Colorectal cancer is a major public health problem. It is the second-leading cause of cancer death in the United States, behind lung cancer, and affects men and women equally. More than 140,000 adults are diagnosed with colorectal cancer annually, yet it is one of the most preventable types of cancer.
Most colorectal cancers develop from polyps, which are abnormal growths in the colon. If polyps grow unnoticed and are not removed, they can become cancerous. The development of more than 75-90 percent of colorectal cancer can be avoided through early detection and removal of precancerous polyps.
The likelihood of developing colon cancer in your lifetime is approximately one in 20. It is most common after the age of 50, but it can occur at younger ages. Risk factors for the development of colon cancer include a personal history of colon polyps or colorectal cancer, a strong family history of the colorectal cancer, African-American race and a history of Crohn’s disease or ulcerative colitis.
Most early colorectal cancers produce no symptoms. This is why screening for colorectal cancer is so important. Some possible symptoms, listed below, do not always indicate the presence of colorectal cancer, but should prompt a visit with your physician:
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▪ New onset abdominal pain
▪ Blood in or on the stool or a change in stool caliber or shape
▪ A change in typical bowel habits, constipation, diarrhea
According to the American Cancer Society, the colon cancer death rate in this country could be cut in half if Americans followed recommended screening guidelines. Last year alone, more than 50,000 people died of colorectal cancer in the United States. About one in three adults between 50 and 75 years old — about 23 million people — are not getting tested as recommended. This has prompted an initiative by the National Colorectal Cancer Roundtable, entitled, “80 percent by 2018.” The goal of this initiative is to reduce colorectal cancer as a major public health problem for those 50 and older by ensuring 80 percent of adults aged 50 and older are being regularly screened for colorectal cancer by 2018. The 80 percent by 2018 initiative is led by the American Cancer Society, the Centers for Disease Control and Prevention and the National Colorectal Cancer Roundtable (an organization co-founded by ACS and CDC).
▪ Colonoscopy every 10 years is the preferred colorectal cancer prevention test. For normal risk individuals, colonoscopy is recommended for those older than age 50; however, African-Americans should begin screening at age 45. Other possible screening tests for colorectal cancer include:
▪ Fecal immunochemical test, a relatively new test performed annually that detects hidden blood in the stool. If results are positive, a colonoscopy is performed.
▪ CT colonoscopy or “vitual colonoscopy” is an X-ray designed to look for colon polyps and cancers. It is performed every five years. If polyps are detected, a colonoscopy is performed to remove these precancerous growths.
▪ Flexible sigmoidoscopy, which is similar to a colonoscopy but only evaluates a portion of the colon.
Recently, I had the privilege of being invited to participate in the National Colorectal Cancer Roundtable event held in Harrisburg, with government officials, other health care providers, representatives from health systems and community and business leaders to form a plan for Pennsylvania to meet the 80 percent screening recommendation. By achieving screening for 80 percent by 2018 nationally, 277,000 cases and 203,000 colorectal cancer deaths would be prevented by 2030.
Some of these saved lives could be you, your friends, or your loved ones. This year, discuss colon cancer screening with your health care provider, and ask your friends and family to do the same. Remember, screening for colorectal cancer can save lives, but only if people get tested.
Dustin G. Case, DO, is the medical director of the gastrointestinal endoscopy unit at Mount Nittany Medical Center.