Colorectal Cancer Awareness and Prevention

Colorectal Cancer Awareness Month occurs every March in the U.S. Therefore, this article will highlight the importance of this disease. Colorectal cancer is a disease in which malignant cells form in the tissue of the colon or rectum. Colorectal cancer is the second leading cause of death from cancer in the U.S. Cancer, in general, is second to heart disease as the cause of death from all causes in our nation. In fact, the data shows that one in every four deaths in the U.S. is due to some form of cancer. The number of new cases of colorectal cancer has decreased in recent years. However, in adults younger than 50 years of age, the number of new cases has slowly increased. The number of new cases and deaths from colorectal cancer are higher in African Americans than in other races. In light of these facts, prevention and early detection via screening become very important.

Cancer prevention is action taken to lower the chance of getting cancer in a group or population. Hopefully, this will lower the number of deaths caused by cancer. Scientists look at risk factors to prevent new cancers from starting. Anything that increases your chance of developing cancer is a risk factor. Anything that lowers your chance of developing cancer is a protective factor. Some risk factors can be avoided and others cannot. For example, smoking can be avoided, but inherited genes cannot. Regular exercise and a healthy diet are protective factors you can control. Avoiding risk factors and increasing protective factors may lower your risk, but it doesn’t mean that you won’t get cancer at all. Risk factors for colorectal cancer include the following: 1. Age – The highest risk occurs after age 50. 2. Family History – Having a parent, sibling or child with CR cancer increases your risk. 3. Personal History – Having previous CR cancer or high risk adenomas (polyps that are 1 cm or larger and look abnormal under the microscope) increases risk. Also a history of having ovarian cancer or inflammatory bowel disease increases risk. 4. Inherited risk – Certain gene changes, when inherited, including those linked to familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC), increase one’s risk. 5. Alcohol consumption, especially more than 3 drinks per day increases risk of large adenomas, which can become cancerous. 6. Cigarette smoking – This increases the occurrence and death rate from CR cancer. 7. Obesity – This is linked to increased occurrence and death rate of CR cancer.

Cancer protective factors include 1. Physical activity – decreases risk of CR cancer. 2. Aspirin – Several large clinical studies have shown that taking an aspirin tablet daily for 5 years did lead to a decreased risk for occurrence of CR cancer and decreased death from same. In another large study of women, taking an aspirin tablet every other day for 10 years also decreased the risk of CR cancer. One should get advice from your physician, however, before taking aspirin. 3. Polyp removal – While most colorectal polyps are adenomas, removal of them 1cm or larger provides protection from CR cancer. Polyps are detected via colonoscopy, which is advised for men and women age 50 and older every 10 years or more frequently if certain risk factors are present. In spite of what one reads in some popular health magazines and newspapers, real scientific studies of the effects of specific diets, vitamins and calcium as protection against CR cancer are still in the investigative, but inconclusive phase.

The National Cancer Institute has a program called Screen for Life: National Colorectal Cancer Action Campaign. It informs men and women aged 50 years and older about the importance of CR cancer screening. Screening tests help find pre-cancerous polyps so they can be removed before they have a chance to turn into cancer. According to the CDC, about 1/3 of adults aged 50 or older (the group at greatest risk of developing CR cancer) have not been screened. The CDC has a program called Colorectal Cancer Control Program (CRCCP) which provides funding to 25 States (including Georgia) and 4 Indian tribes across the US. Its goal is to increase colorectal cancer screening rates from 64% to 80%. An increase in screening rates will reduce illness and death from CR cancer.

“A prudent man sees danger and takes refuge; but the simple keep on going and suffer for it.” (Proverbs 22:3)

John W. Downing, Jr., M.D.