While it is difficult to predict which health conditions may affect you in the future, you can look to your family history and lifestyle to offer some hints about what may increase your risk—especially for certain types of cancer. March is Colorectal Cancer Awareness Month and it is a natural time to learn more about any history of this illness in your family and to discuss the importance of screening tests to lower your risk of developing it.

What is colorectal cancer?

Colorectal cancer impacts the large intestine, or the colon and the rectum – the last part of the digestive system – and according to the American College of Gastroenterology (ACG), colorectal cancer is the second leading cause of cancer-related deaths. It is also the third most common cancer diagnosed in both men and women in the United States. However, unlike some other types of cancer– it is highly preventable. With appropriate screening to detect colorectal cancer and to get timely treatment, patients can have more control over their health.

What are some things that can increase risk?

Similar to other illnesses, personal and family history can play an important role. Talk to family and loved ones to find out if anyone in your family has had this type of cancer. Having a first degree relative (mother, father, sibling or child) can increase your risk. If you have had a history of colorectal polyps or inflammatory bowel disease, including conditions like ulcerative colitis (a condition that causes inflammation in the bowels) or Crohn’s disease, that can increase chances of having colorectal cancer. Other personal medical conditions may be associated with an increase in risk for colorectal cancer and lifestyle choices can affect your health as well. Being overweight or obese, smoking or heavy alcohol use, can all increase the risks. It is important to review your family, personal medical history and lifestyle choices with your doctor.

How can you prevent colorectal cancer?

In addition to learning about individual risk factors and making healthy changes, following screening guidelines is just as critical. Screening doesn’t need to be uncomfortable, costly or take a lot of time. There are different options available. The United States Preventative Task Force recommends persons of average risk receive routine colorectal cancer screening between the age of 50-75. Risk factors like family history or other medical conditions can affect the age to start screening, the type of screening test used and the frequency it is performed. African-Americans are diagnosed with colorectal cancer at a younger age and more frequently, when compared with other groups, so the ACG recommends screening for colon cancers beginning at age 45. For people of average risk, ages 50 to 75, the FIT test (Fecal immunochemical test) is an annual noninvasive screening test. The FIT allows patients to collect a small stool sample at home and mail it to a lab for processing. Your physician will contact you with the results and discuss whether more testing is recommended. If your test is positive, indicating blood in the stool, you will be referred for a colonoscopy.

A colonoscopy can be completed as a follow up to a positive FIT test or may be used as a primary screening test as well. This procedure would be performed at a medical office and requires you to be sedated to allow a specialist to look closely for any abnormalities, like polyps (which can be pre-cancerous growths). The results of the colonoscopy, as well as personal and family medical history, help to determine the frequency of this test.

Other screening options are also available so talk with your doctor to determine the best option for you.

In between screenings, what symptoms can you look for? 
Screenings are so important because most early colorectal cancers do not show any symptoms. The goals of screening are to help prevent colon cancer by removing a polyp that could turn into cancer over time or finding a cancer in an earlier stage. If you notice changes like blood in the stool, difficulty in passing stool, and abdominal pain its best to share those concerns with your physician.

Knowing your health history, managing your risk factors and following screening guidelines can make all the difference in preventative care.


Rebecca Fitch, MD was interviewed for this article, and is proud to be a practicing Internal Medicine physician and the Physician Director of Population Care Management with the Mid-Atlantic Permanente Medical group.  Dr. Fitch cares for patients at the Kaiser Permanente Northwest, DC Medical Center. This article was contributed by Kaiser Permanente, a regional not-for-profit health system which provides top-rated care and coverage for its nearly 800,000 members in the Mid-Atlantic region. The organization recently received accreditation from the American College of Surgeons’ Commission on Cancer with commendation and achieved a screening rate of 84.95% for colorectal cancer, according to the 2018 National Committee for Quality Assurance’s Quality Compass® data.  The annual Quality Compass data assesses the performance of nearly 400 Private/Commercial health plans nationwide spanning all lines of business on critical clinical quality and service standards. The annual Quality Compass database includes scores from the Healthcare Effectiveness Data and Information Set, or HEDIS, a tool that is used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service, including medication management, maternal care and respiratory conditions.

WI Guest Author

This correspondent is a guest contributor to The Washington Informer.

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