About Colorectal Cancer After lung cancer, colorectal cancer is the second leading cause of cancer-related deaths affecting men and women of all races in Michigan. In the United States, the number of cases and deaths from colorectal cancer are highest in African American men and women.
Colorectal cancer (CRC) is a cancer that develops in the colon (large intestine) or rectum. This is the area of the body where the food that is eaten is digested, processed for energy, and then excreted; this area is frequently referred to as the digestive system or tract.
Colorectal cancers usually develop slowly over a period of many years, with most cancers starting as a small, non-cancerous polyp (fleshy mushroom-like growth) beginning somewhere in the digestive system. When polyps are removed early in their small pre-cancerous (adenomatous) state, a potential cancer is prevented. Because colorectal cancer frequently develops without symptoms, screening (a test used to find the disease before there are symptoms) is important in detecting colorectal cancer in its early, treatable and most curable stage.
Screening should begin at age 50 for all average-risk men and women. People at increased risk for colorectal cancer due to family history should talk to their physician and be screened before the age of 50.
Q. Are there symptoms with colorectal cancer?
A. Frequently, colorectal cancer has no symptoms until the cancer has advanced to less treatable stage. When there are symptoms, they may include:
blood in the stool;
bleeding from the rectum;
abdominal pain or cramping;
a change in the stool shape;
a feeling of fullness or urge to have a bowel movement when there is no need;
Why Your Family History is Important
Knowing your family health history is valuable for your continuing good health and especially important in the early detection and prevention of colorectal cancer.
If there is a history of colon cancer or polyps in one of your immediate relatives (mother, father, sister, or brother), you are above average risk for developing colorectal cancer. This does not mean that you will develop colorectal cancer; it means that your chance of developing colorectal cancer is greater than someone who does not have a family history of the disease. It is important for you to share this information with your healthcare provider, and it is important for you to be screened at an earlier age.
There are some forms of inherited colorectal cancers that occur in families at an early age. If an immediate family member is diagnosed with a type of genetic colorectal cancer called hereditary nonpolyposis colon cancer (HNPCC or Lynch Syndrome) or familial adenomatous polyposis (FAP), sharing that information with a healthcare provider is essential.
Although these cancers are caused by a specific gene and are rare, some family members may also carry the gene and require early screening. All individuals with a family history of colorectal cancer are encouraged to contact that affected family member for test results related to a diagnosis.
Lynch Syndrome is a rare inherited condition that increases your risk for colon and other cancers. People with Lynch Syndrome may also have a family history of the following cancers at an early age: endometrial, ovarian, kidney, stomach, small bowel, and liver. If your immediate family members have a history of cancers found at a young age, share that medical information with your provider.
FAP is an inherited disease where hundreds of non-cancerous (benign) polyps may begin to grow in the colon. Removal of these polyps will not stop the polyps from growing again and, unless the colon is removed, the polyps will become cancerous. Although a rarer cancer, some family members may also carry the gene and require early screening and follow-up to prevent colon cancer from developing.
Understanding Your Risks for Developing Colorectal Cancer A risk factor is something that increases your chance of developing a disease. There are many risk factors you cannot control (non-modifiable) such as age, sex, and family history. But, there are also many risk factors under your control (modifiable) that may significantly improve your health when managed well. Some possible risk factors for colorectal cancer that are controllable include: smoking, diet, activity, and obesity.
Non-modifiable risk factors for colorectal cancer include:
Age: If you are over 50, you are at higher risk for colorectal cancer.
If you have a family history of colon cancer in a first-degree relative (mother, father, sister or brother) you have approximately twice the risk of developing colon cancer as someone without a family history.
Personal or family history of polyps of any kind. Non-cancerous or pre-cancerous polyps, depending on polyp size and age when they were found, places you at higher risk for colon cancer.
If you or a family member were younger than 60 when diagnosed with colon cancer, your risk for developing or re-developing colon cancer is greater.
Personal or family history of “bowel disease,” including chronic inflammatory bowel disease, ulcerative colitis, and Chron’s disease.
Family history of familial adenomatous polyps (FAP) or multiple polyps.
Modifiable or controllable risk factors for colorectal cancer include:
physical inactivity;
obesity;
diet (high consumption of red or processed meat, diet low in fiber or calcium); and
the use of alcohol and smoking, both of which have been linked to increasing the risk of developing polyps.
Working toward increasing physical activity to a moderate level (30 minutes a day, five days a week) has multiple benefits, including improving heart health and reducing the risk for colorectal cancer. Reducing obesity, especially abdominal obesity, is also important in reducing risk for colon cancer. Improving diet with the addition of high-fiber fruits, vegetables, calcium, milk, and plenty of fluids while reducing red and processed meats may lower the risk of colon cancer.
Colorectal Cancer Screening Tests Regular screening, beginning at age 50, is important in preventing colorectal cancer. Over 90 percent of the new cases of colorectal cancer are found in adults over 50 years of age. Knowing your family history and beginning screening earlier than age 50 is important if you are at higher risk for colorectal cancer.
Because colorectal cancer is frequently without symptoms, the following screening tests are very important for the early detection of colorectal cancer:
Annual: Fecal occult blood test (FOBT), which checks for hidden blood in three consecutive stool samples
OR
Every 5 Years: Flexible sigmoidoscopy, a procedure in which physicians use a flexible, lighted tube (sigmoidoscope) to visually inspect the interior walls of the rectum and part of the colon.
OR
Every 5 Years: Double-contrast barium enema, a test that uses a series of X-rays of the colon and rectum (taken after the patient is given an enema containing barium dye, followed by an injection of air in the lower bowel).
OR
Every 10 Years: Colonoscopy, a procedure in which physicians use a flexible, lighted tube (colonoscope) to visually inspect the interior walls of the rectum and the entire colon. During this procedure, samples of tissue may be collected, or polyps may be removed.
All positive tests (FOBT, flexible sigmoidoscopy, barium enema) should be followed up with colonoscopy.
What You Can Do Most colorectal cancers are preventable, and screening for colorectal cancer saves lives. Sharing your family health history with your health care provider is the first step in understanding your risk for colorectal cancer and deciding when you should begin your screening.
Take control of your health! Talk to your health care provider today to find out what screening test is appropriate for you. When it’s time, get screened!
