Excluding skin cancers, colorectal cancer is the third most diagnosed cancer in men and women and is the third-leading cause of cancer deaths in the country. It's expected to be the cause of about 52,000 deaths this year.[1]

March is Colorectal Cancer Awareness Month, so now is the right time to talk about this life-threatening disease. This is particularly relevant considering President Biden’s recent announcement to expand medical screenings and research with the goal of cutting U.S. fatalities from cancer in half over the next 25 years. [2]

One of the keys to potentially reducing cancer deaths is by detecting cancer early. According to the American Cancer Society, when colon cancer is localized (i.e., before it has spread), the five-year relative survival rate is 91 percent. When the cancer progresses and spreads outside the colon or rectum, survival rates are much lower.[3]

Key facts about colorectal cancer:

• Colorectal cancer (CRC) is used to describe cancer that develops in the colon or rectum. (The colon is a part of the large intestine or large bowel, and the rectum is the passageway that connects the colon to the anus.)

• CRC usually begins as a noncancerous growth called a polyp that develops on the inner lining of the colon or rectum and usually grows slowly over a period of 10 to 20 years.

• Early CRC is often associated with no symptoms, which is why screening is so important. As a tumor grows, it may bleed and/or obstruct the intestine causing a variety of symptoms including a change in bowel habits and abdominal pain. In some cases, blood loss from the cancer leads to anemia (low number of red blood cells), causing symptoms such as weakness, excessive fatigue and shortness of breath.

• Warning signs include:

o   Bleeding from the rectum

o   Blood in the stool or in the toilet after having a bowel movement

o   Dark or black stools

o   A change in bowel habits or the shape of the stool (i.e., more narrow than usual)

o   Cramping or discomfort in the lower abdomen

o   An urge to have a bowel movement when the bowel is empty

o   Constipation or diarrhea that lasts for more than a few days

o   Decreased appetite

o   Unintentional weight loss

Colon cancer statistics: 

• Aside from certain types of skin cancer, colorectal cancer is the third most commonly diagnosed cancer and the third-leading cause of cancer death in men and women in the United States.

• The American Cancer Society estimates that there will be 106,180 new cases of colon cancer and 44,850 new cases of rectal cancer in 2022. Colorectal cancer is expected to cause about 52,580 deaths during 2022. [4]

• On average, the lifetime risk of developing colon cancer is about one in 23 for men and one in 25 for women, however this risk varies widely according to individual risk factors. [5]

How dangerous is colorectal cancer and who is at risk?

• Colorectal cancer, when discovered early, is highly treatable. Even if it spreads to the nearby lymph nodes, surgical treatment, followed by chemotherapy can be highly effective.

• In the most difficult cases – when cancer has spread to the liver, lungs or other sites – treatment can be effective in controlling the disease for a time and may even lead to cure in some.

• The United States Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer in all adults ages 45 to 49 years as well as in all adults 50 to 75 years (this decision was recently updated to include adults in the 45-to-49-year age group). The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults ages 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient’s overall health and prior screening history. [6] NOTE: This recommendation may differ from other health source recommendations, such as the American Cancer Society (ACS) on the topic.

Colorectal cancer and ethnicity and race:

• Colon cancer and rectal cancer incidence and mortality rates are highest in African Americans.

• During 2009-2013 colon cancer and rectal cancer incidence rates in blacks were about 20 percent higher than whites.

• Colon cancer and rectal cancer death rates in blacks are 40 percent higher than in whites. According to a recent study of average-risk adults, it was concluded that although rates of colorectal cancer screening have increased overall since 2008, they have increased disproportionately in each racial and ethnic group and disparities in screening uptake persist. [7]

Colorectal cancer and family history:

• People with a first-degree relative (parent, sibling or children) who have colorectal cancer have between two and three times the risk of developing the cancer than those without a family history.

What are the signs of colorectal cancer?

• Most colorectal cancers develop first within polyps, which are abnormal growths inside the colon or rectum that may later become cancerous, if not removed.

• While colorectal cancer screening is the single most important thing you can do to help prevent the disease by finding polyps before they turn cancerous or help ensure early discovery, there are other steps you can take to decrease your chances of developing the disease.  Among these steps are developing a healthy lifestyle such as eating a healthy diet, getting regular exercise and avoiding or minimizing alcohol consumption and use of tobacco products.

General source: Colorectal Cancer Facts & Figures 2020-2022

[1] Colorectal Cancer Statistics | How Common Is Colorectal Cancer?

[2] Fact Sheet: President Biden Reignites Cancer Moonshot to End Cancer as We Know It | The White House

[3] Colorectal Cancer Survival Rates | Colorectal Cancer Prognosis

[4] Colorectal Cancer Statistics | How Common Is Colorectal Cancer?

[5] Colorectal Cancer Statistics | How Common Is Colorectal Cancer?

[6] Draft Recommendation: Colorectal Cancer: Screening | United States Preventive Services Taskforce (uspreventiveservicestaskforce.org)

[7] Disparities in Colorectal Cancer Screening in the United States Before and After Implementation of the Affordable Care Act - PubMed (nih.gov)