Colorectal cancer is the second-leading cause of cancer-related deaths in the United States. In fact, it's estimated that almost 150,000 men and women will be diagnosed this year. Researchers believe that by 2030, colorectal cancer may be the leading cause of cancer in adults under 50. Thankfully, when found in its earliest stages, 90% of patients survive the disease.
We spoke with Kristin Sharp – the associate director of family medicine with the residency program at Saint Joseph Health System – to help patients answer questions they might have about colon cancer.
"Colorectal cancer is essentially an abnormal proliferation of the cells in the colon. It's something that we see relatively often and, with regular screenings, we can catch it earlier and quickly provide the necessary treatment for patients," says Dr. Sharp.
What is colorectal cancer?
The colon and rectum are parts of the digestive system, specifically the large intestine. The colon is responsible for absorbing water and electrolytes from the indigestible food. The rectum is the final portion of the large intestine before digested food is expelled from the body.
Polyps are abnormal growths of tissue that can occur in various parts of the body. In the context of colorectal cancer, these polyps can be of two main types: adenomatous and hyperplastic. Adenomatous polyps have the potential to become cancerous over time, while hyperplastic polyps are usually benign.
Colorectal cancer typically begins when normal cells in the colon or rectum transform into cancerous cells. These mutations can accumulate over time and lead to the uncontrolled growth of cells, forming tumors.
What are the risk factors of colorectal cancer?
Like many other cancers, there isn't one or two risk factors that cause colorectal cancer. Instead it's a variety of factors, some you can control and others you can't, that lead to someone being diagnosed. Some of the most common risk factors include:
- Age: Colorectal cancer is more common in older adults, with the risk increasing significantly after the age of 50.
- Family history and genetics: Individuals with a family history of colorectal cancer or certain genetic syndromes (such as Lynch syndrome or familial adenomatous polyposis) have an increased risk.
- Personal history of colorectal polyps or cancer: If you've had colorectal cancer before or have a history of certain types of polyps, your risk is higher to get it again.
- Inflammatory bowel diseases (IBD): Conditions such as ulcerative colitis and Crohn's disease increase the risk of colorectal cancer.
- Diet: A diet high in red and processed meats, and low in fruits, vegetables, and whole grains, may contribute to an increased risk.
- Lifestyle factors: Lack of physical activity, obesity, and smoking have been linked to higher risks of colorectal cancer.
- Type 2 diabetes: Individuals with type 2 diabetes may have an increased risk.
- Race and ethnicity: African Americans have a higher incidence of colorectal cancer compared to other racial and ethnic groups.
- Alcohol consumption: Excessive alcohol consumption is associated with a higher risk of colorectal cancer.
- Screening practices: Lack of regular screenings for colorectal cancer may contribute to a higher risk, as early detection and removal of polyps can prevent the development of cancer.
"One of the biggest risk factors is family history. There are certain types of colon cancer that do have a pretty strong genetic predominance. If a family member currently has or has had colon cancer then they should get screened 10 years before their family member was diagnosed," says Dr. Sharp. "For example, if a patient's father was diagnosed at 50 years old, the patient should be screened starting at 40."
What are the symptoms of colorectal cancer?
Recognizing the symptoms of colorectal cancer is crucial for early detection and treatment. It's important to note that the presence of these symptoms does not necessarily mean you have colorectal cancer. But if you experience any of them, it's advisable to consult with a healthcare professional. Some of the primary symptoms include:
- Changes in bowel habits, such as persistent diarrhea or constipation
- Blood in the stool
- Abdominal discomfort, such as persistent abdominal pain, cramps, or discomfort
- Unexplained weight loss
- Fatigue and weakness
- Incomplete bowel movement or feeling that your bowel doesn't empty completely
- Iron deficiency anemia
- Nausea or vomiting
- Changes in appetite
- Jaundice due to the cancer spreading to the liver
It's also possible that colorectal cancer can be diagnosed with showing any symptoms at all. This is why starting screenings at 45 years old is important.
"Recognizing symptoms for colorectal cancer can be difficult because many of the symptoms are fairly general. The big things that we look for is blood in the stools, changes in bowel habits and persistent abdominal pain," says Dr. Sharp. "If a patient is experiencing those symptoms than it's possibly colorectal cancer."
What is the screening process for colorectal cancer?
Screening is a crucial aspect of preventive health care. Screening helps detect colorectal cancer or precancerous polyps early, when treatment is most effective. Different screening methods are available, and the choice of screening depends on factors such as age, risk factors, and personal preferences. Currently, the general guideline for most people is to start getting screened at 45 years old.
"Patients should know that the old guideline was screening at age 50. Now, it's 45. There are multiple different method for screening for colorectal cancer, but the gold standard is still a colonoscopy," says. Dr. Sharp. "If a patient doesn't want to do that then there are other options like Cologuard®."
Here are some common screening methods:
Colonoscopy
A colonoscopy involves a flexible tube with a camera being inserted into the rectum to examine the entire colon. Polyps can be removed during the procedure.
Typically recommended every 10 years, starting at age 45. More frequent screenings may be recommended for those at higher risk.
Flexible Sigmoidoscopy
Similar to a colonoscopy, but it examines only the lower part of the colon using a shorter tube. Recommended every 5 years, often combined with a yearly stool test.
Stool Tests
There are many tests that can check stool for signs of colorectal cancer. Some check for hidden blood while others detect genetic changes. The frequency of these can range from every year to every five years.
The choice of screening method should be discussed with a health care professional, taking into consideration individual health history, preferences, and any specific risk factors. It's important to note that positive results from non-colonoscopy screenings may require follow-up with a colonoscopy for further evaluation.
Screening guidelines also may vary, and some individuals may need to start screening earlier or have more frequent screenings based on family history, personal health, or other risk factors. Early detection through regular screenings can significantly improve the chances of successful treatment for colorectal cancer. Be sure to consult with a health care provider to determine the most appropriate screening plan for your individual situation.
