New Brunswick, NJ— Despite declines in the rates of cancer diagnoses and deaths, colorectal cancer remains prevalent in the United States, with more than 140,000 new cases in Americans each year and the number of new cases on the rise—making colorectal cancer the third most common cancer among those affecting both men and women, according to statistics from the Centers for Disease Control and Prevention (CDC). It is also the second-leading cause of cancer-related deaths among those types of cancers. But screenings and early detection have been found to save lives and reduce risk. As the nation recognizes Colorectal Cancer Awareness Month, Dr. Ruby Greywoode, assistant professor of medicine in the Division of Gastroenterology and Hepatology at Rutgers Robert Wood Johnson Medical School and a gastroenterologist providing clinical services as part of Rutgers Health, shares some important information about colorectal cancer and what you can do to reduce your risk.
Q: What is colorectal cancer?
Dr. Greywoode: Colorectal cancer, which is sometimes referred to as colon cancer, is a type of cancer that occurs in either the colon—the large intestine—or the rectum. The rectum is the part of the gastrointestinal tract that connects the large intestine to the anus. Colorectal cancer develops as a result of abnormal growths, called polyps, that form in the colon or rectum. If left untreated, polyps can become cancerous over a period of time. With proper screening, these polyps can be found and removed before they develop into cancer. Screening can also find early-stage cancer, when treatment is most effective.
Q: What are the signs and symptoms?
Dr. Greywoode: Because polyps do not always cause symptoms, you may have colorectal cancer and not realize it. That’s one of the reasons people may not discover they have colorectal cancer until late stages of the disease. However, if you do experience symptoms, these may include blood in your stool; pains, aches or cramps in your stomach that don’t go away; or unexplained weight loss. Because these symptoms can be caused by other issues than cancer, it’s important to discuss them with your doctor.
Q: Who is at risk?
Dr. Greywoode: Colorectal cancer occurs in men and women, with a slightly higher rate among men. Although the vast majority of people who develop colorectal cancer do not have known risk factors, there are some things that could increase your risk. For example, if you have inflammatory bowel disease, like Crohn’s disease or ulcerative colitis, then you are at increased risk. Other risk factors include a personal or family history of colorectal cancer or colorectal polyps, and genetic or hereditary syndromes such familial adenomatous polyposis (FAP) or Lynch syndrome. There are also a number of lifestyle factors that could put you at risk, including smoking and tobacco use, lack of regular physical exercise, obesity, alcohol consumption, and a diet low in fiber and high in fat.
Most importantly, your risk of developing colorectal cancer increases as you get older. More than 90 percent of colorectal cancers occur in people who are age 50 years or older, according to the CDC. Between the ages of 50 and 54, for example, the rate of new colorectal cancers is roughly 60.2 per 100,000; between 65 and 69 years old, that rate jumps to 117.3 per 100,000, and for individuals age 75 to 79, the rate is approximately 190.5 per 100,000—more than double that of 50- to 54-year-olds, the latest CDC statistics show. As a result, as you age, it is even more important to discuss colorectal screening recommendations with your doctor.
Q: When should I get screened?
Dr. Greywoode: In general, I recommend the US Preventive Services Task Force (USPSTF) colon cancer screening guidelines for patients who do not fall into high-risk groups. This means regular screening, beginning at the age of 50 and at regular intervals through the age of 75. If you are at high risk, you may need to begin screening earlier than the age of 50 or to continue at different intervals than is typical. There are also different recommendations if you are older than the age of 75. It is important to discuss a recommended screening schedule with your doctor.
There are a number of different colorectal screening tests available, including stool tests and colonoscopy. Your doctor can help you decide which test is best for you.
Studies show that millions of people are missing out on the opportunity to identify and treat colorectal cancer early. One-quarter of adults between the ages of 50 and 75 have never been screened, and more than one-third of adults with health insurance are not up to date with their screenings, CDC stats show. The most important thing to remember and which I stress to my patients is that colorectal cancer screening saves lives.
A member of the Rutgers Robert Wood Johnson Medical School faculty since 2018, Dr. Greywoode is a board-certified internist who currently serves as an assistant professor of medicine in the Department of Medicine’s Division of Gastroenterology and Hepatology. She received her medical degree from George Washington School of Medicine and Health Sciences in Washington, D.C., and completed her internship and residency training in internal medicine at Columbia University Medical Center and in gastroenterology at The Mount Sinai Hospital, where she served as chief gastroenterology fellow and sat on its Quality Improvement in Colon Cancer Screening Task Force. Dr. Greywoode provides clinical services as part of Rutgers Health, the most comprehensive academic health care provider in New Jersey, combining an unprecedented scope of clinical care, research and education.