By: Gregory P. FitzHarris, M.D., colorectal surgeon with Sentara Surgery Specialists
Cancers of the large intestine (colon) or the last few inches of the large intestine, known as the rectum—together are called colorectal cancer. Colorectal cancer
is the third deadliest cancer in the United States.
Risk Factors for Colon Cancer
|Age. More than 9 out of 10 people diagnosed with colorectal cancer are 50 or older.|
Personal history of colorectal polyps. If you’ve had adenomatous polyps, you’re at greater risk of developing colorectal cancer, especially if they were large or numerous.
Family history. If you have parents, siblings, or children with colon cancer, you’re at greater risk of the disease.
Inflammatory bowel disease. People with IBD ( ulcerative colitis, or Crohn’s disease) are at greater risk.
Racial and ethnic background. African Americans have the highest incidence and mortality rates of colorectal cancer of any other racial group. Ashkenazi Jews also have one of the highest risks of colorectal cancer.
Lifestyle factors. Physical inactivity, obesity, smoking, and heavy alcohol use increase risks of colon cancer.
One of the simple truths about colon cancer is you can survive, if you catch it early. But early means years before symptoms occur. And you may never have symptoms. Many patients who are diagnosed with colon cancer have no symptoms at all.
When colon cancer is found, it has usually been there for years. When a tumor is discovered, that patient may have literally been sitting on colon cancer for up to 10 years. If a patient has waited that long, frankly, the odds are against him or her.
So what does that mean for catching colon cancer? It means you have to get screened through a procedure called a colonoscopy to detect colon cancer at its earliest stages, and even better, before it has a chance to become cancer.
Another truth is that about 90% of all colon cancer is preventable, if only people would follow the screening guidelines. Most American adults should be screened for colon cancer at age 50. For African-Americans, the recommended first screening is five years earlier at age 45. Anyone with a family history of colorectal cancer should be screened 10 years prior to the age at which the close family member was diagnosed. For example, if your dad was diagnosed with colon cancer at 53, you’d need to be screened starting at 43.
Truly, I can’t think of a good reason not to get screened for colon cancer. Some might be embarrassed while others worry about discomfort of the procedure. Frankly, the prep is the worst of a colonoscopy. The day before the procedure, waste in the colon is eliminated by drinking fluids and medications (laxatives), causing diarrhea.
New Technology Makes Colonoscopy Screenings Comfortable
During a colonoscopy, patients relax under mild sedation. During the procedure, a doctor uses a slender, flexible fiber-optic camera to examine the interior of the large intestine for polyps or abnormalities. Most polyps discovered can be removed on the spot, preventing them from growing into cancers. The procedure is very low risk, involves little or no discomfort and most patients won’t need another screening for 10 years. However, if a patient is asked to come back for a rescreening in three to five years because the cancer-causing polyps were found and removed, it’s imperative to follow those recommendations. Come back for rescreening at the right time.
Let me leave you with one thought. Early detection is the best prevention, so don’t sit on colon cancer.
5 Stats about Colorectal Cancer
1. Most patients diagnosed with colorectal cancer have no symptoms at all. If patients wait for symptoms, for many, it could be too late.
2. Colorectal cancer is the 3rd leading cause of cancer death among men and women in the U.S. One in 18 men and one in 20 women will be diagnosed with colon cancer during their lifetime. 1
3. Portsmouth, Western Tidewater and Chesapeake have among the highest mortality rates from colorectal cancer in Virginia, well above the Virginia average. 2
4. Colorectal screenings are lower among adults who are less educated, have lower incomes or are uninsured but do not differ between African-Americans and Whites.3
5. Nearly 90% of all colon cancer is preventable, if everyone followed the screening guidelines. African-Americans should begin their screenings at age 45, instead of age 50 advised for other populations. Those with colorectal cancer in their family should talk with their doctor about when to begin screenings.4
Changes in your body or bowel movements can be an important signal. If you notice any of these, see your doctor immediately:
Rectal bleeding or blood in your stool
Change in your bowel habits, including diarrhea or constipation for more than 2 weeks
Narrowing of stool that could signal an obstruction
Abdominal discomfort, such as cramps, gas or pain lasting longer than 2 weeks
Feeling that your bowel doesn't empty completely
Weakness or fatigue
Unexplained weight loss
Remember, you shouldn’t wait for these symptoms to have a colonoscopy.
For more health information and the latest press releases, go to the Sentara news page on Sentara.com.
1 American Cancer Society Cancer Facts and Figures 2009
2 Virginia Department of Health Division of Health Statistics. Based on combined data from 2004-2008
3 Virginia Risk Factor Surveillance System Based on 2006 and 2008 pooled data.
4 American College of Gastroenterologists
Dr. Greg FitzHarris is a colorectal surgeon who earned his medical degree from the Duke University School of Medicine in Durham, NC and gained fellowship training in colorectal surgery at the University of Minnesota in Minneapolis. He is a member of Sentara Surgery Specialists and practices in Hampton, Newport News, and Suffolk, Virginia.