Colorectal Cancer Archive

In the last decade, overall rates of colorectal cancer have been falling among the general population in the US. However, African Americans are more likely to develop colorectal cancer at younger ages, and to die from it. The reasons for this disparity are unclear, but they are rooted in socioeconomic and racial inequities.

News briefs

The pandemic may have you feeling reluctant to seek medical treatment. But when it comes to cancer care, even a short delay in treatment may lead to deadly outcomes, according to a review of 34 studies published online Nov. 4, 2020, by BMJ. Researchers evaluated treatment delay and survival in more than a million people who had cancer of the bladder, breast, colon, rectum, lung, cervix, or head and neck. Each four-week delay in treatment — whether surgery, radiation therapy, or medication (such as chemotherapy or immunotherapy) — was associated with an increase of 6% to 8% in the likelihood of dying during the study period. Scientists say delays of up to eight weeks and 12 weeks further increased the risk of death. For example, in women who delayed breast cancer surgery by eight weeks, there was a 17% increased death risk; women who delayed surgery by 12 weeks had a 26% increase. Keep in mind, there are lots of unavoidable reasons why cancer treatment might be delayed, such as not being strong enough to undergo procedures or scheduling issues at a treatment center. But if there isn't a good reason to delay, it's best to get treatment as soon as possible.

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In the journals

Colon cancer prevention involves following a healthy lifestyle — for instance, exercising and not smoking — and periodically getting a screening test such as a colonoscopy. But what impact do diet and medications have? A recent review of 80 statistical analyses published over the last 40 years explored this question. The review was published online Oct. 1, 2020, by the journal Gut.

Over all, the results were disappointing in that no specific drug, food, or supplement stood out in the body of evidence. Yet some of the reviewed studies did show a link between a lower risk of colon cancer and use of nonsteroidal anti-inflammatory drugs (NSAIDs) — such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) —and a higher intake of fruits, vegetables, and fiber. But other studies did not.

When do you need to get screened, and how often?

One of the deadliest cancers can be prevented or detected at a curable stage if you follow recommended screening guidelines.

Colon cancer is the second most common cause of cancer deaths in the United States, according to the American Cancer Society (ACS). The good news is that the death rate has steadily dropped over the past several decades among older adults. (However, among people under 55, death rates from colon cancer have grown slowly, but steadily, since 2008.)

Ask the doctors

Q. I have hemorrhoids. Could this increase my risk of colon cancer?

A. In short, no. Hemorrhoids don't cause or increase your risk for colon or rectal cancer. However, the two conditions may be mistaken for one another because they can produce similar symptoms, such as rectal bleeding, itching, and pain.

News briefs

Eating a diet high in foods tied to inflammation — such as processed meat, sweets, and refined grains — is associated with many health problems, including an increased risk for colon cancer, heart disease, stroke, or diabetes. A Harvard study published online May 7, 2020, by Gastroenterology found another potential risk: Crohn's disease, a condition characterized by areas of inflammation throughout the large and small intestines. Researchers evaluated 30 years' worth of self-reported diet information from more than 208,000 men and women. Diets were scored based on foods that promote inflammation. Compared with people who had the lowest inflammatory diet scores, people with the highest scores had a 51% higher risk for developing Crohn's disease. The risk for Crohn's doubled among people who went from a low- to a high-inflammatory diet during the study. The study is observational and doesn't prove that an inflammatory diet causes Crohn's disease. But with so many other risks associated with foods that promote inflammation, it's important to eat as many foods that fight inflammation as possible. In other words, focus on whole, unprocessed foods with no added sugar — such as vegetables, fruits, whole grains, legumes (beans, lentils), fish, poultry, nuts, seeds, a little bit of low-fat dairy, and olive oil.

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Research we're watching

According to a report published March 12 in the journal Cancer, the rate of death from cancer has continued to decline in the United States, dropping on average 1.5% a year from 2001 to 2017. The decline showed up for all ethnic and age groups between 2013 and 2017. The findings were based on cancer incidence data collected by the CDC and the National Cancer Institute.

But not all news was good: the number of new cancer diagnoses in women rose slightly during 2012 to 2016. A more detailed look at cancer deaths among women found a drop in cancer deaths for a majority of the most common cancers, including breast cancer, melanoma, lung cancer, and colorectal cancer. But deaths in women increased when it came to uterine, brain, liver, heart, and pancreatic cancer.

In the journals

Bleeding is a common side effect of anticoagulants (blood thinners). However, people with atrial fibrillation (afib) who take the drug for stroke prevention should not ignore any bleeding from their lower gastrointestinal (GI) tract, as it may signal colon cancer. That study finding was published online Feb. 7, 2020, by the European Heart Journal.

Researchers analyzed 125,418 patients who took anticoagulants for afib. Only 2,576 had lower GI bleeding during the first six months of treatment, regardless of age. Yet those who did experience bleeding had 10 times the risk of being diagnosed with colon cancer during the subsequent year compared with those who hadn't had any bleeding.

Approaches to using laxative solutions for colon cleansing have changed since your last colonoscopy.

Preparing for a colonoscopy isn't fun. Indeed, many people dread the colonoscopy prep more than the colonoscopy itself. Traditionally, you have had to change your diet for a few days, drink quarts of laxative solutions — and then spend hours in the bathroom enduring diarrhea and discomfort as your colon empties. In the past few years, though, the approach to taking laxative solutions has evolved to become a little less unpleasant.

Lower-volume preps

Instead of downing 4 liters of medicated liquid, which was once the standard, most people now need to drink about 2 liters (a bit more than 64 ounces). The reduced volume of laxative fluid is often combined with laxative pills, to help you clear your bowels.

On call

Q. I'm 80 and no longer do colon cancer screening. However, I recently noticed some bleeding from my rectum. Does that change my need for a colonoscopy?

A. Screening for a disease means the person has no symptoms. Since you now have rectal bleeding, a colonoscopy would be considered not a screening test, but a diagnostic test. Whether you have it now or wait to see if more bleeding occurs depends upon many factors. The most important question is whether anything found on the colonoscopy will lead to treatment that improves your quality of life.