Colon Cancer Screening Awareness Campaigns May Be Paying Off
- Sarah Beran, a busy mom of two, initially dismissed frequent bathroom visits—an often overlooked sign of colorectal cancer—and was misdiagnosed with a parasite before discovering blood in her stool.
- A colonoscopy revealed Beran had over 100 precancerous polyps and a mass, leading to a stage 3 colon cancer diagnosis. She underwent surgery and 12 rounds of chemotherapy for treatment.
- Stage 3 colon cancer means the disease has spread from the colon to nearby lymph nodes. Standard treatment typically involves surgery followed by chemotherapy, according to experts. “When it’s stage 3, it means the cancer has left the organ site in the colon and traveled toward the local nodes,” Dr. Daniel Labow, Chief of the Surgical Oncology Division at Mount Sinai Health System, said.
- A new study published in the peer-reviewed medical journal JAMA Network examined colorectal cancer screening rates between 2016 and 2023. After analyzing 7.8 million colorectal cancer screenings, the study found that once screening guidelines indicated people begin screening at 45, the number of screenings spiked among 45-49 year olds.
- Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts. A colonoscopy involves a long, thin tube attached to a camera used to examine the colon and rectum for polyps (small growths in the colon that aren’t yet cancerous). If found, doctors can remove them during the procedure.
- Colorectal screenings are recommended to begin around age 45. However, people at increased risk – such as having a family history of the disease – may want to screen sooner. Discussing your screening options with your doctor is recommended.
When Beran finally went to the doctor about the anomaly, she was initially told that she may have a parasite, and it was nothing too serious. However, Beran’s bathroom habits grew more worrisome when she noticed increasing amounts of blood in her stool. She went back to the doctor, who performed a colonoscopy after a bit of convincing from the mother of two.
Read More“Stage three colon cancer is colon cancer that is in the colon and has spread to the local lymph nodes,” Dr. Daniel Labow, Chief of the Surgical Oncology Division at Mount Sinai Health System, explains to SurvivorNet.
“The lymph nodes are glands that drain the area around, not just the cancer, but everywhere in the body. When it’s stage 3, it means the cancer has left the organ site in the colon and traveled toward the local nodes,” Dr. Labow added.
Dr. Labow says the traditional standard of care for stage 3 colon cancer is surgery followed by chemotherapy. As for Beran, she dealt with twelve rounds of chemotherapy and surgery for treatment.
Colon Cancer Cases Rising in Adults Under 50—Screening Rates Are Climbing Too, Especially Among 45-49 Year Olds
The average age at which people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society.
However, the National Cancer Institute reports that since the 1990s, colorectal cancer cases have been rising among adults younger than 50. Research published in CA: A Cancer Journal for Clinicians found that cases in people younger than 55 “increased from 11% in 1995 to 20% in 2019.”
“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” cancer epidemiologist and lead study author Rebecca Siegel said.
WATCH: Understanding the Function of the Colon and the Rectum
Researchers are still trying to determine why younger people are being diagnosed in more significant numbers. Some experts point to risk factors, which include obesity, physical inactivity, and smoking, as a possible explanation for the increase.
“We don’t know for sure why we are seeing earlier onset and death from colon cancer,” Dr. Yeo told SurvivorNet.
“It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors,” Dr. Yeo added.
A new study published in the peer-reviewed medical journal JAMA Network examined colorectal cancer screening rates between 2016 and 2023. Researchers conducting the study analyzed more than 7.8 million colorectal cancer screenings conducted at more than 1,350 hospitals throughout the United States.
A point of note from the study was that the rate of colorectal cancer screenings appeared to correlate with guideline changes from the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) for people at average risk to begin screening at age 45.
- CRC screenings among adults aged 45–49 increased nearly tenfold, from 2.9% to 17.8% of all screenings between 2016 and 2023.
- Monthly screening volume for this age group rose 955%, compared to a 46% increase among adults aged 50–75.
- The surge reflects rapid guideline adoption in hospital settings and early uptake even before the USPSTF changes.
The findings from the study highlight the impact of hospitals following recommended screening guidelines for their patients. It’s important to note that the study does not account for at-home colorectal screenings.
