Colorectal cancer is the second leading cause of cancer-related deaths in the United States, according to the American Cancer Society. However, a large majority of deaths related to the cancer could be prevented with a screening.
Even so, many people are not up to date on their screenings. The American Cancer Society recommends people who are at average risk start regular screenings at the age of 45.
“The common misconception about colorectal cancer is that people believe they don’t have any symptoms, so they won’t have any polyps,” said Rajiv Chhabra, MD, a gastroenterologist with Saint Luke’s GI Specialists. “Don’t assume. Go and get your screening done. If you meet the screening guidelines or have any family history, don’t wait until you have symptoms.”
Most cases of colorectal cancer are age and genetics-related. However, there are some things you can do to reduce your risk.
“Eating too much red meat, obesity, and lack of physical activity does increase your risk, so avoiding those can certainly help,” Dr. Chhabra said. “There is some evidence that shows eating more fiber, vegetables, and fruits, as well as taking aspirin on a regular basis may reduce the risk of the development of polyps. However, you should consult with your doctor before starting any new medication.”
Screenings allow doctors to detect any polyps and remove them before they become cancerous. If abnormal polyps are found during a colonoscopy, the endoscopist can remove them during the screening in most cases.
"The colon, or large intestine, is about five feet long," said Robert Amajoyi, MD, a board-certified colorectal surgeon with Saint Luke's Surgical Specialists. "As you can imagine, the colon is a large organ and has millions and millions of cells that are constantly exposed to toxins and carcinogens in certain foods we ingest. These toxins and carcinogens can lead to mutations that could lead to the cells losing their intelligence to stop growing and ultimately develop into a polyp. Polyps are precancerous lesions."
If you are holding off on screening because you dread getting a colonoscopy, there are many other options. Saint Luke’s offers at-home stool-based tests, DNA tests, CT-based tests, and a partial colonoscopy-like test, which examines only the lower part of the colon. Talk to your provider about the best option for you.
The frequency of needed follow-up screenings varies from person to person, depending on individual results and risk factors. Talk to your gastroenterologist about when you should return for another screening.
If a screening is missed, there are some warning signs of potential colorectal cancer.
“The biggest warning sign is blood in the stool,” said Addison Tolentino, MD, an oncologist and hematologist with Saint Luke's Cancer Institute. “That’s when you should seek help right away. Other warning signs can be changes in bowel habits or unexplained anemia found in a doctor’s visit.”
"Do not assume it's something benign like hemorrhoids," Dr. Amajoyi said. "If you're having persistent issues for up to a month, you definitely need to get checked out by your doctor. Do not try to wish it away."
Most early colorectal cancer cases can be removed through surgery. More advanced cases may require chemotherapy or other treatment. Clinical trials may be another option for certain patients.
“The earlier the cancer is detected, the better,” Dr. Tolentino said. “Don’t forget to bring it up with your primary care physician… and if you don’t have one, start there.”
Saint Luke’s has a multidisciplinary team to treat colorectal cancer, including dedicated colorectal surgeons, gastroenterologists, endoscopists, oncologists, and more.
Learn more about colorectal cancer.