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PUBLIC HEALTH & SCIENCE
Colorectal Cancer - Fact Sheet
 

The following information is provided by the American Cancer Society.

General Facts

  • Colorectal cancer (commonly referred to as “colon” cancer) develops in the lower part of the digestive system, also referred to as the gastrointestinal, or GI, system. The digestive tract processes the food you eat and rids the body of solid waste matter. This cancer usually develops from precancerous changes or growths in the lining of the colon and rectum. These growths in the colon or rectum are called polyps.
  • In 2005, an estimated 145,290 new cases of colon cancer will be diagnosed in the United States. Of these new cancer cases, 104,950 will be colon cancer and 40,340 will be rectal cancer.
  • An estimated 56,290 deaths due to colon cancer are expected to occur in 2005, accounting for about 10 percent of cancer deaths this year in the United States.
  • Colon cancer is the third most common cause of cancer and cancer death in both men and in women in the United States, causing 10% of all cancer deaths.
  • Colon cancer is the second most common cancer among African-American women and the third most common cancer among African-American men.
  • Colon cancer is the second most commonly diagnosed cancer in both Hispanic/Latino men and women.
  • African Americans have the highest death rate from colon cancer of any racial or ethnic group in the United States.
  • Colon cancer is the second leading cause of cancer deaths among African-American men and women combined
  • Colon cancer is the second leading cause of cancer death among Hispanic/Latino men and women combined.

Risk Factors

  • Age: The risk of colon cancer increases with age. More than 90 percent of cases are diagnosed in individuals over the age of 50.
  • Family History: A personal or family history of colorectal cancer or polyps or of inflammatory bowel disease of significant duration increases the likelihood of having colorectal cancer. Also, there are certain genetic factors that increase the likelihood of having colon cancer, including conditions called familial adenomatous polyposis (FAP), Gardner’s syndrome, hereditary non-polyposis colorectal cancer, and being of Ashkenazi Jewish descent.
  • Race: African Americans have the highest colon cancer rates and the highest rate of death from the disease of any racial or ethnic group in the United States.
  • Other risk factors include:
    • Smoking
    • Alcohol consumption
    • Obesity
    • Physical inactivity
    • Diet high in fat and/or red meat
    • Diet low in fruits and vegetables

Symptoms

Early colon cancer usually causes no symptoms and can be detected by available colorectal cancer screening tests. However, as colorectal cancer progresses, the disease may cause symptoms. People with the following symptoms should see their doctor immediately:

  • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
  • A feeling that you need to have a bowel movement that doesn’t go away even after you do have a bowel movement
  • Bleeding from the rectum or blood in the stool
  • Cramping or gnawing stomach pain
  • Decreased appetite
  • Weakness and fatigue
  • Jaundice (yellow-green color of the skin and white part of the eye)

Note: Signs and symptoms of colon cancer typically occur in advanced stages of the disease.

Testing/Detection

There are several colon cancer early detection tests. According to the American Cancer Society guidelines for the early detection of colon cancer, starting at age 50 both men and women should discuss the full range of testing options with their doctor or health care professional and choose one of the following testing options:

  • Yearly fecal occult blood test (FOBT)
  • Flexible sigmoidoscopy every five years
  • Yearly FOBT andflexible sigmoidoscopy every five years (preferred over either FOBT alone, or flexible sigmoidoscopy alone)
  • Double-contrast barium enema every five years
  • Colonoscopy every 10 years

Note: All positive tests should be followed up with a colonoscopy. People with a family or personal history of colon cancer or polyps, or history of chronic inflammatory bowel disease, should be tested earlier, and may need to undergo testing more often.

Common Treatments

  • Surgery is the most common form of treatment for colon cancer. For cancers that have not spread, it frequently controls the disease.
  • Chemotherapy or chemotherapy with radiation treatment is given before or after surgery to most patients whose cancer has spread into the bowel wall or to the lymph nodes.
  • A permanent colostomy (creation of an abdominal opening for elimination of body wastes) is very seldom needed for colon cancer and is frequently not required for rectal cancer.

Survival

  • When colon cancers are detected at an early (i.e. localized) stage, the five-year survival rate is approximately 90 percent; however, because screening rates are so low, only 39 percent of colorectal cancers are detected at this stage.
  • There is a 67 percent chance of five-year survival when the cancer has spread only to nearby organs or lymph nodes.
  • Once the cancer has spread to other parts of the body, the five-year survival rate is about 10 percent.

The American Cancer Society and Colon Cancer

  • Research: As of January 2005, the American Cancer Society currently funds 97 colon cancer-related grants totaling approximately $50.8 million. The Society has also conducted national surveys to learn more about the public’s knowledge, attitudes, and practices associated with colorectal cancer testing.
  • Education: The Society delivers health information to the public so that individuals can make informed personal decisions. Examples include printed materials, media coverage, community-based outreach programs, and free, nationwide services such as the www.cancer.org Web site and a 24-hour information and support line at 1-800-ACS-2345.  The Society also delivers health information to health care professionals, including testing guidelines.
  • Awareness:  In February 2005, the Society will be kicking off a nationwide colon cancer public awareness advertising campaign to raise awareness of the personal need to get tested for colon cancer. The campaign will target both consumers and doctors and will appear in print, radio, television, and online.
  • Advocacy: With the help of grassroots volunteers in communities across the country, the Society advocates action at both the state and federal levels to ensure responsible health policies that improve access to colorectal cancer screening and increase our federal investment in cancer research, which will improve the prevention, detection and treatment of cancer, including colon cancer. For example, the Society was instrumental in securing coverage for the full-range of colon cancer screening tests for Medicare beneficiaries, for many federal employees, and for privately insured individuals in 16 states and the District of Columbia. The Society is continuing efforts to ensure all Americans have coverage for the full range of colon cancer screening tests for people age 50 and older.  Finally, as part of the Society’s goal of lowering cancer incidence and mortality among minority and other medically underserved populations, the Society is working on efforts to authorize through federal legislation a CDC pilot program for colorectal cancer screening and treatment in medically underserved communities.
  • Service: The Society works to improve quality of life for people living with cancer through a variety of support services and programs helping patients and families cope with the disease.
  • Collaboration: Along with the Centers for Disease Control, the American Cancer Society established the National Colorectal Cancer Roundtable, an organization consisting of more than 50 organizations dedicated to working together to increase colorectal cancer testing.

The American Cancer Society is dedicated to eliminating cancer as a major health problem by saving lives, diminishing suffering and preventing cancer through research, education, advocacy, and service. Founded in 1913 and with national headquarters in Atlanta, the Society has 14 regional Divisions and local offices in 3,400 communities, involving millions of volunteers across the United States. For more information, call 1-800-ACS-2345 or visit www.cancer.org.