By Anish A. Sheth, M.D.
As the third leading cause of cancer death in the United States, colorectal cancer is expected to claim the lives of more than 52,000 people across the nation this year, according to the National Cancer Institute.
And while the incidence of disease in older adults has declined in recent decades, cases in younger adults are on the rise.
In fact, as the National Cancer Institute reports, the rate of colorectal cancer has more than doubled among adults younger than 50.
Today, because of the rise of colorectal cancer in younger adults, multiple medical societies, including the U.S. Preventative Services Task Force and the American Cancer Society, recommend screening for colorectal cancer starting at age 45 for men and women of average risk.
Risk Factors
It is not clear why there is a rise in colorectal cancer rates in younger adults, but there are several factors that may play a role, including obesity, lack of physical activity and smoking.
Research also indicates that an unhealthy diet – one that is high in processed meat and fat, and low in fruits and vegetables – may be linked to early onset colorectal cancer.
Additionally, according to the American Cancer Society, incidences of colorectal cancer continue to disproportionately affect members of the Black community.
In fact, African Americans are more likely to develop colorectal cancer than other groups. There are complex reasons for this disparity, including difference in risk factors and access to healthcare and health screenings.
Other risk factors for colorectal cancer include a personal history of polyps or colorectal cancer, inflammatory bowel disease, and a family history of polyps or colorectal cancer.
Few Early Symptoms
There are few noticeable early signs of colorectal cancer, which is why screening is so important. However, warning signs that you should bring to your doctor’s attention include:
• A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool lasting more than a few days
• Blood in the stool or dark, tarry stool
• Weakness, fatigue or unintentional weight loss
• Iron deficiency anemia
If you experience any of these symptoms, you should seek a medical evaluation so a prompt diagnosis can be made.
Screening Key to Early Detection
As with many types of cancer, early detection can help make colorectal cancer easier to treat and even prevent it entirely.
Most colorectal cancers start as growths – also called polyps – in the colon, or less commonly, in the rectum. If left undetected, over time these growths can develop into cancer. However, through colonoscopy, physicians can identify and remove abnormal growths before they turn cancerous.
While there are several types of screening tests available, colonoscopy remains the only screening tool that – through the removal of polyps – can prevent cancer before it starts.
If a colonoscopy finds no polyps or other concerns, follow up screening is typically recommended in 10 years. If polyps are found, your physician will recommend the appropriate screening schedule.
Before having a colonoscopy, you should talk with your gastroenterologist about their rate of polyp detection and the average time they spend withdrawing the camera. These can be indicators of thoroughness of the procedure.
Reduce Your Risk
In addition to colonoscopy, there are several steps you can take to help reduce your risk for colorectal cancer and lead a healthy lifestyle. The American Cancer Society recommends the following:
• Be physically active. Regular moderate to vigorous physical activity can lower your risk for colorectal cancer as can limiting how much time you spend sitting or lying down.
• Eat a healthy diet. Overall, diets that are high in vegetables, fruits and whole grains, and low in red and processed meats, are believed to lower colorectal cancer risk.
• Maintain a healthy weight. Being overweight or obese increases the risk of colorectal cancer in both men and women.
• Limit alcohol use. Several studies have found a higher risk of colorectal cancer with increased alcohol intake, especially in men. It is best not to drink alcohol. For people who do drink, they should have no more than one drink per day for women or two drinks per day for men.
• Don’t smoke. Long-term smoking is linked to an increased risk of colorectal cancer, as well as many other cancers and health problems. Quitting smoking may help lower you risk of colorectal cancer and many other types of cancer, too.
Most important, be sure to see your doctor for an annual physical exam and to discuss your risk factors and recommendations for health screenings.
To find a primary care physician or gastroenterologist affiliated with Penn Medicine Princeton Health call 1-888-742-7496 or visit www.princetonhcs.org.
Anish Sheth, M.D., is board certified in gastroenterology. He is Chief of Gastroenterology and Co-Medical Director of the Center for Digestive Health at Penn Medicine Princeton Health.
