New cases of colon and rectal cancer are occurring at increasing rates in young and middle-aged adults.
This is why it’s important to talk to a doctor about your risk for colorectal cancer and determine when it’s the right time to start getting screenings. If everyone age 50 and older got screenings, six out of 10 deaths from colorectal cancer could be prevented.
With March being Colorectal Cancer Awareness Month, here’s a reminder of what you need to know about the disease and its prevention.
Colorectal cancer gets its name from the parts of the body it affects.
Colorectal cancer is cancer that occurs in the colon or the rectum. These cancers can also be called colon or rectal cancer depending on whether the cancer starts in the colon or rectum.
Colorectal cancer is a deadly disease.
Colorectal cancer is the second leading cause of cancer-related deaths in the US among cancers that affect both men and women, accounting for about 51,000 deaths in 2019.
This year, there will be approximately 101,000 estimated new cases of colon cancer and 44,000 new cases of rectal cancer in the U.S. The lifetime risk of developing colorectal cancer is about one in 22 people. While the overall incidence of colorectal cancer has decreased over the last decade, it has also increased by 1.8 percent annually for people younger than 55 between 2006 and 2015.
Some signs of colorectal cancer are invisible, while others are clear.
Colorectal cancer can sometimes be silent and people may not have any signs or symptoms. In others, symptoms include a sudden change in bowel habits, abdominal pain, bright red blood in the stool, black or tarry stools or unintentional weight loss. Sometimes, blood in the stool can be difficult to see, but this could be because the patient has a low red blood cell count. Other conditions besides colorectal cancer can cause similar symptoms, including infection, inflammatory bowel disease, irritable bowel syndrome and hemorrhoids.
Detecting colorectal cancer is key to prevention.
Screening tests are used to detect a disease before you develop symptoms. Colorectal cancer usually develops from precancerous polyps in the colon or rectum. The hope with a screening test is to find these precancerous polyps and remove them before they develop into cancer.
Most people can start screening at age 50, but some should start earlier.
The U.S. Preventive Services Task Force and the Multi-Society Task Force on Colorectal Cancer recommend starting colorectal cancer screening at age 50 and continuing until age 75 for individuals who are average-risk or asymptomatic. The American Cancer Society recommends starting screening at age 45.
People with a family history of colorectal cancer or advanced polyps in an immediate relative under age 60 or two immediate relatives at any age should start getting screened 10 years before the age in which their family member was diagnosed, or at 40 years old — whichever comes first. From ages 76 to 85, the decision to screen should be individualized and take into account patient preference and overall health.
There are different ways to screen for colorectal cancer.
There are several different ways of screening for colon cancer, including visual exams and stool tests. Colonoscopy is a common way of screening and requires a doctor to use a flexible tube with a camera at the end to directly look at your colon and rectum. Suspicious areas can be biopsied and removed if necessary. A “virtual colonoscopy” uses a CT scan to take images of your colon and rectum. Both these tests require a bowel prep to allow for good visualization.
Stool-based tests include two blood tests that look for hidden blood in the stool and one that tests the stool for abnormal DNA indicative of cancer or polyp cells. If a test other than a colonoscopy is performed and turns up abnormal results, it should be followed up with a colonoscopy.
Amrit K. Kamboj, MD, is an internal medicine resident and member of the ABC News Medical Unit.
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