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Colorectal cancer develops from non-cancer polyps called adenomatous polyps.
A polyp is a grape-like growth on the inside wall of the colon or rectum. Polyps
grow slowly over three to ten years. Most people do not develop polyps until
after the age of 50. Some polyps become cancerous, others do not. In order to
prevent colorectal cancer, it is important to get screened to find out if you
have polyps, and to have them removed if you do. Removal of polyps has been
shown to prevent CRC.
Everyone has a risk of developing CRC. However, your risk depends on several
factors.
You are at average risk for colorectal cancer if you:
 | Are age 50 or older and have no other risk factors.
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You are at increased risk for colorectal cancer if you:
| Have a personal history of CRC or adenomatous polyps
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| Have a family history - one or more parents, brothers and/or sisters, or
children - of CRC or adenomatous polyps |
| Have a family history of multiple cancers, involving the breast, ovary,
uterus, and other organs |
| Have a personal history of inflammatory bowel disease, such as ulcerative
colitis or Crohn’s Disease |
There are several inherited disorders that greatly increase your risk of CRC.
However, they are not very common.
Other factors that increase your risk of developing CRC are:
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A diet that is low in fiber and high in fat |
| A sedentary lifestyle |
Aren’t Women at Less Risk for Colorectal Cancer than
Men?
Men and women are equally affected by colorectal cancer. In fact, colorectal
cancer is the third leading cause of cancer death in women. Also, about 67,000
women are diagnosed with this cancer each year and more than 40 percent of them
- 28,600 - die from the disease.
What are the Symptoms of Colorectal Cancer?
Colorectal cancer begins with no symptoms at all. However, over time, there
are a number of warning signs:
| Rectal bleeding |
| Blood in your stool (bright red, black, or very dark)
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| A change in your bowel movements, especially in the shape of the stool
(e.g., narrow like a pencil) |
| Cramping pain in your lower abdomen |
| Frequent gas pains |
| Discomfort in or the urge to move your bowels when there is no need
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| Weight loss without dieting |
| Constant fatigue |
What Should I Do if I Have These Symptoms?
Call your doctor and schedule an appointment. Only your physician can
determine if your symptoms are due to CRC.
Why is Screening Important If I have No Symptoms?
Screening is important for two reasons. The early stage of CRC - which is
when it is most curable - frequently does not cause any symptoms. And, just as
important, screening is the only way to find polyps. If the polyp is removed, it
cannot develop into cancer.
What Type of Screening Tests are Available?
There are several types of screening tests. Talk with your doctor about which
one is best for you. People at average risk should start screening at age 50.
People at increased risk start at age 40.
| Digital rectal examination: In this test, the
doctor manually inserts a gloved finger into the rectum to feel for
abnormalities. While this test is easy to do, it is not very effective.
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| Fecal occult blood test (FOBT): In this procedure,
the stool is tested for the presence of blood that is invisible to the eye.
The test is available in a kit and can be taken at home to collect stool
samples. The stool cards can be mailed to your doctor. This test is relatively
easy and inexpensive, however, many factors can interfere with its accuracy.
This test is recommended annually for persons beginning at age 50 for people
at average risk. |
| Sigmoidoscopy: Your doctor will use a long,
flexible, lighted tube to check the rectum and the lower part of the colon for
polyps and cancer. If a polyp is found, it can be sampled through the scope
and sent to a lab to be tested. This test can be performed in a doctor’s
office, and does not require any anesthesia or sedation, but does require
limited preparation such as an enema. Insertion of the tube may be somewhat
uncomfortable, and some cramping may occur during the procedure, which takes
about ten minutes. After the test, there may be some mild abdominal gas pains.
If the doctor took a biopsy, some traces of blood may be in the stool for a
few days. This test is recommended every five years beginning at age 50 for
people at average risk. |
| Colonoscopy: This procedure is done by a
gastroenterologist. He or she will use a long, flexible, lighted tube - called
the colonoscope - to view the entire colon and rectum for polyps or cancer. A
bowel cleansing preparation of the colon is required before the procedure. The
colonoscope has a camera at the end, which can project images on a TV screen.
If a polyp is found, it can be removed by a wire loop that is passed through
the colonoscope and is hooked around the base of the polyp. The doctor sends
an electric current through the loop, which severs the polyp from the colon
wall and pulls it out of the colon. The polyp is then sent to a laboratory to
be tested to determine if it is cancerous. This procedure requires patients to
be sedated, and usually takes about 20 minutes. There is some pressure that
can be felt from the instrument’s movements and some cramping afterwards, but
this is usually all that occurs. Some traces of blood may be in the stool for
several days after the procedure if a biopsy was taken. |
| Barium enema: This test is an X-ray examination of
the entire colon and rectum and may be done instead of a colonoscopy. After
cleansing of the colon, a soft, flexible tube is inserted into the rectum and
a liquid called barium is inserted into the tube. Special X-rays follow the
flow of the barium in the colon and outline any lumps, polyps, or
abnormalities. A person may feel some cramping and a strong urge to defecate
during the test. This procedure is recommended as a substitute for colonoscopy
every ten years. |
How Do I Prepare for These Screening Tests?
Proper preparation is the most important thing you can do to help ensure you
get the most accurate screening possible. Your doctor will give you complete
instructions on what to do. Before any test, let your doctor know about any
medicines you are taking because they may affect the test results.
What if I Am Diagnosed with Colorectal Cancer?
If you are diagnosed with CRC, surgery is generally required to remove the
cancerous polyps and other malignant tissue. The type of surgery and follow-up
treatment will depend on how far advanced the cancer is. In the past, a
colostomy was usually necessary. However, new surgical technologies can
eliminate the need for a colostomy in many patients.
How Can Colorectal Cancer be Prevented?
There is no way to completely eliminate the risk of developing CRC. That is
why screening is so important. However, there is evidence that you can reduce
your chance of getting CRC by doing the following:
| Have a diet that is rich in fiber; eat plenty of whole grains, fruits, and
vegetables |
| Eat cabbage, broccoli, cauliflower, and brussel sprouts often
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| Avoid foods that are high in fat, particularly saturated fat
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| Eat foods that are high in calcium |
| Exercise regularly |
Researchers are also investigating the possibility that some drugs such as
aspirin, ibuprofen, calcium supplements, folic acid and others may help prevent
colorectal cancer.
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