By Ernst Lamothe Jr.
The numbers are scary. For those who are diagnosed with late stage colon cancer, the five-year survival rate is an abysmal 12 percent, according to the American Cancer Society.
Colorectal cancer can start in the colon or in the rectum and begins as growths in the inner lining. The growths — called polyps — can change into cancer over time, although not all polyps become cancer.
This year alone, more than 145,000 new colon and rectal cancer cases are expected to be detected and more than 51,020 people will die from the disease. That figure takes on even more weight considering what medical experts have been telling patients for decades — colorectal cancer is highly preventable.
“With early screening programs, precancerous growth in the colon can be detected and removed,” said Borys Buniak, gastroenterologist at St. Joseph’s Health.
Buniak offers five pieces of information people need to know about colon cancer.
1. Family history is important
There is no way to know for certain if you will develop colon or rectal cancer, but there is a variety of factors that may increase your risk for these cancers. One is age — the risk of cancer of the colon and rectum increases with age. You are at a higher risk if you are over the age of 50, for example. Having a close family member (parents, brothers, sisters, or children) with colon and rectum cancer history is another risk.
Understanding the importance of early screening, the American Cancer Society and the American College of Gastroenterology recommend beginning screening for colon cancer at the age of 45.
“If there is a strong family history of colon cancer, screening should start even earlier,” said Buniak.
2. Different types of screenings
Screening tests can detect colon and rectal cancer at its earliest, most treatable stage. A colonoscopy looks for precancerous growths or polyps by placing a thin tubular camera into the rectum and passing it through three to four feet of colon. The procedure is usually performed under anesthesia and typically takes 10 to 15 minutes to complete.
It is important to consult your doctor if you experience a change in bowel habits — such as diarrhea or constipation — or have a feeling that your bowel is not emptying completely or there is a narrowing of the stool. Other feelings include an enlarged abdomen, weight loss for no known reason, nausea or feeling of bloating.
The five-year survival rate for colon cancer found at the early stage is 90 percent, according to the Colon Cancer Alliance.
Once a person reaches 50 years of age, most routine, preventable screening colonoscopies are covered with no co-pay under the Patient Protection and Affordable Care.
“Screening may involve something as simple as submitting a yearly stool specimen at your doctor’s office,”said Buniak. “Colonoscopy, virtual colonoscopy and barium enema examines the colon directly. Recently, a more sensitive screening tool was introduced, called Cologuard. For this test, your doctor will order a container delivered to the privacy of your home where a stool sample is submitted and mailed back to the company for genetic testing. They will alert you if you are high risk of having a polyp or cancer. This test could be repeated every three years.”
3. Trends are going down
The death rate from colorectal cancer has been dropping in both men and women for several decades. In addition, treatment for colorectal cancer has improved over the last few decades. As a result, there are now more than one million survivors of colorectal cancer in the United States.
“The death rate from colon cancer has declined from 54.5 per 100,000 individuals in 2000 to 38.6 per 100,000 in 2014, thanks to early detection and screening,” said Buniak.
Although the overall death rate has continued to drop, deaths from colorectal cancer among people younger than age 55 have increased 1 percent to 2 percent per year from 2007 and 2016, according to the American Cancer Society. It’s expected to cause about 51,020 deaths during 2019.
4. Early colon cancer is not cancer
A colon polyp is a small clump of cells that forms on the lining of the colon. Most colon polyps are harmless. But over time, some colon polyps can develop into colon cancer, which is often fatal when found in its later stages. Colon polyps often don’t cause symptoms.
“People with early colon cancer or polyps have no symptoms,” said Buniak. “That’s why early screening is so important. In later stages, you may develop blood in the stool, change in bowel habits, anemia or weight loss. Colon cancer, when it’s detected early, is curable”
5. Low number of people get screened
Only 58 percent of people are screened regularly. “Many decline screening due to embarrassment of the examination or fear of complications like perforation of the colon or bleeding,” said Buniak. “ If a small polyp is found and removed during the colonoscopy, or if there is a family history of colon cancer or polyps, colonoscopies are recommended every five years. If polyps are not found and there is no family history of colon polyps, colonoscopies could be performed every 10 years.”