(also known as Colorectal Cancer)

Colorectal cancer is now the third leading cancer killer in the United States. Each year, 60,000 people die due to colorectal cancer. In addition, more than 200,000 hospitalizations per year are a result of primary diagnosis of colorectal cancer.

[Colon 6] But the statistics don’t have to be this high. If everybody age 50 or older had regular screening tests, at least one-third of deaths from this cancer could be avoided. 

Colorectal cancer has become one of the worst killers in our country, largely because of our discomfort in dealing with it. It’s not a comfortable topic to discuss, and most people are even less comfortable thinking about undergoing the screening methods that can be used to test for it.

But the fact remains, when colorectal cancers are detected at an early stage, the survival rate is 90%, but only 37% of colorectal cancers are discovered at this stage.

It’s time to stop being embarrassed and start talking about it!

Where does it start?

Colorectal cancer is a preventable disease. It occurs in the colon or rectum, and usually starts from polyps, or small growths inside those organs which shouldn’t be there.

Polyps are the precursors to colon cancer. Polyps begin as benign abnormalities of the colon. These cause no pain or symptoms; there is no change in bowel habits. A family history of colon polyps is extremely significant. A family history of colon cancer is important, as well. 

Early colon cancer usually has no symptoms. Signs and symptoms typically occur in the advanced stages of this disease. If you have any of the following symptoms, you should see your physician:

  • Blood in or on your stool (bowel movement). 
  • Pain, aches, or cramps in your stomach that happen a lot and you don't know why. 
  • Losing weight and you don’t know why. 
  • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool for more than a few days.
  • A feeling that you need to have a bowel movement, which doesn’t go away after you go.
  • Decreased appetite.
  • Weakness and fatigue.
  • Jaundice (yellow-green color in the skin and white part of the eye).

Early Detection

Because there are rarely symptoms in the earliest, most treatable stages of this disease, it is especially important to be screened regularly for colorectal cancer.

Several screening methods are available, including the fecal occult blood test, colonoscopy and virtual colonoscopy. 

You should begin colon cancer screenings at age 50, when the risks of developing the disease increase. When detected and treated early, colorectal cancer has nearly a 90 percent cure rate.

Consult with your physician about which colon cancer screening method is right for you.
You can also take action to prevent colon cancer. By having regular screenings and having colon polyps removed when they’re detected, before they become cancerous, you can greatly reduce your risk of developing colon cancer. 

Eating a high-fiber, low-fat diet  has also been shown to help prevent colon cancer.

[Learn more about Colon Cancer Screening and Prevention]

Risk Factors

No one knows exactly what causes colorectal cancer, but the following risk factors appear to increase a person's chances of developing the disease:

Age. This disease is more common in people over the age of 50. However, colorectal cancer can occur at younger ages, even, in rare cases, in the teens.

Gender. Men and women are at equal risk.

Diet. Colorectal cancer seems to be associated with diets that are high in fat and calories and low in fiber. 
[Learn about High Fiber Diets which can help prevent colon cancer] 

Polyps – benign growths on the inner wall of the colon and rectum – are fairly common in people over age 50. Some types of polyps increase a person's risk of developing colorectal cancer.

Personal and family medical history. A person who has already had colorectal cancer may develop this disease a second time. Immediate relatives (parents, siblings, children) of a person who has had colorectal cancer are somewhat more likely to develop this type of cancer themselves, especially if the relative had the cancer at a young age. If many family members have had colorectal cancer, the chances increase even more.

Diagnosis and Treatment

The chance of developing colon cancer is significantly reduced by removing polyps. When a polyp develops, it continues to grow. If the polyp is left in place, colon cancer can begin to develop within approximately 6 to 8 years. Thus, if polyps are removed, the chance of colon cancer is reduced. These facts were established by the National Polyp Study, performed on over 10,000 patients from 1980 to 1990. 

Once colon cancer has been established, the patient will need to be evaluated for the extent of the disease and its location. The patient will usually need a Colonoscopy, CT scan of the abdomen and pelvis, routine blood work, a CEA (carcinoembryonic antigen) and surgery. 
Surgery is very important in colon cancer since it allows a patient to have the tumor removed (resected) and the lymph nodes in the area of the tumor removed as well. By removing the lymph nodes, the extension of the tumor into the local (regional) lymph nodes can be assessed. This is an important factor in assessing the extent of disease. 

The process of determining the extent of disease is known as "staging". Staging of colon cancer is important since it gives your physicians information on which treatments are best and what types of outcomes occur with specific medical treatment regimens. Patients should be aware that a physician experienced with the process should perform this process. This is usually an oncologist (cancer specialist). 

Colon cancer is staged according to many factors. The main factors are size of the tumor, how aggressive the tumor is, degree of tumor penetration through the wall of the colon, the number lymph nodes in which the tumor is found and whether other organs are involved. 
Based upon this, colon cancer patients may receive chemotherapy, radiation therapy or surgery alone, or in combination. 

Points To Remember

  • Screening is important because it can find colorectal cancer early, when treatment can be very effective, and the chance of being cured is excellent.
  • Colorectal cancer usually starts from polyps in the colon or rectum. A polyp is a growth that shouldn't be there. Over time, some polyps can turn into cancer.
  • Screening tests can find polyps so they can be removed before they turn into cancer. 
  • Because polyps or cancer in the colon or rectum often have no symptoms, it is important to be screened regularly, even if you have no symptoms.
  • Most insurance plans, including Medicare, help pay for colorectal cancer screening. 

To find more information on this topic, visit:
National Cancer Institute 

Collagenous Colitis