March is Colorectal Awareness Month
Declaring War on Colorectal Cancer This March
The colon is a long, muscular tube, about five feet long, acting as a processing plant. After the small intestine absorbs nutrients, waste enters the colon. The colon absorbs water and salts, turning waste into stool. The rectum, the last part of the large intestine, is about six to eight inches long and stores stool until you’re ready to defecate. When full, it signals your brain to find a toilet. Together, they complete the food’s journey through your body.
March is observed worldwide as Colorectal Cancer Awareness Month, a time dedicated to educating people about a disease that affects hundreds of thousands of families each year. But what exactly is colorectal cancer? Simply put, it is a type of cancer that starts in the colon or the rectum. It usually begins as small growths called polyps inside the colon or rectum. Not all polyps turn into cancer, but some, if left alone for many years, can slowly develop into cancer. While it has traditionally been seen as a disease of older adults, a worrying trend is emerging: more and more younger people are being diagnosed. In fact, about 45% of new cases now occur in people under the age of 65, with a significant rise in adults aged 20 to 49. This alarming shift makes awareness and education more critical than ever.
Understanding colorectal cancer risk factors can feel overwhelming, but knowing what we can change and what’s beyond our control helps us take empowered steps towards better health. For example, while age, family history, and genetic factors are unavoidable, lifestyle choices such as diet and activity levels are areas where we can make positive adjustments. Eating a balanced diet rich in fruits, vegetables, and whole grains, and limiting red and processed meats, especially when cooked at high temperatures like grilling or frying, can significantly reduce your risk. Maintaining a healthy weight through regular exercise not only boosts your overall well-being but also lowers the chances of developing colorectal cancer. Avoiding tobacco and moderating alcohol intake are also wise choices for your health. Remember, small changes can make a big difference in staying healthy and feeling great.
Doctors diagnose colorectal cancer using a combination of screening tests and follow-up procedures. The gold standard is a colonoscopy, where a thin, flexible tube with a camera examines the entire colon and rectum. If suspicious polyps or growths are found, the doctor can remove them immediately for biopsy, the only way to confirm if cancer is present. Before a colonoscopy, simpler screening tests may suggest problems: the fecal immunochemical test (FIT) checks for hidden blood in stool, while stool DNA tests look for abnormal cells shed by polyps or cancer. If cancer is confirmed, imaging scans like CT, MRI, or PET scans determine if the disease has spread to other organs.
For individuals at average risk of colorectal cancer, starting screening at age 45 and continuing through age 75 is recommended. Between ages 76 and 85, the decision to continue screening should be made together with a healthcare provider, based on individual health and preferences. There are several effective screening options available, each with different testing schedules to suit different needs. The most comprehensive option is a colonoscopy, which examines the entire colon and rectum, and is recommended every 10 years. For at-home testing, the fecal immunochemical test (FIT) should be done annually, while the multi-target stool DNA test (mt-sDNA) is typically performed every 1 to 3 years. Other visual options include CT colonography (virtual colonoscopy) every 5 years, and flexible sigmoidoscopy every 5 years, or every 10 years when combined with yearly FIT. Remember, if any non-colonoscopy screening test comes back positive, a follow-up colonoscopy is essential to thoroughly examine the entire colon.
Treatment varies depending on the stage of the cancer. For early tumors, surgery is often enough to remove them. In more advanced cases, chemotherapy and radiation might be used either before or after surgery to help fight the disease. For certain types of cancer, especially when it has spread, targeted drugs and immunotherapy can be very effective in managing growth and giving patients a better chance at survival.
Finally, understanding survival rates at each stage gives us a clear picture of why early detection is so important. Survival is often measured by the “5-year relative survival rate,” which compares how long people with cancer live compared to the general population. For colorectal cancer, the outcome depends almost entirely on how far the disease has spread at the time of diagnosis. If the cancer is caught early, while it is still localized (meaning it hasn’t spread outside the colon or rectum), the 5-year survival rate is an encouraging 91%. This means that nine out of ten people diagnosed at this early stage will live at least five years. If the cancer has spread to nearby lymph nodes or tissues (regional spread), the survival rate drops to about 72%. Unfortunately, if the cancer has spread to distant organs like the liver or lungs (distant or metastatic stage), the 5-year survival rate is significantly lower, around 15%. However, thanks to new treatments like targeted therapy, even some patients with advanced disease are living longer and better lives.
The message is straightforward: we can combat colorectal cancer, but it requires proactive steps. This March, let’s pledge to recognize the signs, discuss screening options with our doctors, and embrace healthier lifestyles. A simple test now might save your life in the future.