HealthONE - January 07, 2021

Colon Cancer Third Leading Cause of Death, Increasing Cases in Younger Patients

Experts encourage education of risk factors and symptoms to prevent deadly cases.

When it comes to colon cancer, 45 might be the new 50. Recently, the US Preventative Services Task Force (USPSTF) submitted a recommendation that colon cancer screening should begin at age 45, instead of the previously recommended age 50. The update, which is still in draft form until the end of the month, was made in light of a trend of higher rates of colon cancer in those born since 1950. The American Cancer Society previously made similar changes to its guidelines.

Colorectal cancer is the third most commonly diagnosed cancer in the United States, and the third leading cause of death among men and women combined. Experts are urging men and women of all ages to become familiar with the risk factors and symptoms of colon cancer. With this knowledge and regular screening exams, more cases will be detected at an earlier and more treatable stage.

“Colon cancer occurs in the final part of the digestive tract—the large intestine, also called the colon,” explained Daine Bennett, MD, a colorectal cancer surgeon with the Sarah Cannon Cancer Institute at Swedish Medical Center. “Colon cancer arises from polyps. Polyps are small benign growths that can grow into cancer over time. Colon polyps are common. Approximately 25-40% of people over 45 years-old will have polyps.” However, with early detection through screening, these polyps can be removed with colonoscopy, and the cancer risk can be mitigated.

Know Your Risk

Colon cancer can affect any patient, regardless of gender, age, or race. But those with a higher incidence are often: male, ages 50 years and old, of African American descent, have a history of cancer or polyps, have a history of inflammatory intestinal conditions, or have a family history of cancer. “While these particular risk factors cannot be altered, we encourage you to talk openly with your doctor about your risk and the possibility of beginning screening and observation earlier than the current recommendations,” Dr. Bennett said. However, there are some ways that further risk can be reduced. Dr. Bennett suggests:

  • Maintaining a healthy weight
  • Drinking alcohol in moderation
  • Stop smoking
  • Eat a diet rich in fruits, vegetables, and whole grains; low fat, high fiber is best
  • Exercise most days

Be Aware of Symptoms

In addition to understanding your risk and taking steps to live a healthy lifestyle, experts encourage everyone to have a good understanding of the symptoms of colon cancer so that they may be reported to your physician as quickly as possible. These symptoms include:

  • Change in bowel habits (anything from constipation to unexplained diarrhea)
  • Abdominal pain including cramps, gas, and other pain
  • Narrow stools
  • Blood in the stool/ rectal bleeding
  • Iron-deficient anemia
  • Unexplained weight loss
  • Unproductive need to have a bowel movement

“If you experience these symptoms, take note and reach out to your physician for further advice and information,” Dr. Bennett suggested. “There is no need to panic—many of these symptoms can be caused by something more benign, but it is important to report them and keep in communication with your health care provider.”

Get Screened Regularly

There are multiple options for colon cancer screening. A regular screening schedule may include one or more of the following tests:

  • Fecal immunochemical test (FIT): a stool test that can be performed annually
  • Guaiac-based fecal occult blood test (gFOBT): a stool test that can be performed annually
  • FIT-DNA test: stool test that combines the FIT test with a test that detects altered DNA and is done once every one or three years
  • Flexible sigmoidoscopy: this test involves a thin, flexible lighted tube inserted into the rectum to find the presence of polyps or cancer in the rectum and lower third of colon
  • Colonoscopy: this test uses a thin, flexible, lighted tube to check for polyps or cancer inside the rectum and entire colon
  • CT colonography: this test is also called a virtual colonoscopy and uses X-rays and computers to produce images of the entire colon for review

While CT colonography and DNA stool test can identify colon cancer that has already developed, these test are not as reliable to find polyps. Colonoscopy remains the gold standard for colon cancer screening. Colonoscopy also has the added benefit of polyp removal during the exam preventing them from developing into cancer. Patients and their doctors should consider each of these tools and make a plan for screening based on the patient’s medical needs, preferences and availability.

"The most important thing is to know your risk for colon cancer, be aware of the symptoms and have a conversation with your doctor about screening,” Dr. Bennett implored. “When detected early, we often can remove and eradicate the cancer before it spreads, which allows patients to go on to live healthy lives."

To learn more about colon cancer, visit Sarah Cannon. To learn more about treatment at Sarah Cannon Cancer Institute at Swedish Medical Center, visit our oncology page.