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Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.

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Colorectal Cancer Awareness

March is National Colorectal Cancer Awareness Month. Much progress has been made in fighting this deadly disease since Congress first designated the awareness month in 2000. Despite this progress, approximately 52,550 people are expected to die of colorectal cancer this year, and the disease is increasingly diagnosed in patients younger than 50.  Fortunately, colorectal cancer is highly preventable and treatable when caught early.

Throughout March, American College of Surgeons experts will be available to speak to media members to discuss what everyone should know about colorectal cancer.

How Common Is Colorectal Cancer?

Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in the United States and the third leading cause of cancer deaths. When combining numbers for men and women,  colorectal cancer is the second leading cause of cancer deaths, according to the American Cancer Society.

Signs and Symptoms

Unfortunately, colorectal cancer does not always present with signs and symptoms until it is in an advanced stage — that’s why screening remains vital.

“It is common for people to be diagnosed with colorectal cancer even though they have no specific symptoms — they feel fine. That’s why it’s so important to get screened, so we can remove polyps before they can turn into cancer, and find early-stage cancers that are easily curable. Don’t wait until you have symptoms to get checked.”

Thomas Read, MD, FACS

Former ACS Governor and Professor and Chief of Gastrointestinal Surgery at the University of Florida

Although signs and symptoms may not appear until the cancer has advanced, American College of Surgeons experts advise that all people should pay attention to changes in their bowel habits and report these changes to their primary care physician, including:

  • Persistent changes in bowel habits, such as constipation or diarrhea
  • Rectal bleeding
  • Abdominal pain
  • Weight loss, especially when it’s advanced and occurs without reason

“The first word is 'change.' The second word is 'persistent.' A change in bowel habit that persists. That is something that requires evaluation.”

John R. T. Monson, MB, BCh, FACS

AdventHealth

Screening Options

Why Is Screening for Colorectal Cancer So Important?

Screening for colorectal cancer saves lives, and should begin at age 45 for people at average risk of developing colorectal cancer, according to new guidelines issued by the U.S. Preventive Services Task Force. People with a family history of colorectal cancer should be screened 10 years earlier than the youngest age of diagnosis in their family.

Unfortunately, the CDC estimates that only about 70% of U.S. adults aged 50 to 75 are up to date on their screening, and much of the population may not be aware of all the screening options available to them.

“The earlier we can intercept and treat, the better the outcomes is. For screening, the goal is to detect precancerous lesions and hopefully remove them so they never develop into cancer and/or to diagnosis cancer at the earliest stage possible.”

Y. Nancy You, MD, MHSc, FACS

Professor of Colon & Rectal Surgery and Director of the Young-Onset Colorectal Cancer Program at The University of Texas MD Anderson Cancer Center

What Screening Options Are Available for Colorectal Cancer?

There are several options available for colorectal cancer screening:

  • Visual exams: Colonoscopy is considered the gold standard for colorectal cancer screening. With this test, physicians use a flexible tube called a colonoscope to see the inside of the entire colon and rectum. During this test, physicians can remove suspicious growths to biopsy (test) them for cancer. They can also remove pre-cancerous polyps that have the potential to develop into cancer. A colonoscopy should be performed every 10 years or more frequently, depending on the results of the test and if there’s a family history of the disease.
    • Other visualization tests include a CT colonography (virtual colonoscopy) or a flexible sigmoidoscopy, which looks at the lower colon and rectum. These tests should be performed every 5 years.
  • Stool-based tests: Stool-based tests include the fecal immunochemical test (FIT)and guaiac-based fecal occult blood test, which detect hidden blood in the stool. Stool DNA tests can detect blood in the stool and abnormal changes through DNA analysis. These tests should be performed every one to three years depending on the type of test used.

“Stool-based tests are easy to do and can be performed at home, but they’re not specific in the sense that when there's something wrong, we need to perform a follow-up visual screening test to figure out what exactly is happening. Visual tests require an office visit and some prep work, but they don’t need to be done as frequently, typically every 5 to 10 years.”

