Colon cancer: risks, screenings and treatment
Colorectal cancer is the third leading cause of cancer death in the United States. There is some good news though — the number of new cases and the number of deaths from colon cancer have been decreasing over the past two decades, largely because of screening and prevention education.
What is colon cancer?
“Everyone has a colon — men, women, children and adults,” Lanla Conteh, MD, MPH, says. “Colon cancer starts in the colon, which is the last part of the digestive track, where our stool exits. It usually starts as a clump of cells, and over time, those cells may grow to become cancer.”
How colonoscopies save lives
“A colonoscopy is a test where doctors look with a camera on a long instrument that visually inspects the lining of the colon,” Matthew Kalady, MD, says. “Colorectal cancer is one of the few cancers that truly is preventable by doing screening at the appropriate time and getting the right tests
“Cancers start from small changes in individual cells. As those cells grow and replicate, they can form growths on the colon called polyps. A colonoscopy allows removal of the polyps before they become cancer. Thus, colonoscopy is one of the procedures that can actually prevent cancer before it happens.”
What are risk factors?
“We don't know the exact cause of colon cancer, but we know that there are risk factors,” Conteh says. “We know age is a factor, so everyone 45 and over should be getting screened.
“We also know that African Americans don't get colonoscopies at the same rate that others do, and we know that when we do get diagnosed with colon cancer, we’re diagnosed at later stages of the disease, and tend to have more deaths. So, race is a risk factor as well.
“Unfortunately, a lot of American diets are high in fat and low in fiber, and we know that that's a risk factor. We also know that the Mediterranean diet, for example, can be protective against colon cancer.”
What happens after diagnosis?
“A team approach is really important. The surgeon usually is the first point of contact because we'll do what we call a workup or staging evaluation where we get images of the chest, the belly and the pelvis to see if the cancer has spread,” Kalady says. “Usually, surgery is the first step, and after that, we look at everything and can decide on the next course of treatment, which might be chemotherapy, or patients might be treated with surgery alone. Then they go into what we call surveillance programs, where we keep things under close watch for five years. If we diagnose colon cancer early, it's something that's curable.”