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In the United States colorectal cancer is the third most common cancer diagnosed in men and women, with its combined numbers being the second-most common cause of death of both sexes over the age of 50.
The lifetime risk of developing colorectal cancer for men is 1 in 24, women 1 in 26. In those younger, the rate of colorectal diagnoses has increased 2.4% per year from 2012 to 2021.
With early detection of the disease a key player in one’s outcome after diagnosis, March is designated as Colon Cancer Awareness Month, which aims to bring awareness to the diseases and the importance of health screenings.
What it is
Colorectal cancer is a cancer that starts in the colon or rectum, with the two often grouped together due to common features. According to the American Cancer Society (ACS), the most common start of these types of cancers are polyps, or growths, that start in the lining of the colon or the rectum. While polyps are quite common especially as one ages, they can turn into cancer, though the type of polyp has different chances of turning cancerous.
Adenoma polyps are often referred to as a precancerous condition, with hyperplastic and inflammatory polyps common but generally not precancerous, and sessile serrated and traditional serrated adenomas often treated like adenomas due to their higher risk of turning into cancer.
When colorectal cancer forms in a polyp, it can grow into the walls of the colon or rectum, both of which are made up of several layers. Once the cancer cells are in the organ’s walls, they can grow into blood or lymph vessels, traveling to nearby lymph nodes or to other parts of the body.
The amount of the cancer’s spread determines what stage the cancer is at, ranging from Stage 1 to 4. The stages are based on the size of the tumor, spread to nearby lymph nodes and spread to other parts of the body. Generally, a lower stage means the cancer has less spread.
The ACS states that some lifestyle factors have been linked to colorectal cancer: being overweight, Type 2 diabetes, smoking, alcohol use and potential diets.
Factors beyond one’s control are age, racial and ethnic backgrounds, your sex at birth, those who have had their gallbladder removed, personal history of colorectal polyps or cancer, history of inflammatory bowel disease, history of radiation to the pelvic or abdominal area, inherited syndromes and a family history of colorectal cancer.
Symptoms and detection
For many people, the recommendation is to have their first colonoscopy at age 45 and every 10 years after that, five years if there may be an increased risk present. However, with the increase in younger people being diagnosed with colorectal cancer, there are signs and symptoms one should be aware of to know when to talk to their doctor.
The ACS lists the following as the common signs and symptoms of colorectal cancers:
• A change in bowel habits that lasts for more than a few days
• Rectal bleeding with bright red blood
• Blood in stool
• Feeling that you need to have a bowel movement that offers no relief
• Cramping or abdominal pain
• Weakness and fatigue
• Unintended weight loss
While people with colon polyps may not have any symptoms, the following can occur in some:
• Bleeding from the rectum
• Change in stool color
• Change in bowel movements
• Abdominal pain
• Low red blood cell counts due to low iron levels
As many of these symptoms can be caused by other conditions or factors, it is important to talk to your doctor to determine if further testing is needed.
The first step will be a physical exam and medical history. For some, a stool test may be necessary to check for blood not visible to the naked eye. Blood work can look for different indications of cancer.
A diagnostic colonoscopy may be performed where a doctor looks at the entire length of the colon and rectum, and can biopsy any concerning areas if needed; in the case of suspected rectal cancer, a proctoscopy will be performed. Ultrasounds or MRIs might be conducted to look for tumors in other areas of the body.
Treatment and outlook
The main treatment for early-stage colorectal cancer is surgery. In cases of colon cancer, surgery can be to remove polyps or a section of the colon. In some cases, the entire colon is removed.
Surgery is often the first step as well for rectal cancer, with radiation and chemotherapy afterwards. Some stages will require the removal of the rectum.
Radiation, chemotherapy, immunotherapy and targeted therapy drugs for colorectal cancer may also be used.
The five-year relative survival rate for a specific stage of colorectal cancer is about 80%. ACS numbers from 2014 to 2020 for colon cancer ranges from 91% localized to 13% distant colon cancer location. In rectal cancer, the number range from 90% localized to 18% distant. It is important to note that those numbers apply to whatever stage the cancer was first diagnosed at.
Regular screenings are the best option for preventing colorectal cancers. It can take abnormal polyps 10 to 15 years to develop into cancer, making early detection important. Finding colorectal cancer early can increase the chances of catching it when it’s still small and hasn’t spread, making it easier to treat.
Iowa numbers
The 2023 Cancer in Iowa Report stated that Iowa ranks the eighth highest in the national for new cases of colorectal cancer. For cancer overall, Iowa ranks second in the nation for highest and fastest growing rate of new cancers.
In 2024, estimated new colorectal cancers in Iowans made up 1,600, or 7.9%, of the total new cancers. There were an estimated 550 colorectal cancer deaths, a 9.0% rate. Those living as survivors of colorectal cancer in the state totaled 15,765, 9.3% of the total cancer survivors. Studies showed that compared to non-drinkers, heavy drinkers have a nearly two times more risk of developing colorectal cancer; Iowa has the fourth highest incidence of alcohol-related cancers in the United States, and the highest of Midwest states.
Comprehensive cancer care at Clarke County Hospital
Locally, Clarke County Hospital emphasizes the importance of annual wellness exams and encourages individuals to openly discuss their health with their primary care provider. Early detection plays a vital role in preventing and combating colon cancer. Clarke County Hospital offers a variety of colon cancer screening options, including colonoscopies, which can identify cancer in its earliest stages when treatment is most effective.
Depending on age and risk factors, your primary care provider can help determine the best screening method for your individual needs. CCH has two gastroenterologists, Dr. Nagendra Myneni and Dr. Archana Verma, as well as two general surgeons, Dr. Dapka Baccam and Dr. Paul Conte, who can perform colonoscopies.
Recognizing the importance of early detection, national guidelines recommend that individuals aged 45 and older begin regular colon cancer screenings to improve the chances of identifying cancer early when treatment is most effective. Patients are encouraged to consult with their primary care provider to determine the most appropriate screening option based on individual risk factors.
To enhance its cancer care services, CCH partners with Mission Cancer + Blood to provide expert oncology care on-site in Osceola. Dr. Amy Hughes, an oncology physician from Mission Cancer + Blood, and her team visit Clarke County Hospital three times per month to deliver personalized, compassionate care. Dr. Hughes collaborates with CCH’s Diagnostic Imaging department, Lab, Pharmacy, and Infusion department to ensure patients receive comprehensive cancer treatment close to home.
CCH is equipped with state-of-the-art technology, including an in-house MRI and CT scanner, which play a vital role in cancer detection. These advanced imaging tools help identify tumors, assess their size and location, and determine if cancer has spread. MRI scans are particularly effective in detecting brain, spinal, and soft tissue tumors, while CT scans are often used to identify cancers in the chest, abdomen, and pelvis. Both technologies provide detailed imaging that aids in diagnosis, staging, and treatment planning.
By offering advanced diagnostic tools and on-site oncology care, CCH ensures patients have access to high-quality cancer care while remaining close to their loved ones and support network.
Colon cancer is preventable, treatable, and beatable when detected early. To prioritize your health and well-being, questions about colon cancer screenings or cancer care services at CCH or to schedule an appointment, contact CCH at 641-342-2128.