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Colorectal Cancer

3D Illustration showing cancer cells growing in the colon

Other than skin cancer, colorectal cancer is the third most common cancer diagnosed in the US and the third leading cause of cancer death. It affects people in all racial and ethnic groups and is most often found in people age 50 and older. African Americans are at a higher risk of developing the disease.

Cancers that start in the colon (colon cancer) or in the rectum (rectal cancer) are also called colorectal cancer. It often starts as a non-cancerous polyp (growth on the inner wall of the colon or rectum) or as a precancerous polyp that can turn into cancer. These polyps can be present in the colon for years before invasive cancer develops. The two most common types of polyps are adenoma and hyperplastic polyps. Adenomatous polyps have a higher likelihood of developing into cancer.

Some Risk Factors for Colorectal Cancer Are:

Age: Chances of being diagnosed with colorectal cancer increase as a person gets older.
Family History: Having close relatives with colorectal cancer or a history of precancerous colorectal polyps increases a person’s risk. Certain genetic syndromes such as Familial Adenomatous Polyposis (FAP) or Hereditary Non-Polyposis Colorectal Cancer (HNPCC or Lynch Syndrome) can cause an increased risk.
Medical History: Having Inflammatory Bowel Disease, Crohn’s Disease, Ulcerative Colitis, or Type 2 Diabetes (T2D) can be a risk factor.
Diet: Diets high in fat and low in calcium, folate and fiber may increase one’s risk.
Smoking: Smoking may increase the risk of developing polyps and colorectal cancer.
Alcohol: Heavy use of alcohol has been linked to the disease (more than 2 drinks a day for men and 1 drink a day for women).
Lack of Exercise: People who are not physically active have a higher risk of colorectal cancer.
Weight: People who are overweight or obese are at a higher risk of developing colorectal cancer.

Signs & Symptoms

Signs and symptoms are often not present until the disease is more advanced. They are different for each patient. It’s important to discuss any questions or concerns you may have with your physician.

Change in bowel habits including constipation, diarrhea, change in stool size or diameter, or mucous in the stool
Blood in or on the stool
Abdominal discomfort such as cramps, gas pains, or bloating
Unexplained weight loss
Fatigue
Nausea and vomiting

Screening & Diagnostic Testing

The National Comprehensive Cancer Network (NCCN) recommends that people with an average risk begin colorectal screening at age 45. Further, the NCCN shows that if there is a family history of cancer or Lynch syndrome and/or a personal history of polyps or inflammatory bowel disease, screening before the age of 45 may be recommended by your physician.

The U.S. Preventative Task Force recently drafted an updated recommendation for colorectal cancer screening in adults starting at age 45.

In September 2020, the American Cancer Society (ACS) reported that in the United States , the incidence of colorectal cancer in people 65 and older is dropping, but approximately 12%, or 18,000 colorectal cancer cases diagnosed in 2020 will be in people under the age of 50. The ACS had changed their recommended for regular colorectal screening to start at age 45, back in May 2018. For people, who are in good health, with a life expectancy of more than 10 years, the ACS recommends that they continue regular colorectal cancer screening through the age of 75. After age 75, through age 85, consideration for screening should include a person’s preferences, life expectancy, overall health, and prior screening history.

It is important for you to check with your insurance provider to see which screenings are covered in your plan, as well as your costs and copays.

A complete physical exam and medical history should be done. The exam will check for any unusual physical signs. A complete medical history is also important to fully understand a person’s health habits, family history, previous illnesses, and past exposure. Additional testing may include:

High-sensitivity Fecal Occult Blood Test (FOBT)
Stool DNA Test (FIT-DNA)
Flexible Sigmoidoscopy
Standard (or Optical) Colonoscopy
Virtual Colonoscopy
Biopsy

Screening Guides

Download PDF

Guía Para Pruebas del Cáncer de Colon - Parte 1

Guía Para Pruebas del Cáncer de Colon - Parte 2

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Helpful Patient Resources:

We understand that receiving a cancer diagnosis can be very scary and it is an emotional time for the patient and their families. It is very important to discuss any questions or concerns you may have with your oncologist. We highly recommend that if you do any research about your disease, that you do so only with reputable sources. For your convenience, we’ve listed some below.

National Cancer Institute

Colorectal Cancer - Patient Version

American Cancer Society

Colorectal Cancer

National Comprehensive Cancer Network

Guidelines for Patients

Colon Cancer Coalition:

Learn about Colorectal Cancer