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Colorectal cancer – what you need to know

Not too long ago, colorectal cancer was not typically on the radar of folks who were parenting babies and toddlers, but it’s time for that to change. 

Cedrek McFadden, a physician who specializes in colon and rectal surgery at Prisma Health-Upstate, said younger people are now being diagnosed with more advanced cases of colorectal cancer. 

“Traditionally, we have thought of it as being a disease that your risk of increases as you get older – so the older you get, the higher the risks are,” McFadden said. 

While that is still true, cases have declined overall because of increased awareness and screening. 

“We’ve seen increasing numbers in those who are younger than 50,” McFadden said. “It’s been a paradigm shift.”

Colorectal cancer is primarily found when a person either has symptoms or a screening test. Typically, screening has not been routine until age 50. 

“I’ve known patients who were pregnant or just had a baby who perhaps had some bleeding,” McFadden said. “Everybody – they and their doctor – thought maybe it was just hemorrhoidal bleeding, and it gets treated as hemorrhoids, but that bleeding persists. That could be representative of cancer, so that’s why we have to pay attention to symptoms regardless of age, because that could indicate we need to do screening.”

When considering what to look for, McFadden said someone with colorectal cancer may not have symptoms at all. For those who do, rectal bleeding, changes in bowel habits, abdominal pain or changes in weight (primarily, unexplained weight loss) should be considered issues to address with your doctor. McFadden said patients should be persistent and ask for a second opinion if needed. 

“Ultimately, we have to know what’s normal for us, and recognize when there has been a change,” he said. “Just because you have these symptoms, it doesn’t mean you have cancer.”

But it does mean you should not ignore the changes.

If screening is indicated, the type ordered will depend upon a variety of factors, including family history, symptoms, age and more. That could mean a colonoscopy will be needed. 

Other possibilities include at-home kits such as Cologuard (typically done every 3 years), which looks for DNA in the stool. It requires a prescription and involves collecting stool at home and mailing it in via a test kit. A FIT (Fecal Immunochemical Test) is also done at home. It looks for blood in the stool and is done every year. A fecal occult blood test involves mailing stool samples on a card. It looks for hemoglobin in the stool. A positive result from any of the at-home tests may indicate a need for a colonoscopy. McFadden said patients should check with their insurance carrier to determine what tests are covered and if a colonoscopy is covered following a different type of test, if needed. 

Risk factors for colorectal cancer can include the historical factor of advancing age, family history, obesity, a diet high in red or processed meat, high alcohol intake and certain bowel diseases. 

“African-Americans have a higher risk and higher risk of dying from colorectal cancer,” McFadden said. 

To help reduce your risk, McFadden advises patients to have colorectal cancer screenings, eat a diet low in red or processed meat, eat grains and whole foods and maintain a healthy weight.