No Ifs, Ands, or Butts!

by Dr. Jon Avery Go

Colon cancer is a major global health issue and a lethal disease affecting millions of individuals each year. It is among one of the most prevalent cancers worldwide and is the leading cancer cause of mortality.

In the United States, more than 150,000 new cases are diagnosed annually.

The incidence of colon cancer was observed to be higher in developed countries compared to developing ones.

This variation is often attributed to differences in lifestyle, dietary habits, and healthcare access.

Notably, colon cancer incidence rates and mortality are higher among Native American, Native Hawaiian, other Pacific Islander, and African populations.

Several factors increase the risk of developing colon cancer. Age is a significant factor, with the risk rising after age 50.

A family history of colon cancer or polyps, especially with hereditary conditions such as Lynch syndrome and familial adenomatous polyposis (FAP), also elevates the risk.

Dietary habits play a crucial role, as diets high in red and processed meats, high in saturated fats, and low in fiber are associated with an increased risk of colon cancer.

Lifestyle factors, including an inactive lifestyle, obesity, smoking, and excessive alcohol consumption, further contribute to this risk. Additionally, chronic conditions such as inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, can also raise the risk.

Symptoms of colon cancer can be subtle and vary depending on the tumor’s size and location. Early-stage colon cancer often does not have any symptoms, which can delay diagnosis.

Colon cancer usually presents in three ways: suspicious symptoms, asymptomatic individuals discovered by screening, and emergency admission with an intestinal obstruction or perforation.

When symptoms do occur, the most common one is a change in bowel habits. Other symptoms may include diarrhea or constipation, blood in the stool, abdominal pain or cramping, unexplained weight loss, and fatigue. Regular screening is crucial for early detection and effective management.

The United States Preventive Services Task Force (USPSTF) recommends routine screenings to start at age 45 to at least age 75 for average-risk individuals.

This is different from high-risk patients which include patients that have had colon cancer, an adenomatous polyp, inflammatory bowel disease, abdominal radiation for childhood cancer, family members with colon cancer, or a documented advanced polyp.

Colonoscopies are the recommended screening option by many expert groups since it is the most accurate and versatile diagnostic test for colon cancer.

Additionally, a biopsy may be performed during a colonoscopy to analyze suspicious tissue and confirm the presence of cancer.

Colonoscopies can also find precancerous polyps that can be removed. Other screening methods include fecal occult blood tests (FOBT), fecal immunochemical tests (FIT), stool DNA tests, and others.

Colon cancer is considered a relatively slow-growing cancer, with benign polyps typically taking an average of 10-15 years to develop into cancer. Treatment for colon cancer depends on the stage of the disease and may involve several approaches such as surgery, chemotherapy, and immunotherapy.

Preventive strategies for colon cancer include several key approaches, one of which is routine screening.

Having a diet with lots of fruits, vegetables, and whole grains, along with engaging in regular physical activity can also help reduce the risk of developing colon cancer.

As colon cancer often does not show symptoms early on, it makes the importance of regular screening more significant.

Remember, screening saves lives. No ifs, ands, or butts about it!

DR. JON AVERY GO is a board-certified Internal Medicine physician. He practices as a primary care doctor at the Primary Care Clinic of Hawaii.