According to the Colorectal Cancer Alliance, colorectal cancer is the second leading cause of cancer death and fourth most diagnosed cancer, despite the fact that this cancer can be prevented with screening and is highly treatable when detected early. Also called colon and rectal cancer, the number of people who have died from colorectal cancer has steadily decreased in the past 30 years due to increased screening and changing lifestyles.

Each year, about 150,000 people in the United States are diagnosed with colorectal cancer. The average age at diagnosis for men and women is 66.

Groups with higher rates of colorectal cancer

Ethnicity appears to have an impact on the risk of being diagnosed with colorectal cancer. Black Americans are 15% more likely to develop it than Caucasians and are 35% more likely to die from colorectal cancer.

Colorectal cancer rates are rising among people under the age of 50; this population is the only one experiencing annual increases in rates of diagnosis. About 10% of the colorectal cancer diagnoses annually are in people under the age of 50, and that rate is increasing 1-2% per year. It’s currently the deadliest cancer among young men and the second deadliest among young women.

According to the National Cancer Institute, other factors increasing the risk of colorectal cancer include:

• Parent, sibling or child with a history of colon or rectal cancer
• Personal history of colon, rectal or ovarian cancer or high-risk adenomas (colorectal polyps that are one centimeter or larger in size or that have cells that look abnormal under a microscope)
• Genetic mutation
• Personal history of chronic ulcerative colitis or Crohn’s disease for eight years or more
• Consumption of three or more alcoholic drinks daily
• Smoking cigarettes
• Obesity

Signs of colon and rectal cancer

According to the National Cancer Institute, the most common symptoms of colorectal cancer include:

• Blood in the stool
• Change in bowel habits (increased constipation or diarrhea)
• Belly discomfort (cramps, gas, pain)
• Feeling that the bowel doesn’t empty all the way during a bowel movement
• Losing weight without trying

Colorectal cancer screening

Both men and women at average risk should begin getting screened for colorectal cancer at the age of 45. If a family history, genetic predisposition or other risk factors are present, your physician may recommend screening begin sooner.

Colorectal cancer screening checks for precancerous polyps or cancer in the colon and rectum. During the screening, precancerous polyps are removed and biopsies completed, as needed. Called a colonoscopy, this screening is recommended every 10 years beginning at age 45 for average risk patients. If polyps are found, your physician may recommend screening be more frequent going forward. While other less invasive, more convenient screenings are available, a colonoscopy is considered the “gold standard” because it is the most thorough and allows polyps to be removed when identified.

Genetic testing

Like other cancers, genetic mutations can play a role in increasing one’s risk of colorectal cancer. In fact, 5-7% of colorectal cancer diagnoses are in patients with an inherited gene mutation. In adults age 50 and younger, many cases of colorectal cancer have a genetic component.

It’s important to share not only your complete medical history, but that of your family members with your physician, so they can determine if genetic testing is appropriate. Genetic testing provides insights into your risk of multiple cancers and other diseases, so you and your physician can be proactive in managing your risks and doing appropriate screenings and tests.

Treating colorectal cancer

According to the American Cancer Society, “depending on the stage of the cancer and other factors, different types of treatment may be combined at the same time or used after one another.”

Treatment may include:

• Tumor-targeted treatments
  • Ablation and embolization
  • Radiation therapy
  • Surgery
• Drug (“systemic”) treatments
  • Immunotherapy
  • Chemotherapy
  • Targeted therapy drugs

A multi-specialty team of physicians will be involved in your treatment, including a:

• Gastroenterologist: Treats disorders of the digestive tract
• Surgical oncologist
• Colorectal surgeon
• Radiation oncologist
• Medical oncologist

When caught early (e.g., “localized;” stage one-two), the five-year survival rate of colorectal cancer is 90-91%. That’s why it’s important to understand your risks, talk with your doctor and partner together to determine when you should start colorectal cancer screening. Screening is performed by a gastroenterologist. Your primary care provider will refer you to this specialist, so you can proactively manage your risks, if any, and feel confident that you are effectively managing your health.