By Daniel Lindenberg, MD, PA –
Of cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and in women. In 2009:
• 136,717 people in the US were diagnosed with colorectal cancer – 70,223 men and 66,494 women.
• 51,848 people in the US died from colorectal cancer – 26,806 men and 25,042 women.
Since the mid-1980s, the colon cancer death rate has been dropping due in part to increased awareness and screening. By finding more polyps and cancer in the earlier (local and regional) stages, it is easier to treat. Improved treatment options have also contributed to a rise in survival rates. There are currently more than one million colon cancer survivors alive in the US.
What is Colorectal Cancer?
Colorectal cancer is cancer of the colon or the rectum. It is as common in women as it is in men. It develops from adenomatous polyps—grape-like growths that can appear on the lining of the colon and rectum—that may become cancerous over time. With screening, colorectal cancer is very preventable, because polyps can be found and removed before they become cancer.
What Are the Symptoms?
In its early stage, colorectal cancer usually produces no symptoms; it can be the silent killer. The most likely warning signs include:
• Changes in bowel movements, including persistent constipation or diarrhea, a feeling of not being able to empty the bowel completely, an urgency to move the bowels, rectal cramping, or rectal bleeding
• Dark patches of blood in or on stool; or long, thin, “pencil stools”
• Abdominal discomfort or bloating
• Unexplained fatigue, loss of appetite, and/or weight loss
• Pelvic pain, which occurs at later stages of the disease
Prevention & Early Detection the Best Cure:
In many cases, screening can prevent colon cancer by finding and removing polyps before they become cancer. And if cancer is present, earlier detection means a chance at a longer life. Early detection can often lead to a complete cure. A paper published by the New England Journal of Medicine found a 53% reduction in mortality from colorectal cancer in patients who had precancerous polyps removed during a colonoscopy. The 5 year survival rate for colon cancer when found at the local stage is 90%, when found at the regional stage 70%, and when found at the distant stage only 12%.
Recommended Screening Tests and Intervals:
• High-sensitivity fecal occult blood test (FOBT), which checks for hidden blood in three consecutive stool samples, should be done every year.
• Flexible sigmoidoscopy, where physicians use a flexible, lighted tube (sigmoidoscope) to look at the interior walls of the rectum and part of the colon, should be done every five years with FOBT every three years.
• Colonoscopy, where physicians use a flexible, lighted tube (colonoscope) to look at the interior walls of the rectum and the entire colon, should be done every 10 years. During this procedure, samples of tissue may be collected for closer examination, or polyps may be removed. Colonoscopies can be used as screening tests or as follow-up diagnostic tools when the results of another screening test are positive.
For most adults, screening should begin at age 50. If you or a family member has a history of Colon Cancer, inflammatory bowel disease (Crohn’s disease or ulcerative colitis), Lynch Syndrome, hereditary nonpolyposis colorectal cancer, you may need to begin screenings earlier and be tested more frequently.
Between 2002 and 2010, the percentage of adults (50 to 75 years old) in the United States who had received adequate screening for colorectal cancer increased from 52.3 to 65.4 percent. However, 28 million American’s remain out of compliance with screening recommendations.
We’ve made good strides in reducing the number of lives taken by colorectal cancer in the past decade. The Centers for Disease Control and Prevention (CDC) reported that the colorectal cancer death rate fell by an average of 3 percent per year from 2003 to 2007 — meaning this disease took the lives of 31,800 fewer Americans than expected during this period. Half of that decrease can be attributed to more people being screened. But colorectal cancer remains the second-leading cancer killer of men and women combined in the U.S.
More than 51,000 Americans are expected to die from colorectal cancer this year alone. We can reduce that number by 60% if everyone who should be screened for colorectal cancer gets screened. Recommended screening could save the life of 30,600 Americans this year!!! That number exceeds the capacity of FAU stadium.
Daniel Lindenberg, MD, PA
Board Certified Gastroenterologist