Colorectal cancer is a disease of the colon or rectum, which are parts of the digestive system. Unlike most cancers, colorectal cancer is often preventable with screening and is highly treatable if detected early. Most cases of colorectal cancer occur in people 45 years of age and older, but the disease is increasingly affecting younger people.
In the United States, colorectal cancer is the third most common cancer in men and women combined and the second leading cause of cancer death in men and women. According to recent statistics, it is estimated that in 2022, just over one hundred and fifty thousand people will be diagnosed with colon cancer, with 52,580 deaths this year alone. The median age at diagnosis of colorectal cancer in the US population is about 66 years, but the year of onset is gradually shifting toward the younger age group. Colorectal cancer rates appear to be falling for the older age group and this is related to screening in this age group. This data has informed the decision and trend towards screening at an earlier age. The United States Preventive Services Task Force updated its guidelines in May 2021 to recommend colorectal screening starting at age 45, rather than age 50, for the general population at average risk. This does not affect the recommendations of earlier age screening for patients who have a higher risk because of a positive family history or a genetic cancer syndrome.
Stages 1 to 4 of colorectal cancer rank in the order of decreasing likelihood of recovery and increasing morbidity and mortality. The earlier colorectal cancer is detected, the greater the chances of cure. According to the SEER database, between 2011 and 2017, the 5-year survival rate for stage 1 or localized colon cancer was 91% compared to 14% for stage 4 or distant spread. Rates were similar for rectal cancer as well.
Fortunately, there are tools that have been developed over time to help detect early colorectal cancer with the goal of finding these cancers at an early stage, when the chance of a cure is greatest. Colonoscopies offer a unique method for cancer screening; In this they use a one-step approach. With a colonoscopy, we locate and remove polyps with one procedure. These polyps can grow to become cancerous over time. Thus, colonoscopy is an effective method of early cancer detection and prevention. For patients who are unable or unwilling to undergo colonoscopy or FIT, consider ACG flexible sigmoidoscopy every 5–10 years, multitarget stool DNA test (Cologard) every three years, CT colonography every five years, or colon capsule suggests.
Age and, in some patients, genetics, appear to be the only proven non-modifiable risk factors for the development of colorectal polyps, but there are other modifiable environmental factors at play that have not been conclusively proven but may be contributors, including smoking and obesity. can. The increased incidence in younger age groups may be related to a Western diet, but no diet has been proven to reduce the risk of colorectal cancer. Aspirin has a promising role for the chemoprevention of colorectal cancer, but it must be isolated and taken for at least 10 years to be beneficial.
In summary, screening should begin at age 45 for average-risk patients and continue until age 75. For patients with a family history of colorectal cancer or high-risk polyps in their first degree relative, screening should begin at age 40 or less than 10 years of age of the affected relative. Between the ages of 75 and 85, screening recommendations will be based on prior screening history, the patient’s overall health, and preferences.
Contact Western Wisconsin Health at 715-684-1111 to set up your colorectal screening to determine whether you need a colonoscopy with Dr. Chime or Dr. Dahlberg.