By Steven Scarcliff, MD
March is Colorectal Cancer Awareness Month, a time dedicated to bringing awareness to the third most commonly diagnosed cancer among men and women in the U.S. According to the Colorectal Cancer Alliance, more than 1.4 million colorectal cancer patients and survivors are alive today, but a recent finding related to the pandemic is causing concern that could adversely affect this number.
The Colorectal Cancer Alliance estimated last year that pandemic fears caused the number of colonoscopies to drop sharply by 86 percent. This, in turn, could lead to an uptick in diagnoses and affect patient outcomes.
It’s important to get back on track and schedule any screenings that were postponed over the last year. Hospitals have taken appropriate steps and implemented protocols to continue to provide safe care throughout the pandemic. Colorectal cancer screenings (colonoscopies) are crucial in finding small growths inside the colon known as polyps, which are often precancerous. Polyps do not typically lead to clinical signs and symptoms.
Approximately one-third of all adults with no risk factors will develop a polyp at some point. When found early, doctors can remove these polyps before the cancer starts. Colonoscopies are also key to finding cancer in early, more treatable stages.
Colorectal cancer is more common among those over 50 and the risk increases as we age. However, in recent years there has been an uptick in colorectal cancer among younger adults. The death of actor, Chad Boseman, in August 2020 helped to highlight this somber finding. Moreover, African-Americans have the highest incidence rates of colorectal cancer and highest morbidity rate.
So how often do you need a colonoscopy and at what should you begin screenings? The American Cancer Society recommends that adults without a family history begin colorectal cancer screening at age 45. If you’re at normal risk, most physicians recommend a screening every 10 years. You may be at greater risk for colorectal cancer if you previously had colorectal cancer or some types of polyps, have inflammatory bowel disease, a family history of colorectal cancer or polyps, or have a family history of hereditary colorectal cancer.
While colonoscopies provide the most important diagnostic tool of colorectal cancer, there are ways to help foster prevention. A recent paper published by the American Cancer Society, Colorectal Cancer Statistics 2020, indicates more than one‐half of all cases and deaths are attributable to modifiable risk factors. Some risk factors for colorectal cancer, like being over 50 or having a family history of the disease, you can’t change. It’s essential to focus on controlled behaviors to help reduce your risk, such as eating less red meat and processed meats. Add more vegetables, fruits and whole grains to your diet. Maintain a healthy weight, exercise regularly, stop smoking and limit your alcohol consumption.
Note colorectal cancer might not cause symptoms right away, which is yet another reason why screenings are so critical in early detection. If and when symptoms present, they can include a change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days. A feeling you need to have a bowel movement that’s not relieved by having a movement or rectal bleeding with bright red blood or blood in the stool, which might make the stool appear dark brown or black, are among other symptoms.
Over time, the blood loss can build up and can lead to low red blood cell counts, known as anemia. Sometimes the first sign of colorectal cancer is a blood test showing a low red blood cell count. Cramping or abdominal pain, weakness and fatigue, and unintended weight loss are among other symptoms. Many of these symptoms can be caused by conditions other than colorectal cancer, such as infection, hemorrhoids or irritable bowel syndrome. Colonoscopy remains the gold standard in evaluating the colon, identifying/removing polyps and ultimately preventing colon cancer.
Remember, colorectal cancer is preventable and highly treatable, but it’s important to find it in the early, more treatable stages. Talk with your doctor about your medical history and colorectal cancer screenings.
Steven Scarcliff, MD FACS FASCRS, is affiliated colorectal surgery specialist with Princeton Baptist Medical Center
