Most colorectal cancers begin as a growth (polyp) on the inner lining of the colon or rectum.
Statistically, colorectal cancers account for over 150,000 new cancer cases each year according to the American Cancer Society estimates.
About
106,970
new cases of colon cancer will be diagnosed.
About
46,050
new cases of rectal cancer will be diagnosed.
Overall, the lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 26 for women. However, each person's risk might be higher or lower than this, depending on their risk factors for colorectal cancer.
Risk Factors
Certain risk factors can make it more likely for a person to have certain cancers. Some risk factors - like genetics - are beyond patient control. But other risk factors like diet and exercise may be things you can change.
Risk factors include:
- Age: risk increase after the age of 30
- Ethnicity: increase risk for black or Ashkenazi Jewish
- Sedentary lifestyle: not being routinely physically active
- Obesity: increases risk
- Alcohol: heavy alcohol consumption
- Diabetes: people with Type 2 diabetes have an increased risk
- Diet: high in red meats and processed meats can increase risk
- Smoking: increases risk
- Colorectal polyps: history of colorectal polyps
- Cancer: history of colon, rectum, or ovarian cancer
- Ulcerative colitis: or having Crohn’s disease
- Colon or rectum cancer: family history can increase risk
- Certain inherited syndromes: (Lynch syndrome or familial adenomatous polyposis)
Genetics and Family History
Family history is a powerful risk factor, and one that patients can use as an important step to understanding their risk. Family history helps medical providers understand whether our own risk for cancers is normal or high, and can be an indicator if additional preventative measures like genetic testing should be included in a prevention regimen. In fact, there are some conditions within family history which automatically makes a patient eligible for genetic testing (such as ovarian cancer, male breast cancer, or an early onset breast or colon cancer).
If you have a family history of colorectal polyps or cancer, you have a higher risk of getting colorectal cancer. Cancer in close (first-degree) relatives such as parents, brothers, and sisters is most concerning, but cancer in more distant relatives can also be important. Having 2 or more relatives with colorectal cancer is more concerning than having only one relative with it. You also may be at elevated risk if your relatives were diagnosed with cancer at a younger age than usual.
Genetic tests can show if members of certain families have inherited a high risk of colorectal cancer due to inherited cancer syndromes such as Lynch syndrome (also known as hereditary non-polyposis colorectal cancer, or HNPCC) or familial adenomatous polyposis (FAP).
In families known to have one of these inherited syndromes, family members who decide not to get tested are typically advised to start routine screening for colorectal cancer at an early age, and to get screened more often. Family members who are tested and are found not to have the mutated gene may be able to be screened at the same age and frequency as people at average risk.
Clearly, knowing your family history is important, so be inquisitive with family members - especially those who have had cancer - to know your risk.
Prevention
While there’s no definitive way to prevent colorectal cancer, you can make choices and lifestyle changes can help you control and even lower some of the risks. Leading a healthier lifestyle may help lower your risk, including:
- Avoid tobacco use and other people’s smoke
- Maintain a healthy diet: eating plenty of fruits, vegetables, and whole grains
- Limit red and processed meats
- Get enough calcium and vitamin D
- Maintain a healthy weight
- Engage in regular physical activity
- Consider a low-dose aspirin if you also have heart disease
- Women: discuss menopausal hormone use with your provider
- Know your family history of cancers
Screening
For people of average risk for colorectal cancer, experts say screening should start at age 45. Screening may be advised earlier if you are at higher risk. Talk with your healthcare provider about screening to make the choice that's best for you.
Colorectal cancer may be found with a screening test, helping your physician identify some types of cancer early, before the cancer grows or spreads, often making it easier to treat. There are multiple screening tests used to find polyps and identify colorectal cancer, including:
- Colonoscopy
- Flexible sigmoidoscopy
- Virtual colonoscopy (CT colonography)
- Fecal occult blood test (FOBT) or fecal immunochemical test (FIT)
- Stool DNA test
Treatment
At Phoebe Cancer Center, our treatment program is Commission on Cancer certified, and uses a multi-disciplinary team approach to customized cancer care.If you are diagnosed with colorectal cancer, your Phoebe Cancer team will work with you to develop a custom treatment plan, helping build goals, set expectations, and explain any potential side effects of available treatments. Typically, treating colorectal cancer includes one or more treatment modalities, including:
If you are diagnosed with colorectal cancer, your medical team will discuss the best options of treatment with you, including your goal and any potential side effects of the treatments available.
Medical Treatment - Centering on the delivery of oral or intravenous medicines:
- Chemotherapy
- Targeted therapy
- Immunotherapy
- Clinical trials
Surgical Treatment - Focusing on the physical removal of cancerous or precancerous cells:
- Polypectomy
- Local excision
- Colectomy (partial or total removal of colon)
- Diverting colostomy
- Transanal excision
- Transanal endoscopic microsurgery
- Low anterior resection
- Abdominoperineal resection
- Pelvic exenteration
Radiation Therapy Treatment - Treatments that use energy to shrink or eliminate cancer cells and masses:
- Brachytherapy
- External beam radiation
- Radiopharmaceuticals
At Phoebe Cancer Center, we embrace a full team approach to cancer care, which means providing a highly collaborative effort to deliver comprehensive cancer care to our cancer patients. This multidisciplinary approach engages a range of providers across our care community, to ensure we look at every angle for each patients’ unique case.