Colon Cancer: What You Need to Know

March is Colorectal Cancer Awareness Month.

Not only is it a good time to become more aware of colorectal cancer—the second leading cause of cancer death in the United States—but it is also a good time to update our understanding of new screening guidelines for these cancers.

New Screening Guidelines

The United States Preventive Services Task Force recommends that all people at average risk begin getting checked at age 45. People at higher risk may need to be screened earlier. Ask your doctor about screening, as your ethnicity, lifestyle, and family history will impact when you should get checked.

The new guidelines were recommended because of a rise in early-onset colorectal cancer. Defined as a diagnosis before age 50, the incidence of early-onset colorectal cancer has increased about 2 percent per year in recent years and now accounts for about 12 percent of all colon or rectal cancer cases. According to a report from the American Association for Cancer Research, doctors are seeing more cases of early-onset colorectal cancer, and the sharpest increase in metastatic, early-onset colorectal cancer is among people 20 to 39 years old.

Cancer of the colon or rectum is more common in men than women. It is also more common among African Americans than people of other races. The median age of diagnosis in the United States is 66 years, while about 78 percent of newly diagnosed patients are aged 55 and older.

The Centers for Disease Control and Prevention lists other risk factors for colon cancer, too. They include:

• A diagnosis of inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
• A personal or family history colorectal cancer or colorectal polyps
• Lifestyle factors, such as
• lack of regular physical activity
• a diet low in fruits and vegetables
• a low-fiber and high-fat diet
• a diet high in processed meats
• Being overweight
• Alcohol consumption
• Tobacco use

Why Screen?

The National Cancer Institute estimates that 153,020 people in the United States received a diagnosis colon or rectal cancer in 2023 and approximately than 52,550 Americans died of it.

Colorectal cancer screening saves lives, according to the CDC. Screening can find precancerous polyps—abnormal growths in the colon or rectum—that can be removed before they turn into cancer. Screening also helps find colorectal cancer at an early stage, when treatment works best. According to the CDC, about nine out of every 10 people whose colorectal cancers are found early and treated appropriately are still alive five years later.

Colorectal Screening Options

You might have options when it comes to a screening exam for colorectal cancer and each method has its own pros and cons, according to the Colorectal Cancer Alliance. Talk to you doctor about:

Colonoscopy

Considered the gold standard in colorectal cancer screening, it allows doctor to identify and remove polyps in the same procedure.

At-home screening

There are screening kits you can do from the comfort of your home.

Other screenings

With the guidance of your healthcare provider, you might want to explore other options.

• Flexible sigmoidoscopy is a visual exam that needs no sedation, and requires enemas for prep, but only looks at the lower part of the colon.
• Guiaiac fecal occult blood test (FOBT) can detect small amounts of blood in stool and is more specific to finding blood from further up the digestive tract, such as the stomach.
• Double-contrast barium enema (DCBE) uses X-rays to detect polyps or other abnormalities in the colon, a DCBE requires a laxative prep and clear diet the day before the sedation-free procedure.
• CT colonography, also known as “virtual colonoscopy,” is also sedation free.

Don’t Ignore Symptoms

Colorectal cancer doesn’t always cause symptoms, especially at first, which is why getting screened regularly for colorectal cancer is so important. But the CDC recommends that you contact your healthcare provider if you observe symptoms such as:

• A change in bowel habits.
• Blood in or on your stool (bowel movement).
• Diarrhea, constipation, or feeling that the bowel does not empty all the way.
• Abdominal pain, aches, or cramps that don’t go away.
• Weight loss and you don’t know why.

These symptoms could be caused by any number of other health issues, not just cancer, which is why you’ll want to talk to a doctor.