What Is Colorectal Cancer?

Colorectal cancer includes cancers of the colon, rectum, appendix and anus. When abnormal cell growth occurs, a tumor develops. If the cells of a tumor acquire the ability to invade and thus spread into the intestinal wall and to other sites, a malignant or cancerous tumor develops. Most colorectal cancers develop first as colorectal polyps, which are growths inside the colon or rectum that may later become cancerous.

Incidence and Mortality

Out of the 150,000 new cases of colorectal cancer diagnosed each year in the U.S., over 57,000 Americans are expected to die. Colorectal cancer is the second leading killer cancer among men and women combined, second only to lung cancer.

Symptoms

The following symptoms may indicate colorectal cancer. A doctor should be consulted for the appropriate diagnostic tests.

• a change in bowel habits
• diarrhea or constipation
• feeling that the bowel does not empty completely
• vomiting
• blood in the stool
• abdominal discomfort (gas, bloating, cramps)
• unexplained weight loss
• constant fatigue
• unexplained anemia

Risk Factors

Although colorectal cancer can strike at any age, more than 9 in 10 new cases are in people age 50 or older.
Colorectal cancer affects both men and women; however, men are slightly more likely to develop colorectal cancer and die of the disease.

African-Americans are more likely to be diagnosed with colorectal cancer at a later stage and more likely to die from the disease. African-Americans have the highest incidence and death rate for colon and rectum cancer among all racial or ethnic groups in the U.S.

A personal history of colon cancer or intestinal polyps, and diseases such as chronic ulcerative colitis or Crohn’s Disease, and Inflammatory Bowel Disease increase a person’s chance of developing colorectal cancer.

A person who has a specific inherited gene syndrome (such as Familial Adenomatous Polyposis (FAP) or Hereditary Non-Polyposis Colon Cancer (HNPCC) is at increased risk for developing colorectal cancer. People with a significant family history of colorectal cancer (as defined by cancer or polyps in a first-degree relative younger than 60 or two first-degree relatives of any age) are also at increased risk for developing colorectal cancer.

Facts

Colorectal cancer is the third-leading cause of cancer death among both African-American men and women.

Death rates for colorectal cancer among African-Americans are about 30% higher than among Whites and more than two times higher than for Asian-Americans, Pacific Islanders and Hispanics.

There is evidence that African-Americans are less likely to undergo screening tests for colon cancer.

There is evidence that polyps occur more commonly in the middle and right colon in African-Americans. Polyps can be easily removed if they are found. However, polyps in the middle and right colon are not detected by the standard office flexible sigmoidoscope.

African-Americans also have a higher frequency of multiple polyps. These findings suggest that sigmoidoscipy, a test sometimes recommended as a screening test for colon cancer, may not be pertinent to the African-American population, and that a complete colonoscopy is preferable.

Diagnosing Colorectal Cancer

When there are symptoms present, diagnostic tests should be performed. In the absence of symptoms, regular screening should be done. Screening and diagnostic tools include:

• Fecal Occult Blood Test (FOBT)
• Flexible Sigmoidoscopy
• Double Contrast Barium Enema (DCBE)
• Colonoscopy

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