The statistics are somewhat grim: Colorectal cancer is one of America’s leading cancers. It is estimated that there will be more than 135,000 new cases of colorectal cancer in 2018 alone, and more than 50,000 people will die from the disease in 2018 alone. 

That’s enough people to fill up the University of Tennessee’s Thompson-Boling Arena more than twice. In the United States, 8.4 percent of all cancer deaths result from colorectal cancer. Only lung cancer claims more lives.

That’s the bad news. The good news is that modern technology and medical advancement has more than given Americans a fighting chance. Nearly 100 percent of all colorectal cancer cases can be caught early, when the disease is beatable. 

To do so, most Americans will need to undergo screenings as they age. The American Cancer Society recommends colorectal cancer screenings start at the age of 50, or at the age of 40 for those with a family history of the disease. 

The screenings aren’t necessarily pleasant. Many comedians have worked the preparation for colonoscopies into their stand-up routines. But for tens of thousands of Americans, they could prove to be life-saving.

On average, when someone is told they have colorectal cancer, their odds of long-term survival are only a little more than six in 10. About 65 percent of colorectal cancer patients survive five years. That’s better than some cancers, but far worse than others.

But that number is an overall number, regardless of how progressed the cancer is when it’s discovered. Among patients whose cancer is still localized — meaning it hasn’t spread beyond the colon or rectum — about nine out of every 10 will survive five years.

The problem is that fewer than half — about four out of 10 — of colorectal cancer cases are discovered at that earliest stage. Nearly as many are discovered only after the cancer has already reached the lymph nodes, and the five-year survival rate drops to about 70 percent. Sadly, almost a fourth of colorectal cancer patients are not diagnosed until their cancer has metastasized to other parts of the body. In those cases, the five-year survival rate drops to a dismal 14 percent. 

The importance of screening

That’s what makes screening so important, experts say. Once symptoms of the cancer show up, the disease has often progressed, causing a poorer prognosis. But with a colonoscopy — a procedure in which a long, thin, flexible tube is inserted into the colon with a tiny video camera and light at the end that sends images to a video monitor — doctors can find these cancers while they’re still highly curable.

There’s even better news: with screenings, the risk for colorectal cancer can be discovered earlier, before it’s cancer at all. Most colorectal cancers are caused by polyps, or growths on the lining of the intestine. These noncancerous or precancerous polyps can be easily and painlessly removed by a doctor during the colonoscopy. 

Because colon cancer grows slowly, it can take as much as 10 years for a polyp to become cancerous. Therefore, repeat screenings aren’t necessary on a regular basis. For people who do not have polyps or risk factors for colorectal cancer, it may not be necessary to have a follow-up colonoscopy for 10 years. Even when a couple of low-risk polyps are removed, the colonoscopy may not have to be repeated for five years — or longer. That’s a long time for peace of mind, especially considering the simple and routine nature of the colonoscopy. 

Signs & symptoms

As colorectal cancers grow, they eventually begin to cause some symptoms as they disrupt the digestive process or press upon neighboring organs. While any number of digestive ailments can mimic signs of colorectal cancer, a few symptoms that could be cause for alarm are a change in bowel habits that lasts more than a few weeks; a feeling of having to have a bowl movement that doesn’t go away even after doing so; rectal bleeding, or dark stools; stomach discomfort, including bloating and abdominal pain; unexplained weakness or fatigue; and unexplained weight loss.

Anyone who experiences any of those symptoms — especially someone of advanced age or who is at heightened risk for colorectal cancer — should consult with their physician to determine whether a referral to a specialist is recommended.

Am I at risk?

There are a few risk factors for colorectal cancer: men are slightly more likely to die of the disease than women, and black people are slightly more likely to die of it than white people. 

But the single biggest risk factor for colorectal cancer is age. It is most common in people over the age of 50. In fact, it’s most common in people over the age of 75. Almost half of all colorectal cancer deaths occur in those aged 75 and older. Colorectal cancer deaths are rare in Americans younger than the age of 50; only about one in every 10 deaths related to the disease occurs in someone aged 49 or younger.

There are other risk factors, though. Colorectal cancer has a genetic component, and anyone who has a parent, sibling or child with colorectal cancer has a higher risk of developing it themselves, especially if that family member was diagnosed before the age of 60. Inflammatory bowel disease, or IBD, which includes ulcerative colitis and Crohn’s disease, puts you at a higher risk for developing colorectal cancer, though other bowel conditions, such as irritable bowel syndrome, do not. Finally, lifestyle can play a role. Being overweight and having an inactive lifestyle can increase the risk for colorectal cancer, as can a diet high in red meat and processed meat or heavy consumption of alcohol. Smoking has been linked to a heightened risk for colorectal cancer, as well.

The most important thing to remember is a colonoscopy at the age of 50, or younger if you have a family history of colorectal cancer or its risk factors. Because of the slow process from polyps to cancer, colorectal cancer is highly preventable.

This article is the March 2019 installment of Focus On: Health, presented on the second week of each month by Brennan's Foot & Ankle Care, Big South Fork Medical Center, Roark's Pharmacy and Danny's Drugs as part of the Independent Herald's Focus On series. A print version of this article can be found on Page A3 of the March 14, 2019 edition of the Independent Herald.