Colorectal Cancer

What is it?

Colorectal cancer is cancer that begins in the colon or rectum (everyone has a colon and rectum unless they have been surgically removed). This cancer can be prevented with a screening colonoscopy by removing polyps (grape-like growths on the wall of the large intestine, which includes both the colon and rectum) before they become cancerous. With routine screening, you can also detect the disease early when the cancer is small and hasn’t spread.

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Get screened

For those of average risk, colorectal cancer screening should begin at age 45.*

*Source: American Cancer Society

Ages 45–75: Get screened

Start getting screened at age 45 if you’re at average risk for colorectal cancer, and continue getting screened through age 75 if you are in good health with a life expectancy of 10 years or more.

If you are between the ages of 76–85, talk with your health care provider about whether to continue screening. After age 85, you should not get screened.

Visual tests

A health care provider visually examines your colon using a procedural medical tool
Done every 5-10 years, depending on the type of test
Requires bowel prep, which cleans out the colon and enables a health care provider to visualize the lining
May or may not require sedation, depending on the type of test
Opportunity for prevention (colonoscopy) or early detection (all visual testing methods)
Any abnormal results from a visual test that is not a colonoscopy (i.e. a virtual colonoscopy or a flexible sigmoidoscopy) need to be followed up with a timely colonoscopy

Stool-based tests

Non-invasive, at-home method of testing
Done every 1-3 years, depending on the brand or type of test
Requires a stool sample to be mailed to a lab
Stool sample is checked for hidden blood and/or genetic information shed by cancerous or precancerous cells
Any abnormal results from stool-based tests need to be followed up with a timely colonoscopy

Blood-based tests

Newest screening method
Only recommended for those who have declined or have not completed a structural (visual) or stool-based screening test
Done every 3 years
Requires having your blood drawn at a doctor’s office or lab
Blood sample is checked for DNA that could signal cancer
Any abnormal result from a blood test needs to be followed up with a timely colonoscopy

Increased risk

Based on your personal risk, some screening options may not be recommended for you. You may also need to start regular screening at an earlier age and/or be screened more often.

Genetic testing may be an option for those who want more information about their cancer risk based on their family health history.

Screening coverage

The Affordable Care Act mandates that private insurers and Medicare cover certain colorectal cancer screenings. Insurance companies can also choose to cover other types of screening that are not required by law. Check with your insurance provider to find out if which screenings are covered under your insurance plan.

Know your risk

You are at increased risk for colorectal cancer if you:

Are age 50 or older.
Are Black.
Smoke.
Are overweight or obese.
Have Type 2 diabetes.
Are not physically active.
Drink alcohol in excess.
Eat a lot of red meat (such as beef, pork or lamb) or processed meat (such as bacon, sausage, hot dogs or cold cuts).
Have a personal or family history of colorectal cancer or colorectal polyps.
Have a personal or family history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease).
Have a personal or family history of a hereditary colorectal cancer syndrome, such as Lynch syndrome or Familial Adenomatous Polyposis (FAP).

Reduce your risk

You may reduce your risk for colorectal cancer through these lifestyle-related modifications:

Exercise for at least 30 minutes, at least 5 days a week.

Avoid or limit alcohol.

To reduce your risk of cancer, it’s best to avoid alcohol completely. If you do choose to drink, limit your drinking to no more than one drink a day if you were assigned female at birth, and no more than two drinks a day if you were assigned male at birth.

Avoid all forms of tobacco.

Eat less red meat and cut out processed meat.

Maintain a healthy weight.

Eat lots of fruits, vegetables, beans and whole grains.

Get screened for colorectal cancer based on guidelines and your personal risk factors.

Signs & symptoms

Talk with your health care provider right away if you experience any of the following symptoms:

Bleeding from the rectum or blood in or on the stool
Unexplained iron-deficiency anemia
Change in bowel movements that lasts more than a few days
Stools that are more narrow than usual
General abdominal problems such as bloating, fullness or a feeling that you need to have a bowel movement that’s not relieved by having one
Persistent abdominal cramps
Unexplained vomiting, diarrhea or constipation
Weight loss for no apparent reason
Unexplained fatigue

Treatment options

Treatment depends on the stage of the cancer, the type of tumor cells and your medical condition.

Surgery

The most common treatment for colorectal cancer is surgery. This can range from a partial colectomy (removal of part of the colon, also called a colon resection) to a proctocolectomy (removal of the large intestine and the rectum).

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. If the cancer has spread, chemotherapy may be used before or after surgery.

Radiation

This treatment uses high doses of radiation to kill cancer cells and shrink tumors. When the cancer has spread, radiation may be used before or after surgery.

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