Colorectal Cancer: Prevention and Screening Tips

Colorectal cancer is the third most common cancer in the United States and the second leading cause of cancer death overall. Alarmingly, it is now the leading cause of cancer death in people under age 50.

Colorectal cancer also affects communities differently. Rates are 20% higher in Black Americans compared to White Americans.

Before we talk about prevention and screening, let’s start with the basics.

What is colorectal cancer?

Colorectal cancer (CRC), sometimes called colon cancer, develops in the colon (large intestine or large bowel) or the rectum. Over time, abnormal growths called polyps can form in the colon or rectum. While most polyps are harmless at first, some can slowly turn into cancer if they aren’t removed.

That’s why regular screening is so important.

According to the Centers for Disease Control and Prevention (CDC), screening tests allow doctors to find and remove polyps before they become cancerous. Screenings can also detect colorectal cancer early, when treatment is most effective.

What are the symptoms of colorectal cancer?

In its early stages, colorectal cancer often causes no symptoms at all. That’s why screening can be life-saving, especially for people who feel healthy but may have polyps or early cancer without knowing it.

When symptoms do appear, they may include:

• Change in bowel habits
• Blood in or on your stool
• Diarrhea or constipation
• Unexplained weight loss
• Persistent abdominal pain

If you notice any of these symptoms, speak with your healthcare provider.

Who is at risk for colorectal cancer?

Your risk increases as you get older. About 90% of colorectal cancer cases occur in people age 45 or older, but age is not the only factor.

Other risk factors include:

• A personal family history of colorectal cancer or colorectal polyps
• Certain genetic conditions, such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome)
• Inflammatory bowel disease

Lifestyle factors can also raise your risk, including:

• A sedentary lifestyle
• Diets low in fruits and vegetables
• Low-fiber, high-fat diets or diets high in processed meats
• Being overweight or obese
• Alcohol and tobacco use

How can I reduce my risk of getting colorectal cancer? 

Screening, starting at age 45, is the most effective way to reduce your risk.

Nearly all colorectal cancers begin as precancerous polyps. These polyps can remain in the colon or rectum for years without causing symptoms, which makes them especially dangerous. The good news? When found early, polyps can be safely removed before they ever turn into cancer.

Early detection is key. Treatment works best when colorectal cancer is caught early.

Colorectal cancer statistics

• During the COVID-19 pandemic in 2020, many people delayed routine care. Colorectal cancer screening rates dropped by 86%, leading to 32% fewer new diagnoses. Experts estimate this could result in 4,500 additional colorectal cancer deaths over the next decade.

• Since 2005, research has shown that race and ethnicity impact colorectal cancer risk. Black Americans are more often diagnosed at later stages and have the highest death rate from colorectal cancer. Current guidelines recommend that Black Americans begin screening at age 45.

• Research in 2021 confirmed a significant rise in early-onset colorectal cancer (EOCRC) –diagnoses occurring in people under age 50.

When should I speak with my doctor about colorectal screening?

You should speak with your doctor about colorectal cancer screening if:

• You are 45 or older.

• You have an increased risk due to family history, genetics, or other factors.
  

Common screening options include:

• Stool tests
• Flexible sigmoidoscopy
• Colonoscopy
• CT colonoscopy (virtual colonoscopy)

Your doctor can help you decide which screening option is right for you.