Colorectal Cancer

What Is Colorectal Cancer?• Colorectal cancer is the third most common cancer in men and

women.

•It begins in either the colon or rectum, which are both part of the digestive system (where food is processed).

American Cancer Society’s Estimates

In the United States during 2010, colorectal cancer was:

• The third most common cancer in U.S.• 142,570 new cases • The third deadliest cancer• 51,370 deaths

nationwide

Colorectal Cancer Risk Factors • Age

• 90% of cases occur in people 50 and older• Gender

• Slight male predominance, but common in both men and women

• Race/Ethnicity• African Americans have highest incidence and mortality rate

of all groups in U.S., Hispanics the lowest (with considerable variation depending on country of origin)

• Increased rates also documented in Alaska Natives, some American Indian tribes, Ashkenazi Jews

• Increased risk with:• Personal history of inflammatory bowel disease, polyps, or

colon cancer• Family history of polyps, colon cancer, other conditions

Reducing Your Risk• Early detection can help find and remove pre-

cancerous polyps (tissue growths).• It also appears that the following behaviors

may reduce risks: • Avoid tobacco products• Maintain a healthy weight throughout life• Adopt a physically active

lifestyle• Consume a healthy

diet, with an emphasis on plant sources

• Limit alcohol consumption

Symptoms• Early stage colorectal cancer does not usually

have symptoms; therefore screening is necessary to detect colorectal cancer in its early stages!

• Warning signs include:• Rectal bleeding • Blood in the stool• Change in bowel habits • Cramping pain in the lower abdomen

• These are also warning signs for other, less serious illnesses, so if they appear, they should be discussed with a doctor.

Early Detection through Screening• Colorectal cancers can almost always be

cured if detected early. • People of average risk with no symptoms

should begin regular screening at age 50.

•People at increasedrisk should be screened earlier and more often.

Benefits of Screening• Cancer Prevention

• Removal of pre-cancerous polyps prevent cancer

• Improved survival• Early detection

markedly improves chances of long term survival

Screening Guidelines

Tests are grouped into two categories:

• Tests that detect cancer and precancerous polyps

• Tests that primarily detect cancer

2008 CRC Screening Guidelines

• Tests That Detect Polyps and Cancer Flexible sigmoidoscopy (FSIG) every 5 years*, or Colonoscopy every 10 years, or Double contrast barium enema (DCBE) every 5

years*, or CT colonography (CTC) every 5 years*

*Colonoscopy should be done if test results are positive.

2008 CRC Screening Guidelines• Tests That Primarily Detect Cancer Annual guaiac-based fecal occult blood test (gFOBT)

with high test sensitivity for cancer *, ** or Annual fecal immunochemical test (FIT) with high test

sensitivity for cancer*,** or Stool DNA test (sDNA), with high sensitivity for

cancer*, interval uncertain

* Colonoscopy should be done if test results are positive.** For gFOBT or FIT used as a screening test, the take-home multiple

sample method should be used. gFOBT or FIT done during a digital rectal exam in the doctor’s office is not adequate for screening.

CRC Guidelines Continue to Emphasize Options Because:

• Evidence does not yet support any single test as “best”• Screening rates remain disappointingly low• Individuals differ in their preferences for one test or

another • Primary care physicians differ in their ability to offer,

explain, or refer patients to all options equally• Access to some tests is uneven geographically, and in

terms of test charges and insurance coverage• Uncertainty exists about performance of different

screening methods with regard to benefits, harms, and costs

Treatment• Treatment is most successful when

cancer is detected early.• Often two or more

treatment methods are used.

• Patients should thoroughly discuss treatment options with their doctors.

Treatment Options

• Most patients whose cancer has spread receive chemotherapy or chemotherapy plus radiation before or after surgery.

• Regular follow-up exams and blood tests may be recommended.

• Surgery is generally used, and it usually cures colorectal cancer that has not spread.

Survival Rates• 5-year relative survival rate for

localized disease is 91% (Only 39% of colorectal cancers are diagnosed at this stage)• Localized cancer is cancer that, at the

time of diagnosis, had not spread to additional sites within the body. Typically, the earlier a cancer is detected, the more successful the treatment

• 5-year overall relative survival rate is 65% • The 5-year relative survival rates

represent persons who are living 5 years after diagnosis, whether disease-free, in remission, or under treatment.

How Will Cancer Affect Me And My Family?

•From the time of diagnosis, everyone is affected in some way, even family and friends.

•The American Cancer Society works to enhance aspects of life often challenged by this disease through:• Reducing the

physical toll of cancer.

• Reducing barriers to allow those affected to continue with their day-to-day lives.

• Reducing the social and financial impact of cancer.

Cancer Resource Network

Information

Day-to-Day Help

Emotional Support

Hope For The Future• As the nation’s largest private funder of cancer

research, the American Cancer Society is working to better understand, prevent, find, and treat cancer.

• Nationwide, the Society is currently funding 114 multi-year grants in colon and rectal cancer totaling $76 million.

• The Society is currently funding nine grants totaling $5.6 million in the area of colon and rectal cancer in the High Plains Division.

The Bottom Line• Screening tests offer a powerful opportunity for

the prevention, early detection, and successful treatment of colorectal cancers.

•People can reduce their risk by following screening guidelines; eating a healthy, low-fat diet; and increasing their level of physical activity.

Contact the American Cancer Society

• American Cancer Society programs and services are available 24 hours a day, 7 days a week.

• To reach us:• Visit cancer.org

• Call toll-free 1–800–227–2345

©2010 American Cancer Society, Inc. No.0052.21