March is National Colorectal Cancer Awareness Month. According to the American Cancer Society (ACS), excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. The ACS estimates that in 2022, there will be more than 106,000 new cases of colon cancer diagnosed.
National health organizations, including the ACS and Centers for Disease Control and Prevention (CDC), recommend regular colon cancer screenings, beginning at age 45. Until recently, the recommended age to begin screenings was age 50.
“If you’re 45 to 75 years old, getting screened regularly, is a key step in helping to prevent colorectal cancer,” said Xin Yao, MD, Hematologist/Oncologist at Regional Cancer Care Center. “If you’re younger than 45 and think you may be at high risk of getting colorectal cancer, or if you’re older than 75, we want you to talk to your doctor about when is the right time for you to begin screening.”
An increased incidence of late-stage colon cancer in younger people is the reason for this change of recommendations explained Dr. Yao. He stressed the new age 45 guideline applies to most people.
“We are talking about the general population that has a standard risk of colon cancer; that is, they don’t have strong family history or any hereditary factors that predispose them,” he explained. “Younger people with a strong family history, or hereditary factors, need to be screened even younger than 45.”
Molly Schumacher, an Advanced Practice Nurse Practitioner with ThedaCare Cancer Care, added that anyone who has Crohn’s Disease, Lynch Syndrome, ulcerative colitis or inflammatory bowel conditions should also be tested at an earlier age.
“Those diseases put those people at an increased risk for developing colorectal cancer as well because of the cellular changes that happen with those disease processes,” she said.
There are various types of screening tests that can be used to find polyps or colorectal cancer. People should talk with their doctor to determine when to begin screening, which test is right for them, and how often to get tested.
Some of the most common screenings are stool tests, flexible sigmoidoscopy, a CT colonography and a colonoscopy.
Colorectal cancer might not cause symptoms right away. Dr. Yao stressed symptoms can be non-specific, which is why regular colorectal screenings are important. Here are common symptoms:
•A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
•A feeling that you need to have a bowel movement that’s not relieved by having one
•Rectal bleeding with bright red blood
•Blood in the stool, which might make the stool look dark brown or black
•Cramping or abdominal (belly) pain
•Weakness and fatigue
•Unintended weight loss
“These are the types of symptoms a person should be telling their primary care provider about, no matter how old they are,” Dr. Yao said. “With the incidence of colorectal cancer increasing in younger people, we want to empower people to not dismiss such symptoms. Have the conversation with your provider to discuss recommendations and develop a plan.”
The CDC recommends the following colorectal cancer preventive behaviors:
•Maintain a healthy weight
•Get moderate physical exercise – 30 minutes of exercise 5 days a week
•Eat a diet low in animal fats (red meat) and high in fruits, vegetables, and whole grains
•Limit alcohol consump-tion
•Avoid tobacco products
Dr. Yao noted that the Western diet of high-fat/low-fiber foods, including eating more than three servings of red meat each week, is a primary cause of increased levels of colorectal cancer in younger people.
“Previously when we saw younger patients diagnosed with colorectal cancer, we thought it was because of hereditary factors,” he said. “A recent study showed it’s likely more environmental – it is their eating habits. That means colorectal cancer can be considered more like a preventable disease. If people will change their diet, it might help them prevent colon cancer.”
According to the ACS, the death rate from colorectal cancer has been dropping in both men and women for several decades. Dr. Yao noted that is likely due to several reasons including colorectal polyps are now being found more often by screening and removed before they can develop into cancers, or cancers are being found earlier when they are easier to treat. Also, treatments for colorectal cancer have improved over the last few decades.
“These are all great advancements, and it can inspire hope in all of us,” he said. “We want each person to feel empowered to take precautions and following screening guidelines to help prevent a colon cancer diagnosis in their lifetime.”
