Colorectal cancer


What is colorectal cancer?

Colorectal cancer starts in the colon or the rectum and is also sometimes referred to as colon cancer or rectal cancer separately. Each year about 132,700 Americans will be diagnosed with and 49,700 will die of these cancers; however, the death rate has started to decrease in recent years because of improved screening and treatment.

Both the colon and the rectum are part of the body’s gastrointestinal system, which helps to digest food and is made up of several layers. Colorectal cancer begins in the innermost layer and can spread throughout. In most cases, colorectal cancer develops over time as tissue growth or a tumor begins as an adenomatous polyp – a noncancerous growth on the inner lining of the colon or rectum. Only certain types of polyps can become cancer but early removal while they are small may help prevent them from turning into cancer. If cancer does form in the polyp, it can eventually grow into the different layers of the gastrointestinal system and cause the cancer to spread to different parts of the body.

Signs and symptoms of colorectal cancer

Since colorectal cancer does not always show symptoms in its early stages, regular screenings are important. It’s not uncommon for colorectal cancers to bleed, so the patient’s stool may begin to appear darker than usual. This increased loss of blood can lead to anemia (low red blood cell counts), which is sometimes the first sign of colorectal cancer.

Most symptoms of colorectal cancer are typically caused by other medical conditions, such as infection, inflammatory bowel disease, irritable bowel syndrome (IBS) or hemorrhoids, but it’s recommended patients consult with an ETMC First Physician immediately if they begin to notice any of the following:

  • rectal bleeding or blood in stool (may cause stool to look darker than usual)
  • changes in bowel habits, such as constipation, diarrhea or narrowing of the stool that lasts for more than a few days
  • continued discomfort after having a bowel movement
  • fatigue and weakness
  • unexpected weight loss

Risk factors for colorectal cancer

There are a number of factors like poor diet, lack of exercise and obesity that increase one’s chances of developing colorectal polyps and colorectal cancer. While lifestyle-related issues are typically the most common risk factors for colorectal cancer, there are a number of other factors that have been shown to increase the risk of obtaining colorectal cancer as well. It’s recommended that adults begin consulting with an ETMC First Physician before age 50 to discuss screening options if they meet any of the following colorectal cancer risk factors:

Poor diet

Individuals who consume a regular diet that is full of processed meats (hot dogs, lunch meats and sausage) and red meats (beef, lamb, liver and pork) are at a higher risk of obtaining colorectal cancer. Try to substitute these foods with fresh fruits and vegetables as well as whole grains to decrease risk.

Obesity and diabetes

There are strong links between obesity and colorectal cancer cases – most notably in men. Staying physically active not only helps maintain a healthy weight, but it can also reduce the risk of colorectal cancer. Obesity is also commonly linked with Type 2 diabetes, which presents many of the same risk factors.

Alcohol and tobacco use

Heavy alcohol and tobacco use increases the risk of getting colorectal cancer. Men should limit themselves to no more than two alcoholic drinks per day, and women should limit themselves to just one. The effects of long-term smoking can put a heavy strain on the body and lead to numerous health-related issues including a heightened risk of colorectal cancer.


As evidenced by nearly 90 percent of diagnosis occurring in individuals over age 50, the chances of obtaining colorectal cancer increase dramatically with age. While young adults can also develop colorectal cancer, it’s important to get screened regularly as you grow older.

Family history

Even though most cases of colorectal cancer actually occur in people who do not have family history of the disease, those who have a family history of adenomatous polyps or colorectal cancer should consult with an ETMC First Physician before the age of 50 to discuss early screening options. Those born with gene defects should also consult with an ETMC First Physician at an earlier age as a small percentage of people (approximately 5 to 10 percent) who develop colorectal cancer have inherited gene defects (mutations).

Personal history

Patients who have a personal history of adenomatous polyps in the colon or rectum are more likely to develop colorectal cancer – especially if the polyps are large and there are more than one. Those who suffer from inflammatory bowel diseases (IBD), such as Crohn’s disease or ulcerative colitis, also have a heightened risk and should be screened more frequently.

Race and ethnicity

The highest incidence of colorectal cancer and mortality rates in the United States are found in African-Americans, though the reasons why are unknown. Eastern Europeans of Jewish descent also have one of the highest colorectal cancer risks of any ethnicity as several gene mutations linked to colorectal cancer have been found in this group.

Screenings for colorectal cancer

As a general rule, screenings for colorectal cancer should begin at age 50. In some cases, screenings may start earlier. Consult with an ETMC First Physician for more information.

Some of the most common types of colorectal cancer screenings include

  • Colonoscopies: A colonoscopy is one of the most common screenings for colorectal cancer and gives a visual examination of the entire colon using a long, flexible tube with a light and camera. Colonoscopies allow doctors to see swollen tissues, ulcers, polyps and cancer.
  • Digital rectal exams: A digital rectal exam checks for abnormalities in the lower rectum. It is typically a part of a complete physical for a man and part of a gynecological examination to check the uterus and ovaries in women.
  • Double contrast barium enemas: Using a special X-ray of the large intestine, a double contrast barium enema also gives a clear view of the colon and rectum, which can help identify any problem areas.
  • Fecal occult blood testings: Also known as a stool guaiac test, a fecal occult blood test can detect hidden blood in the stool using a simple chemical method.
  • Flexible sigmoidoscopies: In most cases, a flexible sigmoidoscopy is performed in a doctor’s office and provides a visual examination of the lower portion of the colon and rectum.

 Treatment for colorectal cancer

Colorectal cancer treatment is determined on a case-by-case basis. Our experts at the ETMC Cancer Institute work together to help formulate detailed treatment plans to help fight colon cancer with advanced treatment and therapy modalities as well as personalized support services.

For more information regarding colorectal cancer, schedule an appointment with an ETMC First Physician.