Colon or intestine cancer is the second leading cause of cancer death amongst men in the US behind lung cancer. About one in 21 men and one in 23 women will be affected with colon cancer.

The large intestine consists of the colon and rectum. Both parts are often referred to as “colorectal” when discussing the intestine cancer.

Colorectal Cancer or more commonly referred to as colon or intestine cancer is the second leading cause of cancer death amongst men in the US behind lung cancer and breast cancer being 5th most common. Approximately 135,000 per year are newly diagnosed with colorectal cancer and about half of these patient will succumb to the diagnosis. Colon cancer recently caused the death of Chadwick Boseman – star of the Black Panther movie. Other famous individuals falling to this cancer include President Ronald Regan (40th US president) and Audrey Hepburn.

Age which frequently diagnosed is 65-75 years of age, although more recently seen in younger individuals. Certain risks may cause cancer and death at younger age groups. About one in 21 men and one in 23 women will be affected with colorectal cancer.

Types of colon cancer

1. Adenocarcinoma_ most common type-95%
2. Stromal-(GIST) cancer start in the wall of digestive tract
3. Carcinoid tumor- tumor of hormone making cells- also called Neuroendocrine tumor
4. Lymphoma- immune system related cancer
5. Sarcoma- tumor of the muscle, connective tissue or blood vessels

How does intestine cancer start?

A group of cells divide rapidly and abnormally so the immune system cannot control this growth. Polyps first form then these continue to grow and spread.

Also Read: What causes irritation in food pipe?

What increases the risk?

1. Overweight- excess fat around the waist
2. Lack of physical activity
3. Diabetes type 2
4. Cigarette smoking
5. Excessive alcohol consumption
6. Diet high in red meat and charred/smoked meat
7. Low Vitamin D levels
8. Age
9. H/O polyps
10. African Americans and Ashkenazi Jews
11. Family history/genetics – certain genes can be inherited

Symptoms of Colorectal cancer

• Change in bowel habits from diarrhea to constipation
• Bleeding of rectum or bloody stools
• Abdominal pain /cramping
• Feeling bloated/full
• Anemia
• Weakness or fatigue
• Weight loss
• Nausea or vomiting

Things to consider

1. When to begin screening
2. Which test is right for you
3. How often to get screened

Screening options for average risk patient include

1. Flexible sigmoidoscopy every 5 years
2. Colonoscopy every 10 years
3. Double contrast enema- every 5 years
4. CT – colonography (performed if #2,3 is declined) – every 5 years
5. Guiaic based fecal occult blood test (FOBT) – every year
6. Fecal immunochemical test (FIT) – recommended annually
7. Fecal DNA- high sensitivity for cancer-recommended if unable to do colonoscopy – every 3 years
8. Capsule colonoscopy – every 5 years

Also Read: Types of Abdominal Pain and Appropriate Treatments

Age and frequency of screening depends on the risks for colon cancer

• Ages 50-75 years in most patients
• Family history of colorectal cancer or polyps; first degree relatives affected – start screening age 40 years then repeat every 5 years
• African American – recommended at age 45 years of age
• History of Inflammatory bowel disease or ulcerative colitis – 45 years
• Genetic syndrome of polyposis – 45 years

Once testing is done and risk evaluated, follow up evaluation will be based on the findings. Lack of any abnormal findings is a sign of decreased risk.

Microscopy of biopsy samples from polyps or growth will establish the malignant/cancer potential and the need of treatment or follow up colonoscopy.

If intestine cancer is detected, further testing of the abdomen and chest area will help stage cancer from I to IV based on how far it spread. This determines the type of treatment from surgical removal to chemotherapy and or radiation treatment.

Colorectal cancer is easily screened but routinely avoided or overlooked. Everyone detests the idea of having a colonoscopy, and most individuals need only 1 or 2 at the most. Family or other health factors can increase the risk and only those need more frequent monitoring. Routine fecal testing can be done in the privacy of patient’s home.

Please ask your doctor if you have not been screened. Prevent late detection, screen routinely.