COLORECTAL CANCER – WHO IS AT RISK?

March 7, 2023

At the start of the COVID-19 pandemic, colorectal cancer screenings dropped roughly 90% and diagnoses fell by 32%.

Regular colorectal cancer screening is one of the most powerful tools against colorectal cancer.

Screening can often find colorectal cancer early, when it’s small, hasn’t spread, and might be easier to treat.

At Acupath, Molecular Biomarker testing helps guide targeted therapy decisions, and advance personalized care for doctors and their patients. Testing for the HER2 protein and/or the Microsatellite Instability (MSI) Panel which checks for changes in any of the mismatch repair (MMR) genes (MLH1MSH2MSH6, and PMS2). EPCAM, another gene related to MSH2, is also routinely checked. Changes in MSI or in MMR genes (or both) are often seen in people with Lynch syndrome (HNPCC). Lynch syndrome is the most common hereditary colorectal cancer syndrome. It accounts for about 2% to 4% of all colorectal cancers. Most colorectal cancers do not have high levels of MSI or changes in MMR genes. But most colorectal cancers that are linked to Lynch syndrome (hereditary non-polyposis colon cancer) do.

Can Colorectal Polyps and Cancer Be Found Early?

A polyp can take as many as 10 to 15 years to develop into cancer. With screening, doctors can find and remove polyps before they have the chance to turn into cancer. Colorectal cancer is a leading cause of cancer death in the US. But the death rate (the number of deaths per 100,000 people per year) of colorectal cancer has been dropping for several decades. One reason for this is that colorectal polyps are now more often found by screening and removed before they can develop into cancers.

When colorectal cancer is found at an early stage before it has spread, the 5-year relative survival rate is about 90%. But only about 4 out of 10 colorectal cancers are found at this early stage. When cancer has spread outside the colon or rectum, survival rates are lower.

Unfortunately, about 1 in 3 people in the US who should get tested for colorectal cancer have never been screened.

Who Is At Risk?

Some risk factors, like smoking, can be changed. Other factors, like a person’s age or family history, cannot.

  • Being overweight or obese
  • Not physically active
  • Diets high in red meat and/or processed meat. Or low in vitamins C, D and E.
  • Smoking
  • Excessive alcohol use
  • Personal and/or family history of adenomatous polyps
  • Inherited gene changes (mutations)
  • Personal history of Inflammatory Bowel Disease (IBD) and if left untreated.
  • People with type 2 Diabetes

Racial and Ethnic Background Risks

Colorectal cancer also disproportionately affects the Black community, where the rates are the highest of any racial/ethnic group in the US. African Americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups. Recently, the actor Chadwick Boseman, from the movie “Black Panther” lost his battle at the age of 43, but this highlights the grim fact on how this highly affects the Black community.

American Indian/Alaska Native people run with close similarity of higher colorectal cancer incidences and mortality rates.

Jews of Eastern European descent (Ashkenazi Jews) also have one of the highest colorectal cancer risks of any ethnic group.

­­Sex and Age Risks

The risk of being diagnosed men vs women: men are generally diagnosed by age 66 and women by age 69. Your sex is no longer a factor of whom is more at risk, as it is the third most common cancer in both.

The 2023 estimates are that 106,970 people will be diagnosed with colon cancer and 46,050 will be diagnosed with rectal cancer. And approximately 52,550 will die from the disease.

Yet, young on-set colorectal cancer is on the rise. In 2020, 12% of cancer diagnosed was in adults younger than 50, and older adult rates are dropping. The incidence rate is increasing by 2% yearly in young adults. Researchers predict that colorectal cancer will be the leading cause of cancer deaths in young adults ages 20-49.

These statistics are compiled from the American Cancer Society’s Cancer Statistics Center.

This information is for educational purposes only.