What You Need to Know About Colorectal Cancer

Colorectal cancer is commonly known as colon and rectal cancer. This type of cancer is characterized by an abnormal growth of cells in the inner lining of the large intestine or rectum, also known as polyps.

There are several types of polyps, but adenomatous polyps and sessile serrated polyps are the polyp types often associated with increased risk for colon cancer. When polyps become cancerous, they can spread through many layers of the colon. If not detected at an early stage, the cancerous cells can spread throughout the rest of the body.

The Center for Disease Control and Prevention (CDC) reports Colorectal cancer as the fourth most common cancer in the United States. The death rate for colorectal cancer is high. It is important to find out what your risk for colorectal cancer is and to get screened for early detection.

What are the risk factors for colorectal cancer?

Family history of colorectal polyps or cancer

Although colorectal cancer is more common in people without a family history, you are still at an increased risk if you have family members who have had it, especially your parents and siblings.

Inflammatory Bowel Disease (IBD) history

People with a history of IBD often develop abnormal cells due to inflammation of the colon. These cells can eventually become cancerous if IBD is left untreated.

Age

Most cases of colon cancer occur at 50 years old and older. However, the rate of colon cancer in younger adults has increased. Colorectal cancer screening is recommended for anyone between 45 and 75 years old by the US Preventive Services Task Force (USPSTF). This range is where a peak in colon cancer rate is observed.

Race

African Americans are at higher risk for colorectal cancer. The risk of death is also high in this population group.

Diet

It is important to eat a balanced diet to reduce the risk of colorectal cancer. Ways to improve your diet include:

• Increase consumption of fruits and vegetables and high fiber options
• Reduce consumption of processed meats and alcohol (~1 to 2 drinks daily)

Smoking

Tobacco use is not only associated with lung cancer, but it can also increase your risk for other types of cancers like colorectal cancer. Talk to your doctor about quitting options to lower your risk.

How do you screen for colorectal cancer?

Polyps and early tumors are often not symptomatic. Waiting for symptoms to develop before talking to your doctor about colorectal cancer is not the best decision. Early detection through screening tests is extremely important in preventing colorectal cancer, worsening stages of cancer, and possibly death.

If you are at increased risk for colorectal cancer, ask your doctor when to get tested and which test is more appropriate for you to take.

There are many testing strategies, here are the most common ones:

Stool tests

• The fecal immunochemical tests (FITs or iFOBTs) test and the guaiac-based fecal occult blood tests (gFOBTs) are done once a year and they screen for blood in the stool. The presence of blood is a sign that there is a bleeding polyp that can later become cancerous. These two types of tests are available at most of your local pharmacies. The gFOBTs are the cheapest over-the-counter tests. The iFOBTs are more expensive, but they are often covered by your insurance. If your test results are positive, go see your doctor. Your doctor will require more tests to confirm the location of your bleeding.
  
  
• The FIT-DNA is commonly referred at the stool DNA test. This test screens for cancerous cells in the stool. Unlike the stool tests, the FIT-DNA test is recommended every 3 years.

Other screening tests

• Colonoscopy and flexible sigmoidoscopy are more invasive tests performed by inserting a thin, flexible tube into your rectum to find polyps to remove them. The tube for a colonoscopy is longer and is inserted inside the entire colon to look for polyps. Patients need to empty their bowel and prepare their colon before a colonoscopy.

Key takeaway points

The main barriers to colorectal screenings are lack of knowledge and lack of recommendation from providers. Pharmacists are considered the most accessible healthcare professionals to the public; they can help raise awareness of colorectal cancer. Here is how:

• Your pharmacist can share more information about the screening tests with you, they can also answer most questions you may have. Colorectal cancer can be life-threatening if not detected at an early stage, screening tests help in preventing colorectal cancer
• If you are scheduled to have a colonoscopy, your pharmacist can teach you about the best way to use your bowel prep kit if you have any concerns.
• If you are a current smoker and want to reduce your risk for colorectal cancer, ask your pharmacist about ways to quit smoking.

You can also talk to your doctor or visit the CDC website for more information.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2947820/

https://www.cdc.gov/cancer/colorectal/basic_info/what-is-colorectal-cancer.htm

https://www.cancer.org/cancer/colon-rectal-cancer/about/what-is-colorectal-cancer.html

https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html 

https://hollingscancercenter.musc.edu/news/archive/2021/09/20/hollings-researchers-studying-rise-colorectal-cancer-in-young-and-why-minorities-more-vulnerable