9 things you should know about colorectal cancer

Colorectal cancer is one of the most common cancers in the United States, and its incidence is shifting to include young people in recent years. While these facts can be scary, colorectal cancer is preventable and treatable if caught in its early stages.  

To find out your risk for colorectal cancer, take our free, confidential colon cancer health risk assessment. Your results will be emailed to you and there’s no further obligation. 

1.  The colon and rectum are connected inside of the large intestine. 

• The large intestine is the last part of the digestive tract. It contains the colon (the longest part), rectum and anus. 
• Colon cancer and rectal cancer are often grouped together as colorectal cancer, but each has its own treatment guidelines. Anal cancer is not considered a colorectal cancer. 

2.  Colorectal cancer is one of the most common cancers in the U.S. 

• Colorectal cancer is the third most diagnosed cancer and the second cause of cancer-related death in American men and women combined. 
• The lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women. 
• Colorectal cancer develops in people of all races and ethnicities, but is highest in African Americans, American Indians and Alaska Natives, as well as Jewish people of Eastern European descent (Ashkenazi Jews). 

3.  Colorectal cancer is on the rise in younger adults. 

• Colorectal cancer occurs more often in people over 50 years old, but in recent years rates have risen dramatically in people younger than 50. 
• Approximately 20% of colorectal cancer cases are diagnosed in people 54 and younger. 
• People born after 1990 are two times more likely to develop colon cancer, and four times more likely to develop rectal cancer than those born in 1950. 
• Younger patients are more likely to have colorectal cancer in later stages when diagnosed. 

4.  Most colorectal cancers start as polyps. 

• Colorectal polyps are non-cancerous growths. Many, not all, have the potential to turn into cancer. 
• Most of the pre-cancerous polyps take several years to grow into cancer. 
• 90-95% of colorectal cancers are adenocarcinomas arising from the lining of the colon and rectum, and many of these likely started as precancerous polyps that became adenocarcinoma over time. 

5.  Symptoms of colorectal cancer can be misleading. 

• Symptoms of colorectal cancer include unexplained or unplanned weight loss, rectal bleeding, change in bowel habits, change in color or shape of stool and/or belly or back pain. Some of these symptoms are similar to non-cancer conditions, so people may not be alarmed by their symptoms and/or may be misdiagnosed. 
• Colorectal cancer often does not cause symptoms until it is in advanced stages, which is why screening to find precancerous polyps is so important in preventing colorectal cancer. 

6.  Colorectal cancer screening saves lives. 

• The rate of people over 50 being diagnosed with and dying from colorectal cancer has dropped over the last three decades due, at least in part, to more people getting recommended screening tests. 
• Colorectal screening can detect cancer in earlier stages, when it’s more treatable and has a higher survival rate. It can also detect and remove precancerous polyps which can prevent colorectal cancer. 
• There are several colorectal screening tests including home stool tests such as (Fecal Immunohistochemistry Test (FIT)) and a stool DNA test in addition to visual tests such as a colonoscopy, which looks at your large intestine through a flexible lighted tube called a scope. 
• Colorectal surgeons and gastroenterologists consider colonoscopy the gold standard for screening. Colonoscopy allows doctors to take tissue samples (biopsies), remove pre-cancerous polyps and cancer contained within the colon (in situ) and tattoo tumors for future surgery. Any other screening test may require the person to get a colonoscopy for further evaluation. 
• Colonoscopy may not be the best choice for everyone due to reasons such as costs, transportation and existing medical conditions. The best test to start with is the one you are willing and able to do. 
• If you want to know when you should be tested for colorectal cancer, take our colorectal cancer risk assessment. It’s a free, confidential tool that will help you identify your risk for colorectal cancer. 

7.  Colorectal cancer screening should start at 45 for people at average risk. 

• American Cancer Society and the U.S. Preventive Services Task Force lowered the age of colorectal screening to 45 for people with an average risk (no personal or family history of polyps or colorectal cancer or any of the risk factors listed in the next section). 
• If you have symptoms of colorectal cancer, you should see a doctor sooner. 

8.  Colorectal cancer screening is recommended at an earlier age for people considered high risk. 

• Family history of colon cancer/adenomatous polyps, especially in a first-degree relative who was younger than 50 years old when diagnosed. Screening is usually recommended 10 years prior to the age the relative was diagnosed. 
• Inflammatory bowel disease (Crohn’s disease/Ulcerative colitis) for eight or more years will require routine colonoscopies to check for pre-cancerous changes. 
• Family history of an inherited colon cancer syndrome such as lynch syndrome or Familial Adenomatous Polyposis (FAP) will require colonoscopies at a much younger age. 

9.  You can take an active role in preventing and reducing your risk of getting colorectal cancer. 

• Don’t smoke. 
• Maintain a healthy weight.  
• Exercise and increase physical activity. 
• Eat a healthy diet high in fruits, vegetables and fiber and low in red and processed meats. 
• Limit alcohol consumption. 
• Know your family history (you can still get colorectal cancer without a family history). 
• Pay attention to your body and report symptoms to your doctor. 
• See your doctor routinely and get recommended screening exams. 

As part of Sarah Cannon, the Cancer Institute of HCA Healthcare, our family of hospitals provides comprehensive cancer services with convenient access to cutting-edge therapies for people facing cancer in our communities. Our oncology expertise ensures you have access to locally trusted care with the support of a globally recognized network. 

Have colorectal cancer questions? askSARAH can help. Our specially trained nurses are available 24/7, and all calls on this dedicated helpline are confidential. Call askSARAH at (804) 591-4152 or visit the HCA Virginia Health System website. 

It is important to know that the information in this post is accurate as of the publishing date. This blog was originally written for Sarah Cannon. It was medically reviewed and repurposed for HCA Healthcare Capital Division in 2024.