Expert Resources on Colorectal Cancer
Understanding Colorectal Cancer and Its Treatment
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes change into cancer. It takes up to 10 years for a colon polyp to become a full-blown cancer, according to SurvivorNet experts.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, explained.
WATCH: When to get a colonoscopy
Most colon cancers can be prevented if people are regularly screened. The screening usually involves a colonoscopy, in which a long, thin tube attached to a camera examines the colon and rectum. If no polyps are discovered, the following screening won’t be needed for about ten years.
What Treatment Options Exist for Colon Cancer?
“There are a lot of advances being made in colorectal cancer,” Dr. Yeo previously told SurvivorNet.
Colon cancer treatment is more targeted, meaning doctors often test for specific changes or genetic mutations that cause cancer growth.
Biomarkers are key to tailoring specific treatments. Biomarkers are molecular patterns becoming more commonly used in colon cancer diagnosis, prognosis, and management. According to the National Cancer Institute, a biomarker is “a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or a condition or disease,” such as cancer.
“In colon cancer, we’re starting to look more and more at people’s biomarkers, so we’re starting to take the cancers, sequence them, understand where the different mutations are to figure out whether or not someone has a normal gene here or an abnormal gene,” Dr. Yeo explained.
“Those are the areas that people want to be able to target a little bit more. We’re getting close to more what we would call precision medicine, meaning we can start looking at people’s genetic mutations and think about how they might respond to different drugs.”
There are different types of biomarkers, including DNA, proteins, and genetic mutations found in blood, tumor tissue, or other body fluids. The biomarkers most commonly used in colon cancer management are:
Genetic mutations within the tumor, such as MMR/MSI, KRAS, BRAF, and HER2
Bloodstream carcinoembryonic antigen (CEA)
CEA is a protein produced by most tumor cells (but not all) and can be picked up in the bloodstream. High CEA levels do not establish a colon cancer diagnosis. However, higher CEA levels correlate with a worse prognosis and potential metastasis. Carcinoembryonic antigen is important for post-treatment follow-up to ensure the cancer hasn’t returned. Be sure to check with your doctor before treatment starts to ensure a CEA blood sample has been obtained.
More on Treating Colon Cancer
Surgery and chemotherapy are common approaches to colorectal cancer.
Some examples of Food and Drug Administration (FDA) approved chemotherapy drug treatments include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- Trifluridine and tipiracil (Lonsurf)
WATCH: Understanding Your Options with Metastatic Colon Cancer
Among metastatic colon cancer patients, multiple treatment options exist, including surgical and non-surgical options.
One treatment option includes an oral treatment called Fruquintinib, which is a targeted therapy for adults who have metastatic colorectal cancer and have tried other treatments. Results from a trial published last year showed the drug improved overall survival and progression-free survival, which measures the amount of time before the cancer returns or spreads. It works by blocking the growth of blood vessels, which increases tumor growth.
Once you get to the metastatic setting, many patients “just run out of options,” Jennifer Elliott, head of solid tumors at Takeda, explained to SurvivorNet at the ASCO Annual Meeting. So it was critically important for Takeda to do this deal to in-license fruquintinib. We hope to give patients another option.”
Fruquintinib has been approved in China since 2018 and was originally developed by the Chinese biopharmaceutical company HUTCHMED. Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong, and Macau in January 2023.
More on Colon Cancer
Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts.
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
The American Gastrointestinal Association lowered the recommended initial age for colorectal screening from 50 to 45. However, experts recommend screening earlier for some people who may be at an increased risk of developing colon cancer, such as those with a family history of the disease.
WATCH: Debunking misconceptions about colon cancer.
The most poignant signature of colon cancer includes a change in bowel habits. This may include constipation or diarrhea due to changes in the size or shape of bowel movements. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor that lies deep in the colon.
Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss. Finally, some tumors bleed a small amount over a long period of time, resulting in anemia (low red blood cell count) that is picked up on blood work.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
- Could this treatment affect my sex life? If so, how and for how long?
- What are the risks and possible side effects of trea
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