March is a month we generally associate with green. Spring is on its way and the dominating hue of St. Patrick's Day celebrations is hard to miss. But around your physicians' offices, you might see a lot of dark blue ribbons pinned to lapels instead. That's because March is also National Colorectal Cancer Awareness Month.
While colorectal cancer is certainly less fun to discuss than when to plant your spring peas or the possible existence of leprechauns, talking about it—and how to reduce your risk of developing it—could save your life.
Colorectal cancer is an umbrella term for any cancer that occurs in the colon (large intestine) and/or rectum (the connection between the colon and anus). According to the Colorectal Cancer Alliance (CCA), it's the third most common cancer in the nation and the second leading cause of cancer deaths.
More than 50,000 people every year die from colorectal cancer. In 2021, the CCA estimates 149,500 will face this diagnosis—a number that is higher now because of the pandemic, which unfortunately has dissuaded patients from scheduling appointments to get checked. "Screenings really decrease mortality," says Summit Health's Dr. Jonathan Resnick. "People seem like they are quick to get their mammograms but not colonoscopies."
He acknowledges that "patient phobias" drive many people to skip it. Still, colonoscopies do more than look for lesions. "They're both diagnostic and therapeutic," he says. In other words, when physicians spot a polyp during a colonoscopy, they excise it and biopsy it. The earlier that you discover cancer, the easier it is to treat. This is the best-known way to reduce your risk, he says.
While Dr. Resnick says the colonoscopy is the "gold standard," he adds a caveat. "The best test for colorectal cancer is the one you're actually going to do." So, if you fear colonoscopies, even though they're painless, at the very least do a home stool screening that you can send away for results, such as the FIT (fecal immunochemical test).
Typically, doctors recommend that screenings start when patients are 50 years old. But the CCA notes on its website that, from 2007–2016, "rates for people under 55 increased 2% each year." While it's not yet an official call to action, many organizations are pushing to begin screenings at 45. Most recently, the United States Preventative Services Taskforce has published preliminary recommendations that will change the beginning age for screening to 45 for the entire U.S. population.
Earlier screenings are especially important if you have Crohn's disease or ulcerative colitis (UC), which are two inflammatory bowel diseases (IBD) that are known to increase the risk for colorectal cancer.
A family history of colon cancer is an important risk factor. If a family member has a history of colon cancer, the best practice to reduce your risk is to begin screening earlier than age 45. Additionally, men are more likely than women to develop colorectal cancer (one in 23 as compared to one in 25), and according to figures from the American Cancer Society, African Americans have the highest incidence and mortality rates in the nation.
In addition, "Other associated malignancies and syndromes, including Lynch syndrome, are very important," Dr. Resnick says.
Ask your primary care physician or gastroenterologist what the right starting age is for you.
What else can you do to decrease your chances of developing colorectal cancer?
- Quit smoking
- Control your weight
- Increase physical activity
- Increase fiber intake
- Decrease red meat consumption
- Avoid heavy alcohol use
Dr. Resnick cautions that these lifestyle changes don't replace screenings. But they should help increase your health in general in addition to reducing your risk of developing colorectal cancer.
Lastly, watch for warning signs and symptoms, including:
- Blood in the stool
- Abdominal pain
- Unexplained weight loss
- Altered bowel habits
Be honest with yourself and your physician. If you find it difficult or embarrassing to discuss symptoms, practice by talking to a friend first (perhaps over a St. Patty's Day green drink). Then put on your dark blue awareness ribbon and go for a colorectal cancer screening.