March is Colorectal Cancer Awareness Month. In honor of this and all the patients who have fought and are currently fighting this disease, the Paris Charter Against Cancer would like to contribute to the discussion and present some facts about the disease as well as what you can do to decrease your risk of being diagnosed with colorectal cancer.
Statistics
- It is the third most common cancer globally (an estimated 1.9 million cases were diagnosed in 2020)
- Second most common in men, and third most common in women
- It is the second leading cause of cancer-related deaths in the world
- More than 930,000 deaths occurred in 2020 due to this disease
- Older individuals, aged 50 and above, are most commonly affected
- However, since the 1990s, incidence risk in younger people has been rising by 1-2% on average each year
Institute for Health Metrics and Evaluation (IHME) Graphs of Death and Incidence Rate of Colorectal Cancer 1990-2019
Institute for Health Metrics and Evaluation (IHME) Map of Colorectal Cancer Deaths per 100,000 for both sexes 2000 vs 2019
What is Colorectal Cancer?
Colorectal cancer is cancer of the colon (large intestine) or rectum. It’s also referred to as bowel cancer. The first signs of this disease are typically the formation of polyps (small clumps of cells that form in the lining of the colon or rectum). Different types of polyps (Adenomatous, Hyperplastic, Inflammatory, Sessile Serrated (SSPs), and Traditional Serrated Adenomas (TSA)) can occur, each with varying risks of turning cancerous, and all should be taken seriously. Over time, these polyps can grow into the wall of the rectum or colon, spread from there to the other layers of the colon and rectum, and potentially metastasize to other parts of the body after the cancerous cells have reached the blood and lymph vessels.
Who does Colorectal Cancer primarily affect?
The risk of being diagnosed with colorectal cancer increases with age. It’s much more common in people aged 50 years or older, and also more prevalent in men than women. Additionally, having a family history of colorectal cancer or colorectal polyps (specifically adenomatous polyps) presents a higher risk of developing colorectal cancer.
Certain ethnic groups are at a higher risk as well, in particular, Ashkenazi Jews as a portion of the population carries the Adenomatous Polyposis Coli (APC) mutation, which causes an increased risk of developing multiple polyps as the mutation disrupts the function of the APC gene.
Other conditions such as Inflammatory Bowel Disease, Lynch Syndrome (otherwise known as Hereditary Non-Polyposis Colon Cancer or HNPCC), and Familial Adenomatous Polyposis (FAP), are at a higher risk of developing colorectal cancer. Peutz-Jeghers Syndrome (PJS), MUTYH-associated polyposis (MAP), and Cystic Fibrosis (CF) have also been linked to an increased risk of colorectal cancer. In addition, people diagnosed with Type 2 Diabetes are at an increased risk and often have a worse long-term prognosis after being diagnosed.
Prevention & Screening
Several things can be done to decrease a person’s risk of being diagnosed with colorectal cancer. Many of these are lifestyle-dependent. There is strong evidence that being physically active, having a healthy balanced diet rich in fruits and vegetables, not smoking, limiting alcohol consumption, and avoiding exposure to environmental risk factors such as exposure to unsafe chemicals such as asbestos and cadmium, radiation, etc.
Regular screening (colonoscopies) is incredibly important as early detection can significantly increase the prognosis after diagnosis The 5-year survival rate for an early diagnosis is nearly 90%, however, the majority of colorectal cancers are found after the cancer has already spread out of the colon or rectum. Regular screenings can allow doctors to find and remove polyps before they become cancerous, thus reducing the risk of being diagnosed with colorectal cancer.
