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.
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.
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.”
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:
“The first word is 'change.' The second word is 'persistent.' A change in bowel habit that persists. That is something that requires evaluation.”
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.”
There are several options available for colorectal cancer screening:
“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.”
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.”
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).
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."
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."
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 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."
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.”
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.”