BY THE NUMBERS BY THE NUMBERS Colorectal cancer is the second-leading cause of cancer death. There will be an estimated 153,000 cases this year, resulting in 52,000 deaths. The disease is most curable in its early stages. 5-year survival rates by stage

• Stage 1 (limited to colon): 93%

• Stage 2 (spread through wall of colon): 72% to 85%

• Stage 3 (spread to lymph nodes): 44% to 83%

• Stage 4 (spread to other organs): 8% Source: The American Cancer Society YOU CLICKED: WEEK'S MOST POPULAR HEALTH STORIES YOU CLICKED: WEEK'S MOST POPULAR HEALTH STORIES 1: Feds rate U.S. nursing homes 2: Doctors detail first U.S. face transplant 3: Surgeon finds foot in newborn's brain tumor 4: Nursing homes talk new ratings 5: Colonoscopy prep pills carry kidney risk 6: Duggars welcome 18th child No. 7-10: Diabetes drug risks, placebo effect WASHINGTON (AP)  Nearly two-thirds of hospitals fail to check colon cancer patients well enough for signs that their tumor is spreading, says a study that advises patients to ask about this mark of quality care before surgery. National guidelines say when colon cancer is removed, doctors should check at least 12 lymph nodes for signs of spread. Checking fewer than 12 isn't considered enough to be sure the cancer is contained. BETTER LIFE: More cancer news But a study of nearly 1,300 hospitals found that overall, just 38% fully comply with the guideline, Northwestern University researchers report Tuesday in the Journal of the National Cancer Institute. "It's a fairly simple thing we can do to try to improve care for our patients," said lead author Dr. Kyle Bilimoria, of Northwestern and the American College of Surgeons. Colorectal cancer is the nation's second leading cancer killer, set to claim almost 50,000 lives this year. Some 148,000 Americans are diagnosed annually. For many, the node check can be crucial. Whether cancer has entered these doorways to the rest of the body is an important factor in long-term survival — and thus helps doctors decide who gets chemotherapy after surgery and who can skip it. "Patients who could benefit from additional chemotherapy may not be getting complete treatment and have a higher chance of relapse," said Dr. Durado Brooks of the American Cancer Society, who wasn't involved with the study. "It is something that consumers need to begin asking. ... Frankly, that is most likely to change medical practice." To check enough nodes, surgeons must remove enough of the fat tissue by the colon where they hide, and pathologists must painstakingly dissect that tissue to find the tiny nodes. Surgeons frequently tell of getting a pathology report of four clean nodes and asking the pathologist to find more, "and lo and behold, one of those additional nodes turns out to be positive," Bilimoria said. Previous studies have estimated that up to half of colon cancer patients have at least 12 nodes checked. Bilimoria's study is the first look at which hospitals are most likely to follow the guideline — and will report the rates directly to each institution. His team examined a national cancer database for records showing which hospitals checked 12 or more lymph nodes in at least 75% of eligible patients in 2004 and 2005, the latest data available. National Cancer Institute-designated "Comprehensive Cancer Centers" did the best job, with 78% complying. Just under 34% of community hospitals, which are far more common and care for many more patients, complied. Just over half of other academic medical centers and Veterans Administration hospitals met the standard. Improvement takes work from both surgeons and pathologists, Bilimoria said, noting that Northwestern went from about 50% compliance a decade ago to full compliance today. But he expects more 12-node checks soon, saying the National Quality Forum recently listed the standard as a sign of quality care and that at least one insurance giant has begun requiring proof of 12-node checks before listing surgeons as preferred providers. Meanwhile, he advises patients to ask about the 12-node check in choosing a surgeon and to check their pathology report to be sure it was done. Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Guidelines: You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. Read more