One of America’s deadliest cancers also happens to be highly treatable: Colon cancer. It’s the second most common cause of cancer deaths among U.S. men and women, according to the American Cancer Society (ACS).

Dr. Jennifer Dallas smiles in a white lab coat.
Dr. Jennifer Dallas

Colorectal cancer is a cancer of the colon or rectum and is often referred to as one or the other, depending on where it starts. Both cancers have many features in common. While it can be deadly, oncologist Dr. Jennifer Dallas at Novant Health Cancer Institute – Mint Hill said early detection can make it much easier to treat.  

And the ACS now recommends that people with average risk of colorectal cancer begin screening at age 45. The age was lowered by five years in the most recent guideline update after studies detected increased rates of colorectal cancer in people younger than 50.

“We’re seeing younger patients with colorectal cancer in our own practice,” Dallas said. “It’s also increasing among people who are 50 to 65, but not as much as those under 50 and we don’t know why that’s happening.”

While cases in younger people are on the rise, the rate of colorectal cancer in people 65 and older is decreasing, Dallas noted. This decline is related to the success of screening programs.

How to get screened for colorectal cancer

Colorectal cancer often appears without symptoms, so screening is the greatest chance of catching the disease early. A colonoscopy is the best screening method, Dallas said, but there are other options. Some can opt to take a stool test, which can detect a tumor in someone’s DNA.

“If there is a lesion in the colon that is cancerous, there is an 80 percent chance it will be detected in the stool test,” Dallas said. “Because of that, it’s only an option for people who are at average risk.”

If someone with an average risk chooses to go the route of a stool test and something is detected, a traditional colonoscopy is the recommended next step. The same goes for people who receive a CT colonography, a less invasive, imaging colonoscopy.

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For high-risk individuals, including those with a family history of colorectal cancer or Crohn’s disease or ulcerative colitis, or a personal history of precancerous polyps, a colonoscopy is the preferred screening. They should also begin screening earlier than age 45 if a first-degree relative was diagnosed with cancer before age 50. Talk with your physician if you fall into this category.

“It’s so important for people to get screened, because if we can find it in the polyp stage, then it can be removed and we can prevent many cases of colon cancers,” Dallas said.

Polyps are precancerous growths that form on the lining of the colon. Most are harmless, but some colon polyps can turn into cancer.

Not everyone has the same risk for colorectal cancer

African Americans are disproportionately affected by colorectal cancer. They are about 20% more likely to get colorectal cancer, and about 40% more likely to die from it than most other racial or ethnic groups, according to the ACS. Dallas said African Americans are also typically diagnosed with colon cancer at an earlier age than people who are white.

The reasons for the differences can be complex, but some obstacles include a lack of (or less comprehensive) health insurance or a lack of access to healthy foods.

The same has not been found among Hispanics. The ACS said they are less likely to be diagnosed with colorectal cancer than non-Hispanic whites with incidence rates being 7% lower in Hispanic men and 16% lower in Hispanic women.

Factors that increase the risk of colorectal cancer include obesity (especially in the abdominal area), a high consumption of red or processed meat, smoking cigarettes, drinking an excess alcohol or a lack of fruits and vegetables.

Dallas said many people put off colorectal cancer screening because “everybody kind of dreads that.” However, colonoscopy prep isn’t the burden it once was. Read more here. Others may avoid the screening due to a lack of insurance. Dallas said the Colon Cancer Coalition is a good resource for people without insurance.