In February 2000, U.S. President Bill Clinton officially designated March as National Colorectal Cancer Awareness Month. Since then, thousands of patients, survivors, caregivers, and advocates throughout the country rally together to spread colorectal cancer awareness by wearing blue, holding fundraising and education events, talking to friends and family about screening, and so much more.
What is colorectal cancer?
Colorectal cancer is cancer in the colon and/or rectum, or both. The colon is part of the large intestine or large bowel, while the rectum is the passageway that connects the colon to the anus. Most colorectal cancers develop first as polyps, which are abnormal growths inside the colon or rectum that may later become cancerous if they are not removed.
Colorectal cancer is very treatable if discovered early. Even if it spreads into nearby lymph nodes, surgical treatment followed by chemotherapy is very effective. In the most advanced cases — when the cancer has spread to the liver, lungs, or other sites — surgery can often prolong and add to quality of life. Research is constantly being done to learn more and provide hope for people in all colorectal cancer stages.
Colorectal cancer is the third most common cancer in the US and the second leading cause of cancer death. It affects men and women of all racial and ethnic groups and is most often found in people 50 years or older. However, incidence in those younger than 50 is on the rise. This disease takes the lives of more than 50,000 people every year.
What risk factors should I be aware of?
The risk of getting colorectal cancer increases as we get older. About 90% of cases occur in people who are 50 years or older. However, incidence in those younger than 50 is on the rise. Other risk factors include having:
- Inflammatory bowel disease such as Crohn's disease or ulcerative colitis
- A personal or family history of colorectal cancer or colorectal polyps
- A genetic or hereditary syndrome
Lifestyle factors that may contribute to an increased risk of colorectal cancer include:
- Lack of regular physical activity
- A diet low in fruit and vegetables
- A low-fiber and high-fat diet, or a diet high in processed meats
- Overweight and obesity
- Alcohol consumption
- Tobacco use
What are the symptoms of colorectal cancer?
Colorectal cancer first develops with few, if any, symptoms. Be proactive and talk to your doctor. Listed below are a few of the most common symptoms:
Changes in bowel habits. This includes intermittent or constant diarrhea and/or constipation, a change in the consistency of stool, or more narrow stools than usual.
Persistent abdominal discomfort. This includes cramps, gas, pain and/or feeling full, bloated, or a feeling like the bowel is not completely empty. Nausea and/or vomiting can also be a symptom.
Rectal bleeding. This simply means the presence of blood in the stool. The blood can be bright red, or the stool may be black and tarry or brick red.
Weakness or fatigue. This may be accompanied by anemia or a low red blood cell count.
Unexplained weight loss. If you are losing weight for no known reason, or from nausea or vomiting, then it could be a symptom of colorectal cancer.
Many people with colon cancer don't experience symptoms in the early stages of the disease. Symptoms vary depending on the cancer's size and location in the large intestine.
What types of tests are available?
Several screening tests are available for colorectal cancer, which we further outline below:
There are different types of stool tests for colorectal cancer screening, including fecal occult blood tests (FOBT), fecal immunochemical tests (FIT), and stool DNA tests. The specific instructions for each test may vary slightly, but the general process for collecting a stool sample is as follows:
Talk to your doctor: Before starting the test, it's important to talk to your doctor about the best screening options for you, including which test to use and how often to do it.
Obtain the test kit: Your doctor may give you a test kit or you may need to obtain one from a laboratory or pharmacy. Make sure you read the instructions carefully and follow them closely.
Collect a sample: Typically, stool samples are collected using a special container that comes with the test kit. You will need to use the provided stick or brush to collect a small sample of stool and then place it into the container.
Prepare the sample: Depending on the type of test you're doing, you may need to add a preservative or solution to the stool sample to prepare it for testing.
Submit the sample: Once you have collected and prepared the stool sample, you will need to return it to your doctor or laboratory for testing. Follow the instructions provided with the test kit for submitting the sample.
Wait for results: The time it takes to receive test results may vary depending on the specific test and the laboratory processing the sample. Your doctor will inform you of the results and any follow-up testing or treatment that may be necessary.
Flexible sigmoidoscopy is a medical procedure that allows a doctor to examine the lower part of the colon, specifically the rectum and sigmoid colon, using a flexible, narrow tube with a camera attached to the end.
The entire procedure typically takes between 15 and 30 minutes, although the exact time may vary depending on the individual case. You may experience some cramping or discomfort during the procedure, but most are able to resume normal activities immediately afterward. The doctor will discuss the results of the sigmoidoscopy with you, along with any necessary follow-up testing or treatment.
This procedure is similar to flexible sigmoidoscopy, except a longer, thin, flexible, lighted tube is used to check for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can locate and remove most polyps and some cancers.
During this procedure, the patient may be given sedatives and pain medication to help relax and make the procedure more comfortable. The colonoscope is then inserted through the rectum and advanced slowly through the colon, while the doctor examines the lining of the colon for any abnormalities.
Colonoscopies are also used as a follow-up test if anything unusual is found during one of the other screening tests.
CT Colonography (Virtual Colonoscopy)
Computed tomography (CT) colonography, also referred to as a virtual colonoscopy, is a medical imaging test that uses X-rays and computer software to create detailed images of the colon and rectum.
During this procedure, the patient lays on their back or stomach on a special table that moves through a CT scanner, which is a large, doughnut-shaped machine. The doctor inserts a small tube into the rectum and inflates the colon with air to create a clearer image. Next, the patient is moved through the CT scanner, which takes X-ray images of the colon and rectum from different angles.
The doctor then uses the virtual images to inspect the colon for abnormalities, such as polyps or tumors. If any abnormalities are detected, the doctor may recommend a traditional colonoscopy to remove or biopsy the abnormal tissue.
When should I see a doctor?
Earlier is better.
Since the early signs of colon cancer often do not include pain, it is important not to wait and see your doctor soon. Remember, early detection can save your life.
When it comes to colorectal cancer, the most common symptom is NO symptom, which is why we call it the silent killer. If you're 50, average risk, get screened. A screening test is used to look for a disease when a person doesn't have symptoms. (When a person has symptoms, diagnostic tests are used to find out the cause of the symptoms.)
Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so they can be removed before they become cancerous. Screening tests can also find colorectal cancer early - when treatment works best.
Colorectal cancer symptoms can also be associated with many other health conditions. Only a medical professional can determine the cause of your symptoms.
If you think you are at increased risk for colorectal cancer, speak with your doctor about:
When to begin screening
Which test is right for you
How often to get tested
Millions of people in the United States have not been screened as recommended. These individuals are missing the chance to prevent colorectal cancer or find it early when treatment often leads to a cure.
Summit Medical Group provides a variety of colorectal cancer screening tests and procedures, and most insurance plans (including Medicare) help pay for colorectal cancer screening for people who are 50 years old or older. Colorectal cancer screening tests may even be covered by your health insurance policy without a deductible or co-pay. Check with your insurance plan to find out what benefits are covered for colorectal cancer screening.
For more information about Summit's colorectal screening options or to find a primary care physician, visit www.summitmedical.com.
Summit Medical Group provides a variety of colorectal cancer screening tests and procedures, and most insurance plans (including Medicare) help pay for colorectal cancer screening for people who are 50 years old or older. Colorectal cancer screening tests may even be covered by your health insurance policy without a deductible or co-pay. Check with your insurance plan to find out what benefits are covered for colorectal cancer screening. For more information about Summit's colorectal screening options or to find a primary care physician, visit www.summitmedical.com.
Editor's Note: This blog was originally published on 3/25/2021 and updated on 3/31/2023.