[4 minute read]
In this article:
- Colorectal cancer can happen to anyone.
- Black people and those with a family history of the disease are at higher risk.
- Screenings, early detection and follow-up care are essential.
“Colorectal cancer is most common among people age 50 or older, but I’ve seen patients as young as 14 with this disease,” says Amir Bastawrous, M.D., a colorectal surgeon at Swedish. “That’s very rare, but I can tell you in 2020 I’ve treated a half dozen patients under the age of 50 with colorectal cancer.”
Colorectal cancer occurs in the colon, rectum or both, and is the third-most common cancer in adults in the United States. According to the American Cancer Society, incidence rates are 24% higher in non-Hispanic black males and 19% higher in non-Hispanic black females, compared to non-Hispanic whites. Colorectal cancer death rates are 47% higher in non-Hispanic black men and 34% higher in non-Hispanic black women, compared to non-Hispanic white men and women.
If you have a first-degree relative that had colorectal cancer before age 50, you’d usually start 10 years younger than they were when they were diagnosed with colorectal cancer.
The reasons for this are complex and include biological and socioeconomic factors. According to the American Cancer Society, Black patients face a higher incidence of a more aggressive type of colorectal cancer that can be challenging to treat due to the cancer often being located on the right side of the colon. In addition, Black people are also more likely to lack access to timely screenings and other wellness resources that promote colon health, increasing their risk of the disease.
How can we mitigate risk for colorectal cancer?
"I never tell patients to give up everything they enjoy in life," says Melinda Hawkins, M.D., a colorectal surgeon at Swedish. "But decreasing certain things like alcohol consumption and increasing your exercise and focusing your diet on fiber and low-processed meats and fats will help decrease risk. For example, my husband and I try to limit our red meat consumption to one day a week. Smoking is the one thing I will always advocate that my patients fully stop, while recognizing that it's a challenging habit to quit."
The importance of screening
People who do not have a family history of colorectal cancer should get screened at age 45, according to the American Cancer Society. People with a family history of the disease may need to start even younger, Dr. Bastawrous says. “If you have a first-degree relative that had colorectal cancer before age 50, you’d usually start 10 years younger than they were when they were diagnosed with colorectal cancer,” he explains.
Screening types
People need to get screened for colorectal cancer even if they don’t have symptoms. In most people, colorectal cancer cells grow very slowly, and symptoms don’t arise until the disease is more advanced.
People need to get screened for colorectal cancer even if they don’t have symptoms. In most people, colorectal cancer cells grow very slowly, and symptoms don’t arise until the disease is more advanced.
Several screening options are available, such as colonoscopies and a simple, take-home option known as the fecal immunochemical test (FIT). Speak with your primary care doctor about the type of screening that is best for you.
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Description |
Frequency |
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Colonoscopy
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A colonoscopy uses a lighted, flexible tool to view the complete lining of the colon. During this test, the doctor will look for precancerous growths (polyps). This test happens while the patient is asleep (sedated) and requires clearing the colon with medicine (laxatives). |
If no polyps are found, this test only needs to be done about once every 10 years. |
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FIT Test
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The FIT tests (including Cologuard) detect hidden blood in the stool and use DNA to detect cancer cells. Your physician will give you the kit to take home with you, along with detailed instructions on how to use it. These tests require that the individual collect samples of their stool. |
If results come back negative, your doctor will probably recommend you repeat the test one to two times a year. If positive, then you’ll need a colonoscopy. |
Which screening is better?
Both types of screenings can detect precancerous polyps in the colon. These polyps are common, occurring in 30 to 50% of adults.
- Not all polyps will become cancerous.
- It takes many years for a polyp to become cancerous.
- If polyps are found during a colonoscopy, the doctor may remove them immediately or take tissue samples (biopsies) for analysis.
“Colonoscopies and FIT tests are both good because they can detect many early colorectal cancers,” says Kunjali Padhya, M.D., a gastroenterologist at Swedish. “Regardless of which one you have, the most important thing is to follow your doctor’s recommendations afterward. If you have a positive FIT test, you will need to have a colonoscopy. If you have a colonoscopy and the doctor removes polyps, you’ll need to return for follow-up colonoscopies on a regular schedule.”
“Colonoscopies and FIT tests are both good because they can detect many early colorectal cancers,” says Dr. Padhya.
Watch for these symptoms
Dr. Padhya emphasizes the importance of seek medical care if you experience colorectal cancer symptoms, she says. These symptoms include:
- Rectal bleeding (the most common symptom)
- Pain when using the bathroom
- Unintentional weight loss
- Unexplained new constipation or other changes in bowel habits
"If it’s time to schedule your first (or next) colonoscopy, don’t put it off," says Dr. Hawkins. "The bowel prep for a colonoscopy is no fun, but the procedure itself can be life-altering. We can literally change the trajectory of a patient's life because colorectal will not become part of their world; we actually remove precancerous lesions that, if left alone, would become cancer. And the risks of complications during a colonoscopy are lower than your chances of getting into a car accident."
For more information on colorectal cancer screenings, speak with your primary care provider. Make sure he or she is aware of any family history of colorectal cancer.
Scheduling a colonoscopy
You can schedule a colorectal cancer screening without a physician referral. To learn more or make an appointment, call the Swedish Digestive Health Institute nurse navigator at 855-411-MyGI (6944).
Related resources
Don’t delay life-saving cancer screenings
How to prepare for a colonoscopy
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.
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