Colorectal Cancer Awareness

Signs and Symptoms

Screening Options

Early Onset Disease

Disparities in Colorectal Cancer

Surgery for Colorectal Cancer

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.

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

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

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.

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.

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.

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.

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.

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.

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.

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.