Colorectal cancer is the second-leading cancer killer of men and women combined in the U.S. More than 90 percent of colorectal cancer cases are discovered in people age 50 and over. Screening is essential to diagnosing colorectal cancer because the disease typically lacks symptoms in the early stages. Approximately one-third of adults over 50 have not been screened. Colorectal cancer develops in the cells lining the colon and rectum. The stage is based on the extent of the spread of cancer through deeper layers, lymph nodes, and surrounding structures.
- In 2018, an estimated 140,250 cases of colorectal cancer will be diagnosed in the United States.
- An estimated 50,630 people in the United States will die from colorectal cancer in 2018.
- The five-year survival rate for colorectal cancer discovered early and before the cancer spreads is 90 percent, but only 39 percent of colorectal cancers are identified in this early stage.
- In Texas in 2018, there are 11,314 expected new cases of colorectal cancer and 4,144 deaths.
- Age: People age 50 and over have a higher risk of developing colorectal cancer. However, colorectal cancer in people under 50 is rising, accounting for 10 percent of cases.
- Family History: People with a family history of colorectal polyps along with a family history of colorectal cancer are at greater risk. Those with a family history of polyps or colorectal cancer should consult a doctor about screening frequency.
- Inflammatory Bowel Disease: People with inflammatory bowel disease have a higher risk of colorectal cancer.
- Diet: Diets that contain large amounts of red and processed meats can increase risk.
- Personal Health: Overweight and inactive people are at a higher risk. Type 2 diabetes has been linked to an increased risk of colorectal cancer. People with a history of polyps and inflammatory bowel disease are also at an increased risk, and may need earlier or more frequent screening. Long-term smoking and heavy alcohol use raise risk.
- Lynch Syndrome (HNPCC): This inherited condition affecting the body’s genes increases risk of colorectal cancer. Lynch syndrome is responsible for 3 percent of colorectal cancers, and those with the condition have a lifetime risk of up to 80 percent of developing colorectal cancer. Genetic testing can determine if a person has the gene mutation associated with Lynch syndrome.
Typically, people in the early stages of colorectal cancer do not have symptoms; symptoms become apparent as the disease advances. If a person experiences any of the following symptoms, he or she should consult a physician.
- Abnormal bowel habits
- Vomiting, diarrhea, constipation
- Cramping or stomach discomfort
- Frequent gas or feeling bloated
- Bleeding from the rectum
- Blood in the stool
- Feeling of weakness or fatigue
- Stools that are narrower than usual
- Unexpected weight loss
- Feeling that bowel doesn’t fully empty
- Screening: Men and women age 50 and older with an average risk for developing colorectal cancer should discuss the most appropriate screening test with their physician. Screening tests include annual guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT); stool DNA (sDNA) test every three years; flexible sigmoidoscopy every five years; double-contrast barium enema every five years; virtual colonoscopy every five years; or colonoscopy every 10 years. Those with increased risk factors should consult their physician whether to begin screenings earlier than age 50. Approximately 90 percent of colorectal cancer could be prevented by removing colon polyps.
- Lifestyle: Maintaining a healthy weight through a regular exercise schedule and healthy diet may decrease the risk of colorectal cancer. A healthy diet includes plenty of fruits, vegetables, and whole grains, and limited consumption of red and processed meats, and alcohol. Use aspirin and other related drugs in moderation. Aspirin, ibuprofen, and naproxen are linked to lower risk of colorectal cancer and polyps. However, these drugs can have serious side effects. You should talk with your physician before taking them specifically to lower your risk.
Main types of treatment for colorectal cancer include surgery, radiation therapy, proton therapy, chemotherapy, ablation, immunotherapy, and targeted therapies. Specific needs may be addressed by surgeons, gastroenterologists, or medical or radiation oncologists. For complex treatments, a team of specialists may be involved.
Sources: American Cancer Society, American College of Gastroenterology, Centers for Disease Control and Prevention, Colorectal Cancer Alliance, National Cancer Institute, and Texas Cancer Registry