Colon Cancer Awareness

In 2018, the American Cancer Society estimates that colorectal cancer will occur in slightly more than 140,000 Americans making colorectal cancer the 3rd most common cancer diagnosed. Also, 50,630 deaths will occur from colorectal cancer this year making it the 2nd most common cause of cancer related death. Given these sobering statistics, it is imperative to understand the underlying causes of colorectal cancer so this malady can be avoided or at least minimized.

Most colorectal cancers occur from the transformation of a small precancerous polyp into cancer which can take over 10 years. However, some colorectal cancers occur because of genetic disorders that cluster in families (Lynch Syndrome) or due to chronic inflammation in the colon from Crohn’s or ulcerative colitis. In general, smoking, obesity, physical inactivity, diets high in red meat and excessive alcohol consumption are risk factors that are related to lifestyle which can be modified to minimize cancer risk. Other non-modifiable risk factors for the development of colorectal cancer include advancing age, personal and family history of precancerous polyps and/or colorectal cancer, type 2 diabetes and racial/ethnic background (African-Americans and Ashkenazi Jews).

In order to be healthy and prevent colon cancer, patients should eat healthy, exercise, keep their weight in the ideal range and avoid smoking. Colorectal cancer screening is paramount in minimizing the risk of developing colon cancer. The United States Multi-Society Taskforce on Colorectal Cancer recommends starting screening at age 50 in the average risk patient. In African-Americans, screening should start at age 45. Colonoscopy and fecal immunochemical test (FIT) are considered Tier 1 screening options.

Colonoscopy is the dominant and preferred strategy as it can both prevent (by removal of precancerous polyps) and detect colorectal cancer early; whereas, stool tests are considered to be cancer detection tests. A colonoscopy involves looking at the colon from inside the body using a long, thin (about the width of your little finger), flexible tube with a tiny camera on the end, through which the doctor can view your whole colon and rectum for polyps or cancer. If the doctor sees any polyps during a colonoscopy, he or she will remove them right away, during the procedure. You will not be able to feel a polyp being removed and removing them will not impact your recovery time. Removing polyps during a colonoscopy could stop colon cancer from growing or even cure it.

The National Colorectal Cancer Roundtable has set a goal of 80% of eligible Americans being screened for colorectal cancer by the end of 2018 which could prevent 277,000 new cases of colorectal cancer over the next 20 years. March is Colon Cancer Awareness Month. Please make sure you, your family, friends and co-workers are up-to-date on colorectal cancer screening.

Sources: American Cancer Society, American Gastroenterological Association, and United States Multisociety Taskforce Guidelines.

Written and edited by: Rajeev Jain, M.D.