March is Colorectal Cancer Awareness Month. And for most of us, colorectal cancer is an embarrassing topic to discuss. Breast, lung and testicular cancers have lost their public taboo, partly due to celebrities bringing national attention to these deadly diseases. But unfortunately, colorectal cancer still seems to be on the list of unmentionables. And excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States.
“However, it’s important for people to know that colorectal cancer is preventable, treatable and curable,” said Dr. Harry T. Papaconstantinou, chief of the section of colon and rectal surgery at Scott & White Healthcare. “The key is through appropriate cancer screening, including colonoscopy.”
The American Cancer Society’s most recent estimates for the number of colorectal cancer cases in the United States for 2010 are:
• 102,900 new cases of colon cancer (49,470 in
men and 53,430 in women)
• 39,670 new cases of rectal cancer (22,620 in
men and 17, 050 in women)
Are You At Risk?
One third of all adults will develop colorectal polyps, which often turn into cancer, by age 50. That number increases to half by the age of 70. Although the exact cause of colorectal cancer is not known, there are some factors that increase a person’s risk of developing the disease. These include:
• Age. This disease is more common in people over
50, and the chance of getting colorectal cancer
increases with each decade.
• Gender. Women have a higher risk for colon
cancer, and men have a higher risk for developing rectal cancer.
• Polyps. Polyps are fairly common noncancerous growths on the
inner wall of the colon or rectum. Adenoma polyps are noncancerous
precursors to colon and rectal cancer.
• Personal history. Women with a history of ovarian, uterine or breast
cancer have a somewhat increased risk of developing colorectal cancer.
Also, a person who already has had colorectal cancer may develop the
disease a second time. Chronic inflammatory conditions of the colon
such as ulcerative colitis or Crohn’s disease place people at a higher risk.
• Family history. If family members have had colorectal cancer, the risk
increases, as does a family history of polyposis, adenomous polyps or
hereditary polyp syndrome.
• Diet. A diet high in fat and calories and low in fiber may be linked to a
greater risk.
• Lifestyle factors. Alcohol, smoking, sedentary lifestyle and obesity may
also increase your risk.
Protecting Yourself
“In a number of people,” Papaconstantinou explains, “there is no identifiable reason why they developed colorectal cancer. Therefore, without a known cause, preventing the disease can be complicated.”
Research suggests that regular screenings, eating a healthy diet with plenty of fiber, not smoking and getting exercise can help in the prevention of colorectal cancer. The following steps can be taken to help reduce your risk:
1. Follow the screening guidelines to help detect colon or rectal cancer. When it is found and treated at an early stage, it can often be cured. Screening can also find pre-cancerous polyps; removing these polyps helps prevent some cancers. The best screening tool currently available is colonoscopy. In this procedure, a physician passes a lighted flexible endoscope (a tube) through the anus, which allows the entire lining of the colon and rectum to be viewed. The intestines must be clean for this test, and the patient receives medication to minimize any anxiety or pain. Any polyps or growths identified can be removed. Several studies have shown that removing polyps can prevent the development of colorectal cancer.
2. Check with your doctor for advice about screening tests or other tests to find cancer early. Current recommendations include a colonoscopy for average risk patients starting at age 50 and every 10 years after the first colonoscopy. A family history, symptoms or other previously discussed risk factors may suggest a colonoscopy at an earlier age or more frequently.
3. Alter your intake of meat, eggs, dairy products and oils used in cooking and salad dressings to reduce fat in your diet.
4. Increase the amount of fiber in your diet by eating more vegetables, fruits and whole-grain breads and cereals.
5. Take a daily multivitamin containing folic acid or folate, which some studies suggest can lower your colorectal cancer risk. Other studies suggest that getting more calcium with supplements or low-fat dairy products can also help.
6. Make sure you get enough exercise. Even small amounts of exercise on a regular basis can be helpful.
“The lifetime risk of developing colorectal cancer in the U.S. is one in 20,” according to Papaconstantinou. “Therefore, if you have symptoms [or] additional risk factors (outlined above), or are over the age of 50, talk to your primary care physician about colorectal cancer screening that is right for you. It’s time to break the taboo associated with colorectal cancer. The life you save may be your own.”
Dr. Harry T. Papaconstantinou is an associate professor of surgery at Texas A&M Health Science Center College of Medicine, and chief of colon and rectal surgery at Scott & White Healthcare. For more information, call 512-509-0200.
