March is Colorectal Cancer Awareness Month. But what is colorectal cancer? How common is it, what are the risk factors and how do you screen for it and treat it?

What is Colorectal Cancer?

Colorectal cancer (CRC) is cancer of the colon or rectum. It is usually called colon cancer, but can sometimes be referred to as bowel cancer, or rectal cancer if the cancer began in the rectum.

Although diagnosis and death rates have reduced over time, colorectal cancer is still the third most commonly diagnosed cancer in both men and women in the United States, with almost 150,000 new cases estimated for 2022.

Risk Factors For Colorectal Cancer

Men have a chance of 1 in 23 (4.3%) of developing colorectal cancer in their lifetime; women 1 in 25 (4.0%).

Colorectal cancer has similar risk factors to other cancers like breast cancer and ovarian cancer. Improving or removing these lifestyle risk factors altogether could decrease your odds of being diagnosed with colorectal cancer:

• Obesity
• Not following a healthy diet that includes fruits, vegetables, fiber, and whole grains
• Diets containing high amounts of red or processed meat
• Lack of physical activity
• Diets containing food cooked at very high temperatures
• Smoking
• Low Vitamin D blood levels
• Drinking alcohol

21 Risk Factors For Breast Cancer

Colorectal cancer risk factors that cannot be changed include:

• Getting older
• A personal, previous history with colorectal cancer or colorectal polyps
• A personal history with inflammatory bowel disease, including Chron’s disease and ulcerative colitis
• A family history of colorectal cancer or colorectal polyps
• Certain inherited genetic mutations (such as those that cause Lynch syndrome and familial adenomatous polyposis)
• Being of African-American descent
• Being of Ashkenazi Jewish descent
• Having Type 2 Diabetes

How Do You Screen For Colorectal Cancer?

One of the most important and easiest things that you can do to fight colorectal cancer is to get screened and identify pre-cancerous polyps in the colon before they become cancer. Cancer screenings help diagnose the disease earlier, in its more treatable stages, when treatments are more effective and survival rate is higher.

Most adults should begin screening at the age of 45, but those at higher risk should talk to their doctor about beginning earlier. While colonoscopies are the most common screening method, other methods include:

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

If you believe you or your family have an inherited genetic disease or syndrome that may increase your risk for colorectal cancer, a genetic test might reduce stress, answer questions, and help determine an appropriate cancer screening schedule.

How Do You Treat Colorectal Cancer?

The treatment for colorectal cancer depends on the stage and location and can include surgery, radiation treatment, chemotherapy, immunotherapy, or any combination of these.

Colon Cancer Treatment

• In Stage 0, often removal of the tumors through a single colon surgery is the only treatment needed.
• In Stage 1, polyps can be removed in one or multiple surgeries. If the cancer is not in a polyp, removal of part of the colon (called a partial colectomy) plus removal of the nearby lymph nodes, is the most common treatment.
• In Stage 2, a partial colectomy and removal of the lymph nodes is often the recommended treatment, sometimes with chemotherapy afterwards.
• In Stage 3, the cancer has spread to the lymph nodes, but not beyond. A partial colectomy with lymph node removal and chemotherapy afterwards is the standard treatment for this stage, sometimes with additional radiation therapy.
• In Stage 4, the cancer has spread to other organs. If it has spread too much for surgery to be used as a treatment, chemotherapy is the common option. For those with certain genes, immunotherapy can be used. For more advanced cancers, radiation therapy is used.

Rectum Cancer Treatment

• In Stage 0, the cancer has not gone beyond the rectum’s inner lining. Usually surgical removal of the polyp (polypectomy), transanal resection, or local excision is the only treatment needed.
• In Stage 1, the cancer has gone to the deeper layers of the rectum, but has not spread outside the rectum. For healthy individuals one or several surgeries may be needed to remove the cancer. Those that cannot handle surgery might be treated with chemotherapy and radiation.
• In Stage 2, the cancer has spread through the walls of the rectum, but not to the lymph nodes. Stage 2 patients are usually treated with a combination of surgery, radiation and chemotherapy, with the order of the treatments depending on their situation.
• In Stage 3, the cancer has spread to the lymph nodes but not to other areas of the body. Those in this stage are also treated with a combination of surgery, radiation and chemotherapy.
• In Stage 4, the cancer has spread to other areas of the body such as the lungs or liver. In this stage, chemotherapy and radiation are the primary treatments with surgery as an option if tumors are small enough or not as widespread. Like colon cancer, those with certain genes might be treated with immunotherapy. Embolization or ablation, techniques that destroy cancer cells using chemicals, cold, or radio frequencies, can be used on smaller tumors.

Colorectal cancer is a serious cancer in the United States, made more serious by insurance coverage differences. Regardless of whether you are insured, uninsured, or under-insured, remember to practice healthy lifestyle choices, get your cancer screenings, and follow treatment advice from your oncology team. If you cannot afford screenings or treatment, contact us. We help link people to free and reduced cost treatments and screenings.

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Have questions about colorectal cancer? SHAREing & CAREing is a Queens-based cancer non-profit founded by survivors to support patients, previvors, survivors, loved ones, and caregivers. We are here to support you. Contact us for individual support, attend a monthly support group meeting or join our online Facebook group. We offer free patient navigation services, links to free and reduced cost medical care, transportation assistance, and educational prevention workshops offered to schools and the community.

Sources

• “Key Statistics for Colorectal Cancer,” American Cancer Society
• “Colorectal Cancer Risk Factors,” American Cancer Society
• “What Should I Know About Screening?” Centers For Disease Control and Prevention (CDC)
• “Treatment of Colon Cancer By Stage,” American Cancer Society
• “Treatment of Rectal Cancer, By Stage,” American Cancer Society

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