Y. Nancy You, MD, MHSc, FACS

Professor of Colon & Rectal Surgery and Director of the Young-Onset Colorectal Cancer Program at The University of Texas MD Anderson Cancer Center

What Should Patients Know About All the Options Available for Colorectal Cancer Screening?

American College of Surgeons experts recommend that choosing any screening option is better than not getting screened at all.

“Screening is always better than no screening. A good discussion between the patient and their primary care physician can lead to what is best for the patient at the time.”

V. Liana Tsikitis, MD, MCR, MBA, FACS, FASCRS

Chair of the ACS Commission on Cancer for Oregon and a Professor of Surgery at Oregon Health & Science University

Early Onset Disease

Is Colorectal Cancer on the Rise in Younger People?

In recent decades, there has been an alarming rise in the incidence of colorectal cancer in adults under the age of 50. This increase has occurred throughout the United States, as well as in other high-income countries. To address this concerning trend, the National Institutes of Health has called for more research to identify preventive interventions for early-onset colorectal cancer (EOCRC).

What to know

  • 10% of all new colorectal cancer diagnoses are early-onset cases.
  • There has been an increasing rate of colorectal cancer-related mortality among young patients in the last decade.

Source: Mayo Clinic. Addressing the rising incidence of early-onset colorectal cancer.

"Be in tune with your body. Don't be shy about talking about your bowels."

Y. Nancy You, MD, MHSc, FACS

Professor of Colon & Rectal Surgery and Director of the Young-Onset Colorectal Cancer Program at The University of Texas MD Anderson Cancer Center

People of all ages should also pay close attention to concerning changes in bowel activity and other signs and symptoms that could indicate colorectal cancer.

"Young patients often assume a change in bowel habits is attributable to a benign disease, but we shouldn't assume that. They need to get checked."

Roberto Rodriguez-Ruesga, MD, FACS, FASCRS

Texas Colon & Rectal Specialists/Texas Oncology-Baylor Charles A. Sammons Cancer Center

Researchers continue to investigate the reasons behind the increase in early-onset colorectal cancer. Research is underway to determine potential lifestyle factors, including poor diets, sedentary lifestyles, and increasing rates of obesity.

Disparities in Colorectal Cancer

Disparities continue to exist for certain racial and ethnic groups in the diagnosis and mortality rate of colorectal cancer.

Of note, Black Americans have a 20% higher incidence of colorectal cancer than White patients, and they are more likely to develop the disease at a younger age, receive a later stage diagnosis, and are more likely to die of the disease.

Further, although the five-year survival rate improved for White colorectal cancer patients between 1992 and 2013, Hispanic, Black, and Asian patients did not see any improvement during the same time period.

"The disparities are multifactorial. It can be lack of access to care, fear, lack of trust, or a simple language barrier. It's very important to have a diversity of healthcare workers to reach out to their communities."

V. Liana Tsikitis, MD, MCR, MBA, FACS, FASCRS

Chair of the ACS Commission on Cancer for Oregon and a Professor of Surgery at Oregon Health & Science University

Surgery for Colorectal Cancer

When diagnosed with colorectal cancer, patients will often undergo surgery, in addition to receiving chemotherapy and/or radiation therapy. Several types of surgery can be performed depending on the stage of cancer and its location in either the colon or rectum. The American Cancer Society describes the several different types of surgeries available for people diagnosed with colorectal cancer.

“In the last 30 years, the surgery for colorectal cancer has changed dramatically — and for the better.”

John R. T. Monson, MB BCh, FACS

AdventHealth

Recently, advances in minimally invasive surgical techniques have made it possible for people to recover much more quickly than in past decades and spend less time in the hospital away from their daily routine.

“Many patients are eligible for minimally invasive surgeries that are done either laparoscopically or robotically, and that affords patients an easier recovery and earlier return to work. We’re trying to minimize the disruption a cancer operation causes in someone’s daily life.”

Y. Nancy You, MD, MHSc, FACS

Professor of Colon & Rectal Surgery and Director of the Young-Onset Colorectal Cancer Program at The University of Texas MD Anderson Cancer Center