By: Asif Zamir, MD, FACG
DHR Health Gastroenterology Institute
Globally, colorectal cancer [CRC] is the third most commonly diagnosed cancer in males and the second in females. Annually, approximately 52,980 Americans die of CRC, accounting for approximately eight percent of all cancer deaths.
There are numerous risk factors that contribute to colon cancer, but age is the major factor. It is uncommon to see colon cancer prior to age 40, though some registries report a rising incidence of CRC even among young adults 20 to 39 years of age, even though the absolute number of cases in this age group remains far lower than for adults aged 50 or over. Other risk factors include smoking, alcohol use, obesity, inflammatory bowel disease, low fiber and high fat diet, sedentary behavior, occupational exposure to carcinogens, h/o abdominal radiation, and genetic syndromes that make a person susceptible to developing colon cancer. Family history of CRC, an advanced polyp with dysplasia, or family history of polyps >1 cm in size are also some other risk factors.
Given the significantly high incidence of colon cancer, several screening methods have been developed. The primary goal of colorectal cancer screening is to prevent deaths from colorectal cancer. A colorectal screening can help identify cancer early thus, making colorectal cancer potentially curable if caught at an early stage. Screening can also prevent colon cancer by identifying and removing precancerous, abnormal growth called polyps before they become malignant. People with an average risk of colorectal cancer should begin screening at age 50. Numerous screening modalities exist, but colonoscopy is the most common and reliable method. People at risk due to family history of colon cancer need to start CRC screening earlier (at age 40, or 10 years younger than the earliest diagnosis in the family, whichever comes first).
Once colorectal cancer is diagnosed, the next step is to determine its stage. Colorectal cancer stages range from stage I (cancer has invaded into, but not through, the entire wall of the intestine) to stage IV (the cancer has spread or “metastasized” to distant organs, such as the liver or lungs). Earlier stages of disease (stages I through III) are referred to as localized colorectal cancers and are generally treated with surgery, with or without chemotherapy. Stage IV cancer is called advanced colorectal cancer and is generally treated with palliative chemotherapy; some patients may benefit from surgery of the primary tumor prior to treatment of metastatic disease, especially if the primary tumor is causing symptoms.
If you would like more information or to schedule an appointment for a screening, please call the DHR Health Gastroenterology Institute at (956) 362-3636.