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What are the lesser-known risk factors of colorectal cancer?

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In the past week, I’ve heard that two people—a much-beloved high school teacher and a college friend’s father—were each diagnosed with devastating late-stage colorectal cancer. It’s been a most difficult few days, and both families have deep challenges ahead of them as they navigate their way through the chemotherapy treatments that are to come. This is (how shall we say it?) my inaugural post on Examiner.com as a Health Examiner, and I've decided to compile various data on colorectal cancer as I keep them in my thoughts today.

What is colorectal cancer?
Colorectal cancer (“colon cancer”) is the second leading cause of cancer deaths in the United States of cancers affecting both men and women; of the roughly 140,000 Americans diagnosed with colorectal cancer, over 50,000 people succumb to the disease. Despite such grave statistics, this disease is known to be highly preventable in most situations, through screening beginning at age 50. Over 90% of colorectal cancers are in those aged 50 and older.

It is important to obtain regular screenings if you are between ages 50-75, which aids in detecting precancerous growths (polyps) for removal before disease progression. Maintaining physical fitness and a healthy weight is important, as well as abstaining from smoking, processed meats, and overindulgence in alcohol. Symptoms to be aware of include blood in one’s bowel movement, recurrent and inexplicable stomach pains, and inexplicable weight loss.

Screening options include colonoscopies (conducted once every 10 years); high-sensitivity fecal occult blood test (FOBT), stool test, or fecal immunochemical test (FIT) every year; and sigmoidoscopy (every 5 years with FOBT every 3 years).

What are lesser-known risk factors for colorectal cancer?
The CDC does note that certain individuals may be at a higher risk of developing colorectal cancer, and to discuss testing frequency with one’s doctor. The degree to which a risk factor contributes to colorectal cancer is difficult to determine. Examples of (lesser-known) risk factors that may increase the likelihood of colorectal cancer include:

• A personal history of colorectal polyps
• A family history of colorectal cancer or polyps (a doubled risk in those with one affected first-degree relative, higher if the relative was younger than 45 when diagnosed)
• Familial adenomatous polyposis (FAP): FAP is caused by changes (mutations) in the APC gene, that causes the growth of hundreds of polyps in the colon and rectum. About 1% of all colorectal cancers are due to FAP.
• Hereditary non-polyposis colon cancer (HNPCC): HNPCC, also known as Lynch syndrome, causes a few polyps and the resultant risk of colorectal cancer may be as high as 80%. It accounts for about 2% to 4% of all colorectal cancers, and is a defect in the gene MLH1 or the gene MSH2.
• Turcot syndrome: This is a rare inherited condition in which people are at increased risk of adenomatous polyps and colorectal cancer, as well as brain tumors.
• Peutz-Jeghers syndrome: People with this rare inherited condition tend to have freckles around the mouth and a polyp in their digestive tracts (hamartomas). They are at greatly increased risk for colorectal cancer, at a younger than normal age. This syndrome is caused by mutations in the gene STK1.

The American Cancer Society and several other medical organizations recommend earlier screening for people with increased colorectal cancer risk, which leads to the final point:

What else can we do to promote awareness of colorectal cancer?
Apart from offering emotional support, it is imperative that people encourage their friends and family to seek screening.
Historically speaking, March was announced to be the National Colon Cancer Awareness Month by Former President Clinton in February 2000.

Awareness efforts occur by fundraising and education events, and promoting screening. In addition, the National Colorectal Cancer Roundtable (NCCRT) introduced the Blue Star as the symbol of the fight against colon cancer in 2004. Since then, the Blue Star has been adopted by major groups in the colon cancer community. The star stands for the lives lost to colorectal cancer, and the hope for a better future free of colorectal cancer—that might begin with something so simple as a single screening.

Sources

American Cancer Society. “What are the risk factors for colorectal cancer?” 1 January 2014. http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorect....

Centers for Disease Control and Prevention. “Cancer Prevention and Control: Colorectal Cancer Awareness.” 12 August 2014. http://www.cdc.gov/cancer/dcpc/resources/features/ColorectalAwareness/.

Colon Cancer Alliance. “National Colon Cancer Awareness Month.”2014. http://www.ccalliance.org/awareness_month/.

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