Health and Fitness

March 27, 2007

Taking Care

Early screening and awareness is your best bet at preventing colorectal cancer

Did you know colon cancer is the second leading cause of cancer death in the United States? Kaiser Permanente is participating in National Colon Cancer Awareness Month, a prevention campaign that spotlights the disease. Kaiser Permanente wants its members to understand their risks and the importance of regular colon cancer screening.

Cancer is the growth of abnormal cells in the body. These cells grow together and form masses, or tumors. In colorectal cancer, these growths occur in the large intestine. Cancers of the colon and the rectum are often talked about together as colorectal cancer because they have so much in common.

Colorectal cancer is the third-most common cancer in men and women in the United States. It occurs most frequently in people age 50 and older. When caught in its early stages, the disease is easily treated and often cured. But if it is not discovered early, colorectal cancer frequently is fatal.

The exact cause is unknown, but most cases begin as polyps, which are small growths inside the colon or rectum. Colon polyps are very common, and most of them do not turn into cancer. Most polyps are easily found through simple screening tests and can be removed.

Who is at risk?
The primary risk factors for colon cancer include:

• Age: Most cases of colon cancer are diagnosed in men and women age 50 and older.
• Family medical history: You are more likely to get colon cancer if one of your parents, brothers, sisters, or children has had the disease.
• Personal medical history: Your chances of getting colon cancer are higher if you have had inflammatory bowel disease, colon polyps, or colon cancer in the past.
• Lifestyle: Your risk is heightened if you have a diet high in calories, protein, and fat (especially animal fat); if you smoke, are overweight, not physically active and drink more than two alcoholic drinks a day.

Colorectal cancer in its early stages usually does not cause detectible symptoms. When symptoms do occur, the most common are:

• Pain in the belly, especially gas pains, cramps, or a feeling of fullness.
• Blood in your stool or very dark stools.
• A change in your bowel habits (such as more frequent stools or a feeling that your bowels are not emptying completely).

Other, less common symptoms of early-stage colorectal cancer include fatigue and, in rare cases, unexplained weight loss.

If your doctor thinks that you may have colorectal cancer, you will need a test, called a colonoscopy, that lets the doctor see the inside of your colon and rectum. During this test, your doctor will remove polyps or take tissue samples from any areas that appear abnormal. A pathologist will then look at the tissue under a microscope to see if it is cancerous. Sometimes other tests, such as a barium enema, are used to diagnose colorectal cancer.

Treatment depends on where the tumor is and how far it has grown into the wall of the colon. In most cases, surgery is used to remove the cancer. Sometimes radiation or chemotherapy is also used. These treatments have side effects, but the side effects usually are manageable with drugs or home care.

How can I prevent colorectal cancer?
Fairly simple screening tests can prevent many cases of colon and rectal cancer. Regular screening is recommended for most people age 50 and older. If you have a family history of colorectal cancer, you may need to begin screening earlier than that. The most common screening tests include:

• Fecal occult blood test: A small stool sample is sent to your doctor or health facility. A testing solution is dropped onto the sample. A change in the color of the solution means there is blood in the stool.
• Sigmoidoscopy: A doctor inserts a flexible viewing scope through the rectum and into the first part of the colon. This test allows the doctor to see the lower portion of the intestine, which is where most colon cancers grow.
  Barium enema: Barium, a whitish liquid, is inserted through the rectum into the colon. The barium outlines the inside of the colon so that it can be more clearly seen on an X-ray.
• Colonoscopy: A doctor inserts a long, flexible viewing scope through the rectum and into the colon. The scope is usually linked to a video monitor similar to a TV screen. This test allows the doctor to see the entire large intestine.

By making wise choices, you can greatly reduce the risk of colorectal cancer. Eat a healthy diet of fruits, vegetables, and whole grains each day. Eat less red meat and processed foods, and limit alcohol consumption. Maintain a healthy weight and exercise regularly. And quit smoking!

Kaiser Permanente encourages early screening for colon cancer. Talk with your doctor about when and how often to get screened. Early detection can find colon cancer even before symptoms occur. And screening helps find and remove polyps before they turn into cancer. Don't delay – a screening may save your life!

To learn more about our preventive care guidelines for a healthy lifestyle and for staying up-to-date with recommended screening tests and immunizations, visit www.kp.org or talk to your doctor.