Colorectal Cancer Awareness Month: Don’t Delay Care
March is Colorectal Cancer (CRC) Awareness month - a great reminder to take good care of ourselves and talk to your medical provider. Approximately 140,000 people will be diagnosed with CRC this year, and 56,000 people will die from this disease. Yet, if caught early, it is a highly preventable and treatable disease, and an estimated 40,000 or more lives could be saved through screening and early treatment.
Colorectal cancer, or CRC, occurs when abnormal cells form tumors in normal tissues of the intestines and digestive system. It can start as an abnormal tissue growth, known as a polyp, inside the colon or rectum. If cancer forms in a polyp, it can grow into the wall of the colon over time. The type of CRC depends on where the abnormal cells first began and how fast they grow and spread.
The good news is that through screening tests, doctors can find polyps and remove them, which prevents CRC from developing. Worldwide, CRC is the second-leading cause of cancer death, but unlike many cancers, CRC is often preventable with screening, and highly treatable when detected early.
“Colorectal cancer is the third most common type of cancer,” said Dr. Sudy Jahangiri, who specializes in gastrointestinal (GI) and blood cancers, as well as various blood disorders at St. Mary’s Medical Center. “Everyone could potentially be at risk, especially if you have a family history or genetic predisposition. We’re seeing rising rates in younger people, but typically patients are in their 40s-80s.”
Most CRC cases occur in people ages 45 and older, but the disease is increasingly affecting younger people. Today, more than 1 in 10 CRC patients are under the age of 50. The Centers for Disease Control has changed the screening guidelines to start at age 45 instead of age 50 due to the rise of cases of CRC in younger people.
Screening is the No. 1 way to prevent CRC. It’s also the best way to detect it early, when it’s most treatable. It usually develops over 10-15 years and when it’s detected early, survival rates are as high as 90 percent.
“It’s crucial to catch it early,” said Dr. Jahangiri. “If caught early, it’s very treatable and there are many treatment options. If caught at the later stages, it’s treatable but not curable.”
It is estimated that 1 in 3 people are not up-to-date with screenings, even though 60 percent of CRC deaths could be prevented with screening. There are multiple screening options, including visual exams like colonoscopies and stool-based tests to catch precancerous states. Affordable, take-home options, like Cologuard, are also now widely available.
Dr. Douglas Rock is a radiation oncologist who’s worked at St. Mary’s for 25 years. He specializes in GI, prostate and lung cancer, and works with mostly adults to administer radiation treatment to later stage CRC patients.
“Screenings have come a long way,” said Dr. Rock. “The tests are easier to perform and are much more non-invasive. Unfortunately due to the pandemic, we’ve seen a higher rate of people who’ve neglected screenings that could have detected polyps early on and the patient could’ve had them removed before they turned cancerous. It’s very treatable based on the stage, but the key is to catch it early.”
Warning signs and symptoms of CRC include rectal bleeding, pelvic pain or discomfort, iron deficiency, changes in bowels and rectal pressure.
Many lifestyle-related factors have been linked to CRC. According to the American Cancer Society, the links between diet, weight and exercise and colorectal cancer risk are some of the strongest for any type of cancer.
Risk factors you can control include a diet rich in red meats, processed meats and fatty foods, a diet with little fruit, vegetable and fiber consumption, being overweight or obese, having a sedentary lifestyle, smoking and moderate to heavy alcohol use.
There are also several risk factors you cannot change including being older, having a personal or family history of CRC or a personal history of inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, Type II Diabetes and genetic predispositions.
African Americans have the highest CRC incidence and mortality rates of all racial groups in the U.S. Jewish people of Eastern European descent have one of the highest CRC risks of any ethnic group in the world, and men have a slightly higher risk than women.
While there is no way to completely prevent CRC, there are things you can do to lower your risk. Limit your intake of processed and fatty foods, switch to a more plant-based diet, exercise, maintain a healthy weight, limit your alcohol intake and quit smoking.
“We’ve seen cases decrease slightly over the past 10 years, mostly due to changes in healthy lifestyles,” said Dr. Rock. “Colorado is one of the more healthy states in the country because people here are more active.”
Death rates from CRC have dropped by approximately 55 percent since 1970, due to changes in risk factors, like declines in smoking, screening and better treatment options, according to the American Cancer Society. But, death rates are increasing in adults younger than 55 because of increasing incidence.
“When patients come to me, their cancer is more advanced and they need radiation and chemotherapy,” said Dr. Rock. “My advice to everyone would be don’t stick your head in the sand and don’t delay screening or fear of treatments. They’re much better than they used to be and can truly save your life.”
The stage, or extent of spread, of CRC depends on how deeply it grows into the walls of your colon or rectum and if it has spread outside these areas.
“One concern is it spreading to other parts of the body,” said Dr. Jahangiri. “It is common for colorectal cancer to spread from the colon to the lungs, liver and lymph nodes. It’s important to take your symptoms seriously, even in your 30s, and not delay care when talking to your doctor. Many people put off their screenings and ignored their symptoms due to not wanting to go to the hospital during the pandemic.”
It is crucial to not delay care. If you’re over the age of 45, talk to your doctor about your potential risk and schedule your screening. It is your best defense to lower your chances of developing colorectal cancer.