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Colorectal Cancer

Colorectal cancer is cancer of the colon or rectum. This year, more than 145,600 people will be diagnosed with colorectal cancer and more than 51,000 will die of the disease.

With certain types of screening, this cancer can be prevented by removing polyps (grape-like growths on the wall of the intestine) before they become cancerous. Several screening tests detect colorectal cancer early, when it can be more easily and successfully treated.

Colorectal cancer is linked to getting older. However, colorectal cancer in adults younger than 50 is on the rise. Even so, it’s seen more in people age 50 and over.

Other risk factors include having—

  • Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
  • A personal or family history of colorectal cancer or colorectal polyps.
  • A genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).

Lifestyle factors that may contribute to an increased risk of colorectal cancer include—

  • Lack of regular physical activity.
  • A diet low in fruit and vegetables and whole grains.
  • A diet high in red meat (such as beef, pork or lamb) or processed meat (such as bacon, sausage, hot dogs or cold cuts).
  • Are overweight or obese, especially for those who carry fat around their waists.
  • Excessive alcohol consumption.
  • Smoking.

Colorectal polyps and colorectal cancer may not cause symptoms, especially at first. Someone could have polyps or colorectal cancer and not know it. That is why getting screened regularly for colorectal cancer is so important.

Symptoms, may include—

  • Blood in or on your stool (bowel movement).
  • Change in bowel movements.
  • Stools that are more narrow than usual.
  • Stomach pain, aches, bloating or cramps that don’t go away.
  • Losing weight for no apparent reason.
  • Feeling tired all the time.
  • Vomiting.  

If you have any of these symptoms, talk to your doctor. They may be caused by something other than cancer. The only way to know what is causing them is to see your doctor.

Almost all colorectal cancers begin as precancerous polyps (abnormal growths) in the colon or rectum. Such polyps can be present in the colon for years before invasive cancer develops. They may not cause any symptoms. Colorectal cancer screening can find precancerous polyps so they can be removed before they turn into cancer. In this way, colorectal cancer is prevented.

Screening can also find colorectal cancer early, when there is a greater chance that treatment will be more effective. Start screening at age 45 if you’re at an average risk, but if you have certain risk factors you may need to start screening sooner or get screened more often—talk to your health care professional. Continue screening to age 75 if you are in good health, with a life expectancy of 10 years or more. if you are ages 76-85, talk with your health care professional about whether to continue screening. After age 85, you should not get screened.

Screening Guidelines

Stool DNA Test (sDNA)* Every 3 years
Fecal Immunochemical Test (FIT)* Every year
High-sensitivity Fecal Occult Guaiac Test (gFOBT)* Every year
Colonoscopy Every 10 years
Flexible Sigmoidoscopy Every 5 years
Virtual Colonoscopy* Every 5 years


*Follow up a positive test with a timely colonoscopy.

Research is underway to find out if changes to your diet can reduce your colorectal cancer risk. Researchers are studying the role of diet in preventing colorectal cancer, but much still needs to be understood. Generally, experts encourage eating lots of fruits, vegetables and whole grains and limiting red meat and avoiding processed meat for a healthy diet.


References:

American Cancer Society (ACS). (2019) “Cancer Facts & Figures”

Centers for Disease Control and Prevention (CDC). (2019) “What Are the Risk Factors for Colorectal Cancer?”

Centers for Disease Control and Prevention (CDC). (2019) “What Are the Symptoms of Colorectal Cancer?”  

Resources

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