Colorectal Cancer - You Can Prevent It

By Christian Capener DO

Most people do not realize that colorectal cancer is a very common and very deadly in the United States. In fact, colorectal cancer is the second leading cause of cancer death among cancers that affect both men and women. Learn the signs and what you can do if you have it.

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Most people do not realize that colorectal cancer is a very common and very deadly in the United States. In fact, colorectal cancer is the second leading cause of cancer death among cancers that affect both men and women. This year the American Cancer Society estimates more than 140,000 new cases of colorectal cancer will be diagnosed resulting in more than 50,000 deaths. The good news is that unlike most other cancer killers, including breast and prostate cancer, colorectal cancer is highly preventable. In fact, research has shown that if patients undergo appropriate screening, greater than 60% of all colon cancers could be prevented. In addition, for those who undergo a screening colonoscopy where polyps are found and removed their chance of getting colorectal cancer may be reduced by more than 90%.

During the past 10 years, there has been an overall decrease in colorectal cancer mortality by 30%, making it the only major cancer with a steady decrease in number of cases per year. This success story has largely been a result of more and more people getting screened for colorectal cancer. Despite this positive trend, there is still more work to do. Even today, with more awareness about colorectal cancer and its prevention, almost half of people aged 50 or older, for which screening is recommended, are still not getting tested. Sadly, of the more than 50,000 people expected to die from colorectal cancer in 2014, more than half could have lived had they received appropriate screening.

Colorectal Cancer: What is it?

The colon and rectum (also called the large intestine) make up the last part of the digestive system. The food we eat is broken down in the stomach, nutrients are absorbed in the small intestine, and waste is then eliminated from the large intestine. Cancers of the digestive system are most common in the large intestine or the rectum (the last part of the colon). Because the screening is generally the same for both types of cancers, it is often referred together as a colorectal cancer screening.

What is a Polyp?

Almost all colorectal cancers begin as tiny polyps or growths from the inside lining of the intestine. Polyps develop into cancer usually slowly over a period of several years. Precancerous polyps are called adenomas. Adenomas are quite common and it is estimated that one-third to one-half of all individuals will develop one or more adenomas during their lifetime. While not all adenomas will develop into cancer, it is generally not possible to tell which polyps will. Therefore, at the time of a screening colonoscopy, all polyps that are found are usually removed and sent to a pathologist for review. Because colorectal cancer develops slowly from small polyps to larger tumors over time, these lesions can be identified early and removed before cancer forms and potentially spreads outside the colon. This is how colon cancer is prevented.

What Are the Symptoms of Colorectal Cancer?

Typically there are no early signs or symptoms at all for colorectal cancer. This point is really important to remember. Many patients question the need for screening when they don’t have any symptoms. Like many other cancers, colorectal cancer is largely silent until it has reached a more advanced stage. By this time, abdominal pain, weight loss, and/or rectal bleeding may occur. Treatment at this stage may be difficult, with the risk of complications and death increasing dramatically. The key to survival is to catch the cancer early, long before symptoms arise, or even better, to prevent the development of cancer altogether by removing premalignant polyps before they become cancerous.

Who Gets Colorectal Cancer?

Anyone can get colorectal cancer, although colorectal cancer may affect certain populations to a greater degree than others. Approximately 90% of new cases and 94% of deaths occur in individuals over the age of 50. Colorectal cancer cases and mortality rates are highest in African-American men and women compared with other races. In addition, African-Americans tend to develop colorectal cancer earlier in life and have more aggressive forms of colon cancer. Caucasians have the next greatest risk, followed by other major ethnic groups such as Hispanics and Asians. Overall, the number of cases and death from colorectal cancer is slightly higher in men than women. However, since women tend to live longer than men on average, their overall risk of developing colon cancer in their lifetime is similar to that of men.

Who Should be Screened for Colorectal Cancer?

Both men and women should begin screening for cancer at age 50, or age 45 for African-Americans. However, if you have a family history of colorectal cancer or advanced polyps, you may need to begin screening at an earlier age (age 40 or 10 years younger than the family member with cancer), as your risk of colorectal cancer may be much higher than the general population. Scheduling a screening exam is as simple as making a phone call or speaking with your primary care provider. For more information on preventing colorectal cancer, or to schedule your screening colonoscopy with a gastroenterologist near you please visit the index at the back of this publication or visit IntermountainClinics.org.