Colorectal cancer (also referred to as colon cancer ) is a cancer that develops in the colon (large intestine) or the rectum.
Colon cancer is the third most common cancer diagnosed in US, excluding skin cancers. It is the second leading cause of cancer-related deaths in the US.
The American Cancer Society’s estimates for the number of colorectal cancer cases in the United States for 2018 are:
Overall, the lifetime risk of developing colorectal cancer is: about 1 in 22 (4.49%) for men and 1 in 24 (4.15%) for women. This risk is slightly lower in women than in men.
There are several risk factors somewhat modifiable (those you can change) and some are non-modifiable (those you cannot change).
Risk factors that you can change-
1. Certain types of diet- Diet high in red meats such as beef, pork, lamb or liver. Processed meats like hot dogs and some lunch meats.
Cooking meats at high temperature like frying, broiling, etc., will release chemicals that may increase the risk.
On the other hand, diets rich in fruits and vegetables will decrease the risk of colon cancer.
2. Smoking- people who smoked tobacco for a long time are at high risk for several cancers including colon cancer.
3. Excess alcohol use- colon cancer risk increases with moderate to heavy alcohol use. Limiting alcohol intake to not more then 2 drinks a day for men and one drink per day for women may actually have health benefits.
4. Sedentary lifestyle- If you are not physically active, it increases the risk of colon cancer and physical activity will help decrease the risk of colon cancer.
5. Being overweight- If you are overweight or obese, you have a higher risk of developing and dying from colon cancer, especially if you are a male.
Risk factors that you cannot change-
1. Being older- The risk of colon cancer starts after age 40 and it’s much more common after age 50.
2. Family history of colon cancer or precancerous polyps- Although most colon cancers are found in people without a family history of colon cancer, nearly 1 in 3 people who develop colon cancer have other family members who have had it, especially if the relative is a first-degree relative (parent, sibling, child). The risk is even higher if the relative was diagnosed with cancer when they were younger than age 45.
If you have a family member who had precancerous polyps or colon cancer talk to Dr.Kethu about the possible need for a colonoscopy before the age 45.
3. Your race or ethnic background- African Americans are at the highest risk for colon cancer. Jews of Eastern European descent have one of the highest colorectal cancer risks of any ethnic group in the world.
4. A personal history of colon polyps or colon cancer- If you have a history of precancerous polyps or colon cancer, you have a higher risk for developing colon cancer in the future. It is important to have colonoscopies at recommended intervals.
5. Type 2 diabetes People who have type 2 diabetes have increased risk for colon cancer. They also tend to have poorer prognosis from colon cancer.
6. Personal history of Crohn’s disease or ulcerative colitis- If you have inflammatory bowel disease (IBD), including either ulcerative colitis or Crohn’s disease, your risk of colon cancer is increased. IBD is a condition in which the colon is inflamed over a long period of time. People who have had IBD for many years, especially if untreated, often develop precancerous changes which may eventually lead to cancer.
7. Syndromes- Approximately 5% of the people who develop colon cancer have inherited genetic changes that cause different genetic syndromes such as Lynch syndrome, familial adenomatous polyposis, etc.
Colorectal cancer is the second leading cause of cancer-related deaths in men and women in the United States. It is expected to cause about 50,630 deaths during 2018.
As a result of increased colon cancer screening by colonoscopy and improved treatments for colon cancer, there are now more than 1 million survivors of colorectal cancer in the United States.
Colon cancer may not cause any symptoms in the beginning. When it does cause symptoms, it can cause:
Colonoscopy is the single most important preventative test. From the time the first abnormal cells start growing into polyps, it takes several years, up to 15 years for them to develop into a colon cancer. So, you have a long window of opportunity to have a colonoscopy to find polyps and if you do, removing them will prevent cancer. Regular colonoscopies will also find colon cancer at an early stage so that it can be cured more easily.
The patient protection and affordable care act, passed in 2003 waives the coinsurance and deductible for many colon cancer screening tests including colonoscopy.
In February 2013, the Federal government issued an important clarification on preventative screening benefits under affordable care act. Patients with private insurance will no longer be liable for cost-sharing to have a routine screening colonoscopy.