What are the risk factors for colorectal cancer?
Risk Factors:
• Age: 90% of people with colorectal cancer are over 50.
• Family history of colon cancer: Close relatives (parents, siblings, children) of colorectal cancer patients are at higher risk of developing this disease.
• Personal cancer history
• Diet: high amount of fat and calories and subsequently is low in fiber. High intake of red meat
• Large intestinal polyps
• Medical conditions: Ulcerative Colitis, Crohn’s Disease. Women with a past history of developing breast cancer, ovarian cancer and uterine cancer may have increased risk of developing colorectal cancer.
• Sedentary life: People who lead sedentary life, with not much of physical activity may have a higher risk of developing colorectal cancer.
• Race and ethnic background: higher in Jews of Eastern European descent (Ashkenazi Jews) and African Canadian
• Obesity
• Diabetes: Diabetes may increase the chance of developing colorectal cancer by as much as 40%.
• Smoking: Smoking may increase the risk of developing colorectal cancer by as much as 40%.
• Alcohol consumption: Heavy alcohol consumption may increase the risk of developing colorectal
• Genetic or Family Predisposition: There are mainly two genetic disorders associated with increased risk of colorectal cancer 1. Familial Adenomatosis Polyposis (FAP) 2. Hereditary Non-Polyposis Colorectal Cancer (HNPCC)
What are the tests available today?
There are various methods of screening for colorectal cancer:
1. A fecal occult blood test (FOBT)
Is a simple test that you can perform by yourself, in the privacy of your own home.
It tests for small amounts of blood in your stool. Blood in your stool may be a sign of colorectal cancer. Only 2-5% of people will have a positive FOBT (meaning blood will be found in their stool). A positive FOBT requires follow- up to rule out colorectal cancer. A positive FOBT does not necessarily mean that you have cancer. Most people with a positive FOBT do not have cancer; only about 10% of people are found to have cancer during follow-up.
2. A colonoscopy is an examination of the lining of your rectum and colon using a long flexible tube with a camera on the end. A doctor can view the entire colon to see if there are polyps present. Polyps can be “pre-cancer” and are removed during the colonoscopy.
This procedure requires that your colon and rectum be thoroughly cleaned out; bowel preparation begins the day before the procedure. Typically you will be sedated for this procedure.
3. A flexible sigmoidoscopy is similar to a colonoscopy but only examines the lower colon and rectum (where most cancers develop). This procedure requires some bowel preparation on the day of the procedure.
4. During a double contrast barium enema, barium (a thick fluid that shows up on an x-ray) is gently inserted into your rectum and a series of x-rays are taken to show a picture of your lower colon. This procedure requires the same bowel preparation as a colonoscopy.
5. A CT colonography, also called a ‘virtual colonoscopy’, uses a series of x-rays to make detailed images of the colon. These images show polyps and any other abnormal areas of the colon and rectum. This procedure requires the same bowel preparation as a colonoscopy. CT colonography is still being evaluated and is not currently recommended under Canadian guidelines.
What are the benefits of screening?
FOBT testing helps identify polyps before they become cancerous. There are virtually no symptoms in the early stages of colorectal cancer when the disease is most treatable. When caught early through regular screening, there is a 90% chance that colorectal cancer can be cured.
What is my chance of getting the disease and then dying from it?
In Canada, colorectal cancer is the third most common cancer diagnosed in men and women.
Men: 1 in 14 men is expected to develop colorectal cancer during their lifetime and 1 in 27 will die of it.
Women: 1 in 16 women will develop colorectal cancer during their lifetime and 1 in 31 will die from it.
What is the current screening recommendation?
Men and women age 50 and over should have a fecal occult blood test (FOBT) at least every 2 years. Those at increased risk because of having one or more first-degree family members (e.g., parent, sibling, or child) with colorectal cancer or those with positive FOBT results should get a colonoscopy. Those with other risk factors (such as inflammatory bowel disease or known hereditary conditions) should design a personal surveillance strategy with their health care provider.
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Three easy steps to the FOBT
Step ONE
Get an FOBT kit
Your health care provider will give you an FOBT kit
Step TWO
Collect your samples
You have to collect small samples of your stool on three different days. It’s important to follow the instructions in your FOBT kit carefully.
Step THREE
Mail it in
Once you have collected your samples, mail them in the postage-paid envelope (included in your kit) for laboratory analysis, where a technician will examine your stool.
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