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The 101 on Cancer

Colorectal Cancer

Colorectal Cancer

What is Colorectal Cancer?

Colorectal cancer is a type of cancer that starts in your colon or rectum. This type of cancer can also be called colon cancer or rectal cancer, depending on where it starts, but they’re usually lumped together because they have many similar features. The majority of colorectal cancers start as polyps, which are growths on the inner lining of your colon or rectum. However, not all polyps become cancer.

 

Who Does Colorectal Cancer Affect?

Colorectal cancer can affect anyone, but your risk increases if you are older than 45.

In 2022,

106,180 new colon cancer diagnoses

44,850 new rectal cancer diagnoses

52,580 people will die

 

Colorectal Cancer Facts

Colorectal cancer has a

65% 5-year survival rate

Black people are the most impacted by colorectal cancer, closely followed by American Indians and Alaska Natives. Black people have a ~20% higher colorectal cancer incidence rate than White people and the colorectal cancer mortality rate in Blacks is almost 40% higher than in Whites. Additionally, people who live in rural areas have substantially higher colorectal cancer incidence rates than people who live in more urban places.

*Note: All statistics are  based on the U.S. population.

Why? Increased colorectal cancer incidence and mortality among Black people reflect differences in their risk factors and healthcare access, including lower access to insurance, cancer screenings, and care. This means Black people’s colorectal cancer is often caught later when it is harder to treat.

Colorectal Cancer Risk Factors

Colorectal cancer risk factors can either be genetic or based on your lifestyle. Whether you have one, three, or all of these risk factors, there is no guarantee you will develop colorectal cancer in your lifetime. But they are important to understand so you can adjust the lifestyle-based risk factors, talk to your doctor about your overall risk, and develop a routine screening plan to catch colorectal cancer early if it does develop.

  • Personal or family history of colorectal cancer or adenomatous polyps
  • Inhereted genetic syndromes, like Lynch syndrome
  • Inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
  • Type 2 diabetes
  • Excess body weight
  • Physical inactivity
  • Long-term smoking
  • High consumption of red or processed meat
  • Low calcium intake
  • Heavy alcohol consumption
  • Very low intake of fruits, vegetables, and whole-grain fiber
  • Ashkenazi Jewish heritage

 

Colorectal Cancer Warning Signs

  • Bleeding from your rectum
  • Blood in your stool or in the toilet after you have a bowel movement
  • Dark or black stools
  • Changes in bowel habits, such as constipation or diarrhea that lasts more than a few days
  • Changes in stool shape, such as pencil-shaped or narrow stools
  • Feeling like your bowel isn’t completely empty after a bowel movement
  • Abdominal cramping or pain
  • Decreased appetite
  • Unintentional weight loss

Learn more about cancer Early Detection.

Notice a warning sign? Talk to your doctor, not WebMD!

Preventing Colorectal Cancer

Regular screenings can prevent colorectal cancer by finding polyps early before they have time to become cancerous. Learn about your screening options below.

Learn more about cancer Prevention.

 

Finding Colorectal Cancer Early

Routine screening can find colorectal cancer early when treatment is less invasive and more successful. You’ve got options on options when it comes to colorectal cancer screening, but remember that getting screened is a non-negotiable.

 

Stool-Based Tests

You do it at home, people! This type of screening requires you to collect a stool sample at home, which a lab will then test for signs of cancer. Stool-based tests are less invasive than colonoscopies, but you will need to get tested more frequently. Your stool-based test options include:

  • FIT (Fecal Immunochemical Test) – The FIT looks for blood in your stool and is very convenient compared to the other stool-based testing options. Take this test every year.
  • High Sensitivity gFOBT (Guaiac-Based Fecal Occult Blood Test) – This type of test uses a chemical reaction to detect blood in the stool, but is a little more complicated to prepare for. Take this test every year.
  • Cologuard (Multi-targeted Stool DNA Test) – Cologuard looks for blood in your stool, but also genetic mutations in your stool DNA to check for cancer and polyps. Some private insurance companies don’t cover this test. Get a Cologuard screening every 3 years.

