Colorectal cancer occurs in the colon or rectum. The term colorectal cancer is used to describe colon cancer, rectum cancer or both. Most colorectal cancers develop first as polyps, which are abnormal growths inside the colon or rectum that may later become cancerous if not removed.
Colorectal cancer is the third most common cancer in the US, and the second leading cause of cancer death. It affects men and women of all racial and ethnic groups, and is most often found in people 45 years or older. However incidence in those younger than 45 is on the rise.
Colorectal cancer, when discovered early, is highly treatable. Even if it spreads into nearby lymph nodes, surgical treatment followed by chemotherapy is highly effective. In the most difficult cases — when the cancer has spread to the liver, lungs or other sites — treatment can help make surgery an option for many, as well as prolonging and adding to one’s quality of life.
If you’re 45 or older, getting a colorectal cancer screening test could save your life.
All men and women should be screened for colorectal cancer. Your individual risk factors – such as ethnicity, lifestyle and family history – will determine when you should start getting checked. For most adults, it is recommended that colorectal cancer screening should begin at age 45.
Under the Patient Prevention and Affordable Care Act (PPACA), all insurers are required to cover preventive screening tests, like colonoscopies. However, you may still owe a copay or deductible.
You’ll often hear colonoscopies referred to as the “gold standard” of screening. This is because they can both find cancer and remove potentially precancerous growths called polyps. Since most cases of colorectal cancer start as polyps, colonoscopies essentially allow you to stop colorectal cancer before it even starts!
During a colonoscopy, you will lie on your left side on an examination table. In most cases, your doctor will give you a light sedative, and possibly pain medication, to help you stay relaxed. The doctor will then insert a long, flexible, lighted tube called a colonoscope, or scope, into the anus and slowly guide it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again.
Being Overweight or Obese
If you are overweight or obese (very overweight), your risk of developing and dying from colorectal cancer is higher. Being overweight (especially having a larger waistline) raises the risk of colon and rectal cancer in both men and women, but the link seems to be stronger in men.
Physical Inactivity
If you’re not physically active, you have a greater chance of developing colon cancer. Being more active can help lower your risk.
Diets High in Red & Processed Meats
A diet that’s high in red meats (such as beef, pork, lamb, or liver) and processed meats (like hot dogs and some luncheon meats) raises your colorectal cancer risk.
Smoking
People who have smoked tobacco for a long time are more likely than non-smokers to develop and die from colorectal cancer. Smoking is a well-known cause of lung cancer, but it’s linked to a lot of other cancers, too.
Heavy Alcohol Use
Colorectal cancer has been linked to moderate to heavy alcohol use. Limiting alcohol use to no more than 2 drinks a day for men and 1 drink a day for women could have many health benefits, including a lower risk of many kinds of cancer.
Your Age
Your risk of colorectal cancer goes up as you age. Younger adults can get it, but it’s much more common after age 45.
Personal History of Colorectal Polyps or Colorectal Cancer
If you have a history of adenomatous polyps (adenomas), you are at increased risk of developing colorectal cancer. This is especially true if the polyps are large, if there are many of them, or if any of them show dysplasia.If you’ve had colorectal cancer, even though it was completely removed, you are more likely to develop new cancers in other parts of the colon and rectum. The chances of this happening are greater if you had your first colorectal cancer when you were younger.
Personal History of Inflammatory Bowel Disease (IBD)
If you have inflammatory bowel disease (IBD), including either ulcerative colitis or Crohn’s disease, your risk of colorectal cancer is increased. If you have IBD, you may need to start getting screened for colorectal cancer when you are younger and be screened more often.
Family History of Colorectal Cancer
Most colorectal cancers are found in people without a family history of colorectal cancer. Still, nearly 1 in 3 people who develop colorectal cancer have other family members who have had it.
People with a history of colorectal cancer in a first-degree relative (parent, sibling, or child) are at increased risk. The risk is even higher if that relative was diagnosed with cancer when they were younger than 45, or if more than one first-degree relative is affected.
If you have a family history of adenomatous polyps or colorectal cancer, talk with your doctor about the possible need to start screening before age 45. If you’ve had adenomatous polyps or colorectal cancer, it’s important to tell your close relatives so that they can pass along that information to their doctors and start screening at the right ag
Screening for colorectal cancer works in two ways:
According to the Centers for Disease Control and Prevention, only 1 in 3 adults who need to be screened are actually doing it. Why so few? There are many reasons, including:
Polyps are growths that may turn into colorectal cancer over time. While not every polyp turns to cancer, it is difficult to know which ones will. Also, almost every colorectal cancer begins as a small non-cancerous polyp. The good news is that during colonoscopy, these polyps can be identified and removed, preventing a possible colorectal cancer diagnosis. If a polyp is large enough, tissue can be taken and sent for biopsy to determine the exact type of polyp.
Not all polyps are created equal. There are four types of polyps that commonly occur within the colon and rectum: