Kenneth L Abbott, MD, FACP  |  3/1/2022

March Is Colorectal Cancer Awareness Month

As body parts go, the colon and rectum lack glamor and appeal. They’re not likely to win any popularity polls or beauty contests. Usually, the only time you hear mention of them or their function is when someone wants to sell you a remedy for something gone wrong, or there’s a run on toilet paper in the stores. However, the colon and rectum possess an importance out of proportion to their lowly status. These organs play a vital role not just in digestion but in making civilization possible. Think of the consequences of mass incontinence, for example. Sanitation would become impossible and life unlivable. Beyond the considerations of normal function, though, there is also the range of diseases affecting these structures. Specific to the point of this article, like any other part of the human body they can suffer the development of cancer.

Colorectal cancer is the third most common cancer diagnosis in the United States and the third overall leading cause of cancer deaths, after lung cancer and breast cancer. If cancer is found and treated early, cure is typical, although once a person has had colorectal cancer she is at higher risk of developing a new cancerous lesion and so must undergo careful surveillance.

Who is at risk for colorectal cancer? Practically anybody, and the risk increases as we age. There are some people whose risk is higher than average. These should consider discussing the start of screening studies at an age younger than the standard for the general population. Early intervention is warranted if you have one of the inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, or if there is a strong family history for colorectal cancer, or if you were born with one of the genetic mutations associated with an excessive risk, such as familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer (also known as the Lynch syndrome).

Certain lifestyle practices and behaviors appear to influence colorectal cancer risk. It turns out that a lack of adequate physical exercise is not merely bad for the heart. Similarly, such heart disease risk factors as carrying too much weight around your middle, eating a diet rich in red or processed meat, and even cigarette smoking will also raise your colorectal cancer risk. A diet deficient in fruits, vegetables, and whole grains contributes negatively. And drinking alcohol to excess harms the colon and rectum as well as the liver.

Symptoms of this disease can be subtle or even absent in the early stages, which underscores the importance of appropriate screening. During the past two years, among the many adverse health consequences of the COVID-19 pandemic, screening procedures virtually halted. Estimates hold that occasions of colorectal cancer screening dropped by nearly 90% at the start of the pandemic and the number of positive diagnoses fell by roughly one third. This means that as of June 2021 some 18,000 additional people were at risk for a delayed or missed diagnosis, which threatens early intervention and will inevitably lead to additional deaths from what is a highly preventable cause. Look for the imminent reopening of screening opportunities and talk to your health care provider about scheduling a procedure appropriate to your individual circumstances.

There is nothing fun about paying attention to colorectal cancer. However, trying to ignore it can bite you in the…you know where.
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