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
- 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.