Colorectal cancer is a disease people prefer not to talk about, but did you know that it is the second most common cancer in Rhode Island? (Lung cancer tops the list.) Colorectal cancer is an equal opportunity disease, affecting both men and women. The death rate from colorectal cancer in Rhode Island is significantly higher than in the rest of the country. It is 34% higher in men and 21% higher in women here in Rhode Island over the national average. This is a disease that early detection can all but eliminate the need for extensive surgery, chemotherapy, and radiation. Certainly early detection can essentially remove the threat of death.

Almost all colorectal cancers start with a very small non-malignant outgrowth of the bowel wall called a polyp. This polyp grows slowly before it transforms into a cancer and invades the bowel wall and, if it remains undetected, will grow deeper and then spread to the lymph nodes, the liver, and the rest of the body. If the polyp is removed, the cancer won't develop. It's as simple as that.

Every person over the age of 50 should be screened regularly for colorectal cancer. A simple procedure is looking for hidden blood in the stool (fecal occult blood test, or FOBT). This should be done every year. However, inspection of the whole colon and rectum using flexible fiber optic scopes is the best way to be sure that a polyp is not hiding somewhere in the colon or rectum. Flexible sigmoidoscopy combined with the FOBT is a routine procedure that is useful. The gold standard is colonoscopy which examines the entire colon and rectum. A negative examination need not be repeated for five or ten years in most people.

Certain individuals, however, are at particularly high risk. Individuals who have had a first-degree relative (father, mother, or sibling) with colorectal cancer are at high risk. Someone having a grandfather, uncle, or aunt would be above the standard risk, but not high risk. For people in this category, colorectal screening should start ten years before the age at which their relative developed the colon-rectal cancer. In addition, individuals with chronic bowel disease, such as Crohn's Disease and ulcerative colitis, should be considered at a higher risk. There are also families that inherit a tendency to polyp formation. These people need to be screened carefully.

Regular screening for colorectal cancer in the entire population over the age of 50 can make this disease history. Very early cancers that have just gotten started can be cured 90 to 100% of the time. However, if colorectal cancer is discovered at a later stage, after it has started to produce symptoms such as change in bowel habits, pain, or visible blood in the stool, by this time it can be less than 50% curable and will require considerable attention from surgeons, medical oncologists, radiation oncologists, and can produce a change in the quality of life and there will be the potential of not being cured at all, dying of colorectal cancer. Regular attention to this screening test can save your life!

For more information and answers to specific questions contact the Rhode Island Cancer Council at Tel@ricancercouncil.org or call us at (401) 728-4800 or toll free 866-879-4100.

IT IS EASIER TO PREVENT CANCER THAN TO TREAT IT.

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