Posted: 3/2/2016
Parkland physician stresses importance of early detection
Even though it is one of the deadliest diseases around – the second leading cause of death from cancers that affect both men and women – colorectal cancer (CRC) still is not a topic most people want to discuss.
Studies have consistently shown that colorectal screening can save lives, and while screening rates have increased in the U.S., still not enough people are getting screened. In 2012, 65 percent of U.S. adults were up-to-date with colorectal cancer screening; 7 percent had been screened, but were not up-to-date; and 28 percent had never been screened.
And just as troubling, researchers recently found that while colon and rectal cancers generally are thought of as diseases of the elderly, the rate for people younger than 50 is increasing. Experts say the findings indicate the need for increased awareness of warning signs, such as anemia, a change in the size or frequency of bowel movements, and bleeding with bowel movements. Family history also is an important consideration.
“Screening for and awareness of colorectal cancer risk factors are extremely important in detection and eventual treatment,” said Christian Mayorga, MD, Clinical Chief of Digestive and Liver Diseases at Parkland Memorial Hospital and Assistant Professor of Internal Medicine at The University of Texas Southwestern Medical Center. “It is very important that people get screened, especially if they may be at higher risk, such as having a close family member who had colon or rectal cancer.”
According to the American Cancer Society, about one in 20 persons in the United States will develop colorectal cancer sometime in their lives. Men have a slightly higher rate than women.
The American Cancer Society estimates that about 93,000 new cases of colon cancer and almost 40,000 new cases of rectal cancer were expected to be diagnosed in 2015. March is designated as Colorectal Cancer Awareness Month to encourage more people to get screened for the disease.
Average-risk patients should be screened for CRC beginning at age 50. Fecal Immunohistochemistry Test (FIT), a test to check for blood in the stool, and colonoscopy, a flexible scope to look inside the colon, are the recommended screening tests currently available for patients at Parkland.
A screening colonoscopy, sometimes earlier than age 50, is recommended for patients at high risk for CRC.
While overall rates of colorectal cancer among individuals younger than 50 are still quite low, recent research has shown slight increases. For this reason, it is recommended that patients be assessed to determine their risk for CRC no later than age 20.
Dr. Mayorga added that obesity is a significant risk factor for several cancers, including colon cancer.
“There is a strong correlation between body mass index (BMI) and risk of getting colon cancer,” Dr. Mayorga said. “Because obesity rates continue to rise in the U.S., this may explain why we are seeing an increased incidence of colon cancer in younger patients.”
Colorectal cancers almost always develop from precancerous polyps – abnormal growths in the colon or rectum.
“But colorectal polyps and early-stage colorectal cancer don’t always cause symptoms. That’s why screening is important,” Dr. Mayorga said. “If there are symptoms, they may include blood in your stool, stomach pains, aches or cramps that don’t go away or unexplained weight loss. Using a colonoscopy, physicians can detect if any polyps are present and remove them before they can turn into cancer.”
Although the exact cause of most colorectal cancers is not known, about 75 percent occur in people with no known risk factors. But there are some conditions that may increase a person’s risk of developing colorectal cancer, including having a personal or family history of colorectal polyps or colorectal cancer, inflammatory bowel disease such as ulcerative colitis or Crohn’s disease, or genetic predisposition.
While not yet definitive, some research suggests that diet may have a role in whether a person develops colorectal cancer, according to the Centers for Disease Control and Prevention. Lower rates of colorectal cancer are found in countries like Japan where people generally consume diets that are low in fat and high in fiber compared to U.S. diets.
The American Cancer Society also reported last year that there is increasing evidence of a link between smoking and colorectal cancer deaths. Healthcare providers urge individuals to get screened for CRC if they or any close relative has had adenomatous polyps.
To learn more about how to schedule a screening, contact your primary care physician or gastroenterologist. For more information about services at Parkland, visit www.parklandhospital.com