Colorectal cancer, or colon cancer, occurs in the colon or rectum. As the graphic below shows, the colon is part of the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.

Colon cancer, when discovered early, is highly treatable. Even if it spreads into nearby lymph nodes, surgical treatment followed by chemotherapy is highly effective. In the most difficult cases — when the cancer has spread to the liver, lungs or other sites — treatment can help make surgery an option for many, as well as prolonging and adding to one’s quality of life.

Research is constantly being done to learn more and provide hope for people no matter what stage they are. Most colon cancers develop first as polyps, which are abnormal growths inside the colon or rectum that may later become cancerous if not removed.

Stages of colon cancer

Stage 0: This is the earliest stage possible. Cancer hasn’t moved from where it started; it’s still restricted to the innermost lining of the colon. Stage 0 is also called Carcinoma in Situ.

Stage I: Cancer has begun to spread, but is still in the inner lining. Stage I is also called Dukes A colon cancer.

Stage II: Many of these cancers have grown through the wall of the colon and may extend into nearby tissue. They have not yet spread to the lymph nodes. Stage II is also called Dukes B colon cancer.

Stage III: Cancer has spread to lymph nodes, but has not been carried to distant parts of the body. Stage III is also called Dukes C colon cancer.

Stage IV: Cancer has been carried through the lymph system to distant parts of the body, most commonly lungs and liver. This is known as metastasis. Stage IV is also called Dukes D colon cancer.

Symptoms

NOTE: MANY PEOPLE DIAGNOSED WITH CRC NEVER HAD ANY SYMPTOMS NOR EARLY SIGNS
CHECK WITH YOUR DOCTOR IF YOU SUSPECT A PROBLEM

RISK FACTORS FOR CRC

SCREENING GUIDELINES FOR CRC

Screening guidelines for CRC depends on whether you are in the increased or in the average risk group.

INCREASED RISK GROUP

  • Patients with alarms symptoms (like blood in stool, abdominal pain and change in bowel habits, unexplained weight loss, and others).
  • Males / Females who have a family history of known genetic disorders that predispose them to a high lifetime risk of colorectal cancer, such as:
    • Lynch syndrome
    • familial adenomatous polyposis
  • Males / Females who have a personal history of inflammatory bowel disease
  • Males / Females who had a previous adenomatous polyp, or previous colorectal cancer.

AVERAGE RISK GROUP

People who have no symptoms (asymptomatic) who are 45 years and older and who don’t have any of the above increased risk factors.

SCREENING METHODS

The American Cancer Society (ACS), recommends that people at average risk of colorectal cancer start regular screening at age 45.

Stool-based tests

FECAL IMMUNOCHEMICAL TEST (F.I.T.) EVERY YEAR

The fecal immunochemical test (FIT) is a screening test for colorectal cancer. It tests for occult blood (hidden) in the stool, which can be an early sign of cancer. Unlike other stool tests, FIT only detects human blood from the lower intestines and thus medicines and food do not affect the result. It is known to be more accurate withfewer false positive and negatives than other tests.

Visual (structural) exams of the colon and rectum

COLONOSCOPY EVERY 10 YEARS

A colonoscopy is often considered the “gold standard” for colon screening. A gastroenterologist uses a colonoscope to view the entire colon and the rectum and to remove any polyps.


Recommendations for screening:

  • Average risk group:
Screening TestAge at initialFrequency
Fecal immunochemical test (FIT)45 yearsAnnually through age 75

  • Increased risk group:
Screening TestStarting Age and Frequency
ColonoscopyAs recommended by the gastroenterologist

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