March is Colorectal Cancer Awareness Month

By K. Agyei-Gyamfi, MD

Colorectal cancer screening means searching for colon and rectal tumors in those without symptoms and at risk patients with no history of colon or rectal polyps or cancer. Colon and rectal cancer are the third most common cancers in this country. The fight to defeat colorectal cancer is never ending. It has impacted many lives and families in our community.

During March as Colorectal Cancer Awareness Month, we raise awareness that this type of cancer is preventable and can reduce mortality. 

The American Cancer Society’s National Colorectal Cancer goal is to reach colorectal cancer screening rates of 80% and higher in all communities across the nation. Our community has not reached this goal yet and there is a lot of work to be done. More awareness is needed to encourage more patients to get screened, as screening is the best way to achieve this goal.

Who is at risk in our community?

Colorectal cancer affects people of all ages, races, ethnicities, and sexes, it does not always affect them equally.

• Age : The older you are the higher your risk. This is the most important risk. However there has been an increase in colorectal cancer detection at younger age groups known as Early Onset Colorectal Cancer (EOCRC). This has been found in people born from 1960. More cancers are being detected in those between the age 40 – 50 years.
• Sex: Men have higher risk than women.
• Race: African Americans, American Indians, Alaskan Indians are at higher risks. This makes up a larger percentage of our community.
• Family history: Family history of colon cancer or genetic syndromes, ie parents, brothers and sisters and children, puts you at increased to 100% risk.
• Lifestyle: Physical inactivity, excessive alcohol use, smoking.
• Diseases like obesity, Crohn’s disease of colon, ulcerative colitis
• Environment: Exposure to synthetic dyes, Red and processed meat, high fructose diet.

What are the symptoms of colorectal cancer?

Early cancers don’t show any symptoms. Advanced cancers show up as rectal bleeding, change in bowel habits, weight loss, abdominal pains.

Screening is defined as testing an asymptomatic patient. Early detection of cancer in asymptomatic patients is the best way to reduce mortality of this killer.

Who should get screened?

As already stated, age is the most important risk factor, especially for those ages 45 to 75. Seventy five percent of colon cancer patients don’t have a family history of colon cancer.

Why was the starting age changed from 50 years to 45 years in average risk population?

There has been increasing incidence of early-onset colorectal cancer. Ten percent of all new diagnoses of this cancer, with accompanying increase in mortality, has been noted since 1988. It is estimated that 25% of rectal cancers and 10 -12% of colon cancers will be diagnosed in persons younger than 50 years of age in the years to come. By 2030, the incidence is projected to be higher. Most times the tumors are advanced, leading to higher risk of morbidity and mortality.

When do you have to get screened earlier than 45 yrs?

Knowing your immediate family history is very important. If any member of the family ever had a colorectal polyp or cancer before the age of 60, screening should start at 40. If earlier than 45, screening will start 10 years prior to the diagnoses of the immediate family member.

Approximately 25% of patients with early onset colorectal cancer have hereditary syndromes. Genetic studies are always advised on the tumors or blood tests on these patients to assess risk as their immediate relatives may need to be tested for the same genes. These patients may need to be screened in their teenage years or in their 20s.

Delayed diagnoses in younger patients and presentation with advanced disease stages underscore the need for greater awareness of this disease on the part of the general community as well as the healthcare providers

Remember, Colorectal cancer is preventable and can be detected early enough to save your life. Don’t wait to develop colorectal cancer. Knowing your risk is extremely important! If you are not sure, talk to your medical provider to guide you on when to start screening.  

Gastroenterologist Dr. Kwadwo Agyei-Gyamfi is affiliated in private practice with Acme Medical Specialties in Lumberton and is a member of the UNC Health Southeastern Medical Staff.