforts to prevent colon cancer. Q: It was a bold move to have your colonoscopy shown live on national television. What impact do you think this had on people becoming aware of colonoscopy screening and the risk of colon cancer? How did you convince your producers to let you do this? What have you heard from the viewers? A: We wanted to give viewers a sense of just what to expect, from the prep to the procedure itself, and how they would feel afterward. By providing an “up close and personal” account of my colonoscopy, they could see, firsthand, that it’s not that bad. We really didn’t know what the impact would be. Shortly after the segment aired, we began to receive letters from viewers who decided to get tested after seeing it. Many had pre-cancerous polyps removed; others were diagnosed with colon cancer and started treatment. Receiving that feedback has been incredibly gratifying. Q: Are you aware of how many more colonoscopies are done each year thanks in part to your efforts? A: I was so gratified last year by research completed by the University of Michigan, which found that our awareness efforts had increased colonoscopy rates by 20%. That’s great news because it means that not only are we getting our message out, but we are getting people to take action. And that action may save their lives. The researchers called the increase in colon examinations the “Couric Effect,” which I take as a compliment! Q: What do you think is the general resistance to having this simple procedure done to prevent this horrible disease? A: This is a test that can save lives, but “extreme fear factor” sums up how many people felt about colonoscopies. Colonoscopy is the “gold standard” for colon cancer testing. That’s because, as of right now, it is the most complete test available, and if a polyp—a growth that can, over time, turn into cancer—is found, it can be examined and removed right then and there. Q: What more needs to be done to encourage people to undergo this procedure? A: Our most important message is, “get tested.” It’s just that simple. Colon cancer is treatable when caught early. People must talk with their family, friends, and loved ones to ensure that they get tested for colorectal cancer. Katie Couric talks with CNN host Larry King on "Larry King Live." Q: What personal program (diet, supplements, screening, etc.) do you follow to help prevent colon cancer? A: I really do watch out for my health. I try to eat right, exercise regularly, and have appropriate preventive screening tests done. Q: There is a great deal of exciting research about various supplements that can help prevent colon cancer. Are you aware of the research on calcium and folic acid? A: Really, the best advice is to talk with your doctor about your individual risk factors and then work with your doctor to determine what’s right for you.