PALM BEACH, Fla. - BJ Smith looked at her doctor with that eternal question: why me?

She had just been diagnosed with colon cancer and was trying to make sense of it.

She didn't have a family history of the disease, she had an active lifestyle, and she thought she had good eating habits - lots of fruits and vegetables and not much dietary fat.

Yet, there she was, doubled over in pain one morning.

``I'm in excruciating pain,'' she remembers. ``My stomach is distended, and I can't stand up.''

Smith was 54. What she didn't know is that nine out of 10 cases of colon cancer strike people over 50, according to the American Cancer Society.

Beyond that, her doctor had no answers. He told her there were three possibilities: heredity, a lifestyle that abuses your body, and ``the lottery.''

Smith manages a laugh. ``I won the lottery. My number came up.''

Now 62, Smith admits that she never was evaluated for colon cancer before her diagnosis.

And that's something the American Cancer Society wants to change.

``Our research indicates that a majority of people are unaware of this type of cancer and relatively few have been screened,'' says Barbara Mienik, a spokesman for the Florida division of the ACS.

There are several tests for detection, and precancerous polyps can be found and removed before the disease develops.

And early discovery increases survival chances. The five-year survival rate is 90 percent for people whose cancer is found and treated before it has spread.

The most common detection tools are the fecal occult blood test, done at home and returned to the doctor's office; sigmoidoscopy, where a slender tube inserted in the rectum allows the doctor to view the area and part of the colon; and colonoscopy, where the patient is sedated and a tube, linked to a video camera, allows the doctor a better view of the colon's lining.

Jill Medlen, however, isn't a big fan of the fecal occult blood test, and with apparent reason. (The American Cancer Society urges it be done yearly, but in conjunction with a sigmoidoscopy every five years.)

When the Jupiter woman saw blood after a bowel movement, she had a fecal test and it came out negative.

But a year later, when she noticed bloating and blood in the stool, she had a colonoscopy.

She discovered, at 37, that she had colon cancer. At her age, she defied the odds. But she also was unaware that she had had several risk factors before the bleeding was noticeable: ulcerative colitis, and low dietary fiber.

Colitis is a risk factor because the colon is inflamed over a long time and may have ulcers in its lining. Diets high in fat are believed to increase the risk, also.

Medlen, like Smith, had never had routine screenings for colon cancer, even though she was at risk.

Both are now advocates for screening and early detection.

``It takes several years for a polyp to become cancer. If you catch it early, it's treatable,'' Medlen said. ``Don't ignore symptoms, no matter what your age. Cancer doesn't have to kill you.''

FIGHTING COLON CANCER WITH YOUR FORK

True or false?

1. To curtail colon cancer, eat cabbage every day.

FALSE. Cruciferous vegetables, such as cabbage, broccoli, cauliflower and Brussels sprouts, when eaten two or three times a week, seem to go a long way to prevent colon cancer. Daily doses of cabbage are not necessary and could be detrimental to some.

2. While alcoholic drinks should be restricted to no more than two per day, beer is the worst culprit for increasing your risk of colon cancer.

TRUE. Heavy drinking may double or triple your chances of colorectal cancer, and generally, the more alcohol you consume, the more likely the malignancy. Beer is the principal villain, with alcoholic spirits much less dangerous a risk factor for developing colon cancer, and wine the least hazardous.

3. Fiber has been shown to help reduce your risk of colon cancer by speeding the passage of food through your digestive tract before toxins have a chance to be absorbed. Oat bran is the ``best'' fiber to eat.

FALSE. Nobody really knows why wheat bran works, but the ``magic ingredient'' does not seem to be present in other cereals such as oat, corn or rice. Possibly, wheat bran reduces the concentration of bile acids and bacterial enzymes in the stool that are believed to promote colon cancer.

4. Poultry is one of the quickest ways to stop the growth of polyps, precursors to cancer.

FALSE. Fatty fish has been shown to stop the growth of polyps, and thus curtail colon cancer.

5. High-fat foods are only a concern when trying to lose weight. They have no connection to colon cancer.

FALSE. High-fat diets prompt microorganisms in the colon to make more bile acid, a cancer promoter.

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