As a gastroenterologist at Waco Gastroenterology Associates, I was recently touched by the death of Chadwick Boseman, star of the movie “Black Panther,” from colon cancer at the young age of 43.
I am also seeing an increase in the incidence of colon cancer in young Wacoans.
Most people don’t realize that colorectal cancer is the second leading cause of death from cancer in the United States after lung cancer.
Studies also show it may be on the rise for younger people. According to the American Cancer Society, there has been an increase of colorectal cancer in adults in their 20s and 30s.
As a result of COVID-19, we have seen a decline in cancer-related health screenings. Colorectal cancer screenings have declined by 86% during COVID-19, according to the American Cancer Society.
Because of this, the American Cancer Society predicts the following:
•Up to 10,000 more deaths are projected over the next decade.
•An estimated 104,610 new cases of colon cancer will have been diagnosed in 2020.
•An estimated 17,930 (12%) will be diagnosed in individuals younger than age 50.
Because colon cancer is such an insidious disease, it can grow silently without setting off any warning bells or whistles in your body. However, if you have any of these warning signs, schedule an appointment with a board-certified gastroenterologist.
1. Constipation: Having a bowel movement less than three times a week isn’t always related to colon cancer, but sometimes is. A tumor in the colon can make it very difficult for waste to get by, causing constipation.
2. Change in the size or appearance of the stool: If your stool is now long, thin, stringy, dark or black, this could be a warning sign.
3. Rectal bleeding: Bleeding may be red or dark red (indicating dried blood). Bleeding is always a concern and should be checked out.
4. Blood in the stool appearing dark or black:Bleeding that happens higher up in the digestive tract may make stool appear black and tarry. This is also a concern and should be checked out.
5. Cramping in the lower stomach: Although stomach cramps, gas, bloating and abdominal pain can be attributed to other disorders, they can also be symptoms of colon cancer.
6. False urges to use the bathroom: Have a sensation to have a bowel movement when there is no need to have one is also a warning sign. A tumor that grows toward the end of the colon or in the rectum may cause a sense of fullness.
This is because your body senses that there is something else present by the exit. Basically, the body treats the tumor as a stubborn piece of waste that it keeps trying to pass, which is why you will sometimes get these false urges.
7. Unintentional weight loss: Unexplained weight loss can also be a symptom of cancer because tumors use up the body’s energy, thereby burning calories faster.
8. Gas and bloating: A pattern of gas and bloating may be an indication that a tumor is growing in the colon and occasionally causing a blockage. Even if the tumor isn’t large enough to cause a complete bowel obstruction on its own, stool may periodically become caught on the tumor while it is passing by, causing a temporary or partial obstruction.
While your bowel is blocked and air is trapped, you will be bloated. When the blockage resolves itself, all that air will need somewhere to go and you will be gassy.
9. Changes in bowel habits: Colon cancer may affect the large intestine’s ability to perform some of the functions it had before, causing changes in bowel habits. This may be in the form or constipation or diarrhea.
If something used to come easy and now is a struggle or has changed, you may want to get screened.
10. Anemia: Blood loss through the rectum or stool is often the reason anemia could be present. Many times the blood loss occurs slowly and may not be visible to you.
If you meet any of these criteria, you are at an increased risk for colon cancer.
•Are age 45.
•Eat a diet high in fat, processed foods and red meat.
•Eat a diet low in fiber.
•Have colon polyps or a family history of them.
•Smoke or drink.
•Have a sedentary lifestyle.
•Have inflammatory bowel disease.
•Have Lynch syndrome or other genetic syndromes.
How is It Caused?
Colon cancer is a disease in which abnormal cells in the large intestine grow uncontrollably allowing them to invade locally or to other parts of the body.
Most colon cancers start as a polyp which is a growth of tissue in the lining of the colon or rectum. Polyps are common, occurring in 30% to 50% of adults over age 50. Early detection and removal of polyps can mean prevention of colon cancer.
Should You Be Screened?
Traditionally, colorectal cancer screening is recommended for the general population of men and women over the age of 50. However, the American Cancer Society is now recommending even those with an average risk to begin screening at age 45.
Insurance companies are starting to change their policies to address that.
I am often asked about the purpose of colorectal cancer screening and the signs and symptoms of colorectal cancer for adults of any age. Although a comprehensive review of colorectal cancer and screening is beyond the scope of this article, I encourage a discussion between you and your local gastroenterologist about when and what type of screening is right for you.
What is the Screening Like?
There are two broad categories of screening tests: stool tests and structural exams.
Stool tests were primarily designed with the goal of detecting colorectal cancer. Stool tests are less likely to detect polyps.
Structural exams were designed to detect both colon polyps and colorectal cancers. These tests include colonoscopy, flexible sigmoidoscopy, barium enema X-ray and computed tomographic colonography, also known as virtual colonoscopy.
Colonoscopy is the most accurate way to screen for both colon polyps and colorectal cancer. Colonoscopy is performed under anesthesia so it should not be a painful exam.
When to Stop Screening
People in good health and a life expectancy of greater than 10 years should continue colorectal cancer screening until age 75. The decision to screen after age 76 will depend on a combination of personal health, screening history and preference. Routine, average-risk screening is not recommended beyond age 85.
The good news is the rates of colorectal cancer cases and deaths can be decreased through increased awareness of risk factors and implementation of screening guidelines.