Colorectal Cancer Overview

Colorectal cancer is the second leading cause of cancer-related deaths for both men and women combined.

Over 50% of all new cases of colon cancer involve metastatic spread to other organs and parts of the body at the time of diagnosis.
Over 100,000 Americans will be diagnosed with colon cancer this year.
Approximately 50,000 Americans will die from colon cancer this year.
80 to 90 million Americans are at risk of developing colon cancer.
If colon cancer is detected and treated early, the survival rate is high.

Risk Factors

Risk factors of colon cancer include:

Age 50 and older.
Male 50 and older.
Personal or family history of inflammatory condition in the intestines, such as Irritable Bowel Syndrome, Ulcerative Colitis or Chron’s Disease.
A family history of colorectal cancer.
Having a diet high in fat and low in fiber.
Smoking tobacco.

Colorectal cancer is usually a slow-growing cancer that typically develops as pre-cancerous polyps in the lining of the colon. If the polyps are allowed to continue to grow and are not removed by either a colonoscopy or sigmoidoscopy some may become malignant (i.e., turn into colon cancer). Because colorectal cancer may become incurable once the disease has metastasized or spread outside the intestine, it is important for doctors to use early detection measures.

Common colorectal cancer symptoms include:

Bloody stools.
Change in bowel patterns.
Narrow stool.
Diarrhea or constipation.
Gas pain.

However, colorectal cancer, especially in its early stages, often has no symptoms.

Common Types of Colorectal Medical Malpractice

There are many reasons GI doctors and other health providers fail to properly diagnose colorectal cancer. These include:

Failing to recommend and/or order timely screening.
Failing to respond to a patient’s complaints.
Failing to detect cancer and remove polyps during the colonoscopy procedure.
Failure of a family doctor to refer the patient to a GI doctor.
Performing a colonoscopy on a patient who has not sufficiently cleaned his/her colon before the procedure.

Most cases of colon or rectal cancer are diagnosed in patients ages 55 to 84. Almost all colon cancers (95%) are adenocarcinomas. The balance of colon cancers include carcinoid tumors, lymphomas, melanomas, leiomyosarcomas or gastrointestinal stromal tumors.

AMERICAN CANCER SOCIETY UPDATES COLORECTAL CANCER SCREENING GUIDELINES

The American Society (ACS) recently released an updated guideline for colorectal cancer screening (/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html). Among the major guideline changes, the new recommendations begin screening at age 45 (as opposed to age 50) for people at average risk for developing colorectal cancer.

For people of average risk, the ACS lowered the age to start screening after analyzing data from a major analysis led by ACS researchers (/latest-news/study-finds/sharp-rise-in-colon-cancer-and-rectal-cancer-rates-among-young-adults.html). This analysis revealed that new cases of colorectal cancer are occurring at an increasingly alarming rate among younger adults. After reviewing this data, experts on the ACS Guideline Development Committee concluded that a beginning screening age of 45 of adults of average risk for developing colorectal cancer will result in more lives saved

New Screening Age Recommendations for Those at Average Risk

People at average risk of colorectal cancer should start regular screening at age 45.
People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75.
Peoples ages 76 through 85 should make a decision with their medical provider about whether to be screened, based on their own personal preferences, life expectancy, overall health, and prior screening history.
People over 85 should no longer get colorectal cancer screening.

Recommended Colorectal Cancer Screening Tests

Several test options are available for colorectal cancer screening:

Stool-based tests:
Highly sensitive fecal immunochemical test every year.
Highly sensitive guaiac-based fecal occult blood test every year.
Multi-targeted stool DNA test every 3 years.
Visual exams:
Colonoscopy every 10 years.
CT colonography (virtual colonoscopy) every 5 years.
Flexible sigmoidoscopy (FSIG) every 5 years.

The guidelines stress that these screening tests must be repeated at regular intervals to be effective. And, if you choose to be screened with a test other than colonoscopy, any abnormal test result must be followed up with a timely colonoscopy to complete the screening process.

What about those at higher than average risk?

The guidelines also say that people at higher than average risk might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests. People at higher or increased risk are those with:

A strong family history of colorectal cancer or certain types of polyps (/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html)
A personal history of colorectal cancer or certain types of polyps.
A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease).
A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP).
A personal history of radiation of the abdomen (belly) or pelvic area to treat prior cancer.

If you or a loved one has been diagnosed with colorectal cancer, questions may exist about your prior medical care. Call us as we can help you find answers to these questions. We understand that a delay in the diagnosis of colorectal cancer may make a big difference in a patient’s outcome.