 

Visual Exam

This type of screening is performed by a doctor to examine the lining of your colon and rectum. Your visual exam options include:

  1. Colonoscopy – We promise it’s really not that bad! Your doctor uses a long, thin, flexible, lighted tube to check the entire rectum and the entire colon for anything abnormal. Colonoscopies are done only every 10 years when used as a screening test, or they are used as additional screening after abnormal results from a stool-based test or other visual exam.
  2. CT Colonography (Virtual Colonoscopy) – This test uses an X-ray to view the entire colon, which a doctor then exams on a computer screen to check for any abnormalities. These are done every 5 years.
  3. Flexible Sigmoidoscopy – A doctor will use a short, thin, flexible, lighted tube to check out the insides of your rectum and lower third of your colon for polyps or cancer. This test only needs to be completed every 5 years, or every 10 years if combined with a stool-based test every year.

 

How Frequently Do You Need to Get Screened for Colorectal Cancer?

We recommend that everyone:

  • 40-44 Years Old – Talk to your doctor about starting screening if you or a close relative have had colorectal polyps or colorectal cancer, you have an inflammatory bowel disease, or you have a genetic syndrome that increases your chances of colorectal cancer
  • 45-75 Years Old – Depending on the type of screening you complete, your risk factors, and family history, you should complete colorectal cancer screening every 1-10 years.
  • 76-85 Years Old – Talk to your doctor about if you still need to be screened for colorectal cancer

 

Colorectal Cancer Treatment Options

Most colorectal cancers are treated with surgery. If the cancer has spread, it can also be treated with chemotherapy, radiation, targeted therapy, and/or immunotherapy.

 

Surgery

Surgery is a common treatment option for polyps or early colorectal cancers.

 

Polypectomy and Local Excision

These methods remove polyps or cancerous cells during a colonoscopy.

 

Colectomy

This surgery removes part or all of the colon and nearby lymph nodes. In a partial colectomy, about ¼ – ⅓ of your colon is removed and the remaining sections are reattached. Sometimes, rather than reattaching the colon sections, the top end of the colon or the small intestine will be attached to an opening in the abdomen where stool can exit the body. A bag is then attached to the skin around the stoma to collect stool. This is called a colostomy or ileostomy. For most people, having a colostomy or ileostomy is temporary.

 

Chemotherapy

Chemo uses anti-cancer drugs injected into your body or taken orally to fight colorectal cancer. Chemo is frequently used to treat colorectal cancer.

 

Radiation Therapy

Radiation is more frequently used to treat rectal cancer than colon cancer, and uses high-energy rays or particles to kill cancer cells.

 

To learn more about what to expect at your first treatment appointment, visit our Life With Cancer page.

 

After Colorectal Cancer

After finishing treatment, there is always a chance of recurrence, where the colorectal cancer can come back, or a second cancer, where you are diagnosed later in life with an additional type of cancer. Making healthy lifestyle choices can help prevent a second cancer from developing. 

 

Common Experiences of People with Colorectal Cancer

Feeling Worried About a Permanent Colostomy

When first diagnosed with colorectal cancer, many people are worried they will have to deal with a colostomy bag for the rest of their lives. Luckily, a permanent colostomy is not usually necessary to treat colorectal cancer. If you are required to get a section of your colon or rectum removed, the healthy parts can usually be reconnected, meaning you can eliminate bowel movements normally. It might help to connect with people who have also experienced ostomies. Check out these Ostomy Support Groups.

 

Feeling Awkward

We get it, poop is awkward sometimes. And honestly, so is cancer. While you may know that colorectal cancer doesn’t really have to do with your poop habits, it can still feel uncomfortable to tell people that that’s the type of cancer you have. If you need a reminder, though, just go reread that kids book “Everyone Poops.”

Sources: American Cancer Society; Centers for Disease Control and Prevention; National Cancer Institute

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