As the fourth most common cancer diagnosed in the U.S., colorectal cancer poses a significant health concern for many people, especially older adults. Approximately 4.1% of men and women will be diagnosed with it during their lifetime. It's most often diagnosed in people aged 65 to 74. The good news is that new cases have decreased by about 30% from 1985 to 2022 due to increased awareness and routine screening. ¹

All about colorectal cancer

So, what exactly is colorectal cancer? It's cancer that starts in the colon or rectum, usually beginning as a growth called a polyp. While many polyps are benign, some can change and become cancerous.

There are two main categories of polyps: adenomatous polyps (adenomas) and hyperplastic/inflammatory polyps. Adenomas carry a higher risk of becoming cancerous over time. 

Most colorectal cancers are adenocarcinomas, which start in the mucous-producing cells that lubricate the colon and rectum. The larger the polyp and the more abnormal the cells, the greater the risk of it becoming cancerous. Colorectal cancer starts in the innermost layer of the colon or rectum wall but can spread to other parts of the body.

Researchers aren't entirely sure what causes colorectal cancer, but they've identified several risk factors. Risk factors you can’t control, or change include:

• Age
• Family history of colorectal cancer or polyps
• Inflammatory bowel disease (IBD)
• Inherited syndromes such as Lynch syndrome or familial adenomatous polyposis
• Ethnic background
• Type 2 diabetes

Many lifestyle habits can be changed, including being overweight or obese, physical inactivity, a diet high in red and/or processed meat, cooking meats at high temperatures, smoking, and heavy alcohol use.

Screening tests to help detect colorectal cancer

Regular colorectal cancer screening is one of the most powerful tools we have against this disease. Unfortunately, a significant number of people who should be tested aren't. Screenings can often find cancer early, when it's easier to treat. The American Cancer Society recommends that individuals aged 45 to 75 be screened for colorectal cancer. If you're older than 75, talk to your healthcare provider about whether screening is right for you.²

Several tests are available:

• Stool-based tests: Fecal immunochemical test (FIT), guaiac-based fecal occult blood test, and stool DNA test
• Visual (structural) exams: Colonoscopy, CT colonography (virtual colonoscopy), and flexible sigmoidoscopy

Planning for a colonoscopy

It’s natural to feel uncomfortable or nervous about scheduling a colonoscopy, primarily because the screening does require preparation and causes anxiety.

• Ask your doctor for prep instructions well in advance and review them carefully.
• Plan ahead so your prep day is as stress-free as possible. Stock up on clear liquids to make the laxative solution more tolerable.
• Stay focused on your goal: reducing your risk of colorectal cancer!
• Talk to your provider about all your screening options.

How colorectal cancer is treated and prevented

If a polyp or tumor is found during a colonoscopy, a biopsy can be performed to check for cancer. If cancer is detected, a pathologist will determine how deep it has spread, which helps doctors stage the cancer. Cancer is staged in numbers 0 to 4 with the higher numbers indicating more advanced cancer.

Treatment depends on the type and stage of the cancer and may include surgery, radiation therapy, chemotherapy, or targeted therapy. Your care team will guide you through each option and what to expect

Life after colorectal cancer can be both exciting and scary. Work with your healthcare team to create a survivorship plan that includes:

• Follow-up exam and testing schedules
• A list of potential side effects and when to seek help
• Healthy lifestyle tips including diet and exercise recommendations

Colorectal cancer survivors are at greater risk of recurrence, but there are steps you can take to reduce that risk.

Colorectal cancer is a serious disease, but with awareness, screening, and healthy lifestyle choices, you can significantly reduce its impact. Talk to your doctor about your risk factors and the best screening options for you. Your health is worth it!

This blog is based on insights shared in Conviva on Demand: Colon screenings: What are the options?, available on the Engagement Hub.

Content contained on this page is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before starting any new fitness or dietary plan. References are provided for informational purposes only and do not imply endorsement of any website or other sources. For any health-related questions, contact your healthcare provider.

• “Cancer Stat Facts: Colorectal Cancer,” National Cancer Institute. SEER Cancer Statistics Factsheets: Colon and Rectum Cancer, last accessed March 17, 2025, https://seer.cancer.gov/statfacts/html/colorect.html
• “Colorectal Cancer Screening,” U.S. Preventive Services Task Force, last accessed on March 17, 2025, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
• “Can Colorectal Polyps and Cancer be Found Early,” American Cancer Society, last accessed on March 17, 2025, https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/detection.html
• “Colorectal Cancer”, American Cancer Society, last accessed March 17, 2025, https://www.cancer.org/cancer/types/colon-rectal-cancer.html
• “Colorectal Cancer- Patient Version,” National Cancer Institute, last accessed March 17, 2025, https://www.cancer.gov/types/colorectal
• “Colon Cancer Facts,” Colon Cancer Coalition, last accessed March 17, 2025, http://coloncancercoalition.org/get-educated/what-you-need-to-know/colon-cancer-facts/
• “Preparing for a Colonoscopy,” Harvard Health, last accessed March 17, 2025, https://www.health.harvard.edu/diseases-and-conditions/preparing-for-a-colonoscopy