According to the Centers for Disease Control and
Prevention (CDC), colorectal cancer (or colon cancer)
is the second leading cause of cancer deaths in the
United States. It is also the second leading cause of
cancer death in women and the third in men.
Colorectal cancer is a type of cancer that begins in the
colon, also known as the large intestine, where the
digestive tract ends, and usually starts as an abnormal
growth called a polyp. The polyp can be easily
removed before it becomes cancerous and spreads to
other parts of the body. Additionally, while colon
cancer was believed to be most common in older
people, recent evidence shows the disease developing
in adults under the age of 50. This was made apparent
by the sudden death of actor Chadwick Boseman, who
was most famous for his on-screen portrayals of Jackie
Robinson, James Brown, and the Black Panther.
Boseman passed away in August 2020, at the age of
43, after being diagnosed with stage III colon cancer in
2016.
According to the CDC
, the risk of developing colon
cancer rises significantly around age 50, and Black
Americans have the highest rates of the disease,
followed by white people and Latin Americans. While
middle-aged to older Americans are believed to be at
most risk of colon cancer, the number of younger
adults with the disease is rising. The American Cancer
Society estimates that nearly 18,000 people diagnosed
with colon cancer this year will be under the age of 50,
and recommends that people start screening at age
45. Additionally, Black people are 20% more likely to
develop colon cancer and almost 40% more likely to
die from it. Part of this is due to inequities in
healthcare, such as access to qualified healthcare
facilities and total lack of insurance coverage.
Younger people and people with reduced access to
healthcare are more likely to mistake symptoms of
colon cancer for something less serious because they
don't know their risk or symptoms. Symptoms of colon
cancer can include:
● Abdominal pain
● Bloody stool
● Constipation
● Diarrhea
● Weight loss
● Lack of appetite
People might mistake symptoms of colon cancer for
irritable bowel syndrome (IBS) or hemorrhoids.
However, it's possible for colon cancer to have no
symptoms at all, especially in the beginning. This is
why the importance of early screening is stressed.
Younger people and Black Americans are more likely to
be diagnosed with late-stage cancer because they are
less likely to be screened early.
The cause of colon cancer in younger adults is unclear,
but experts believe that genetics play a role. It's
recommended that those with a family history of colon
cancer be screened 10 years before the recommended
age, as well as screening for genetic mutations every
few years. For example, if someone is 35 and has a
family history of colon cancer, they should begin
screening right away instead of waiting until age 45.
However, there are barriers to access these
screenings, as insurance might not cover such
preventive measures due to the person being under
the age of 50. It's important to speak with insurance
providers and confirm whether or not their policies
cover early prevention screenings.
There are several different types of colon cancer
preventive screenings, including a traditional
colonoscopy (an exam of the entire colon), virtual
colonoscopy (a CT scan of the abdomen and pelvis), or
a flexible sigmoidoscopy (an exam of the lower part of
the large intestine). There are also tests that screen
stool for signs of the disease, such as blood or altered
DNA in the stool. It's important that individuals discuss
their options with their doctor and decide which
screening tool is best for them. With a doctor, a
patient will usually discuss their family history, medical
history, and other risk factors (such as chronic IBS)
and decide which procedure to move forward with.
During colonoscopies, patients are sedated and won't
feel pain or discomfort, according to the UT
Southwestern Medical Center. If any polyps are found
in the large intestine, they will be removed during the
procedure. A colonoscopy can easily catch the cancer
early and potentially save the patient's life. In the case
that the polyps are already malignant, treatment is
much easier in the early stage of cancer than it is in
the later stage. The chances of surviving colon cancer
are also significantly higher if the disease is discovered
early.
After diagnosis, treatment usually consists of minimally
invasive surgery, chemotherapy, and radiation.
However, what treatment or combination of treatments
appropriate for the patient is decided on a case-by-
case basis. In advanced stages of colon cancer, the
cancerous part of the colon might be removed, and the
patient's lymph nodes may be removed and tested for
cancer. Drug therapy, immunotherapy, and overall
care focused on reducing pain and discomfort are also
treatments for advanced colon cancer.
The Mayo Clinic outlines several pre-appointment
considerations and questions to ask the doctor, should
a person schedule themselves a colonoscopy. The
American Cancer Society also provides detailed
information regarding screening coverage under
private insurance, Medicare, and Medicaid. Those who
are uninsured might contact their state or local health
department and ask if the department participates in
the CDC's Screen for Life program. Through this
program, participating health departments are
reimbursed for cancer screenings. If diagnosed, a
patient might be able to work out a payment plan at
the hospital to afford treatment.
Cancer is a scary disease, but with prevention
measures and equitable healthcare it can be overcome.
It's also important for people to be diligent about their
health, and not ignore signs and symptoms out of fear.
The earlier a cancer is caught, the easier it is to treat
and the more likely the patient is to survive. If an
individual has questions regarding any aspect of their
health, they should contact their doctor, the health
department, or their local community health center.
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