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Published on September 14, 2020

What You Need to Know About Colorectal Cancer

The sudden passing of actor Chadwick Boseman made big headlines recently. After being diagnosed with stage III colon cancer, Boseman fought for four years before passing away at just 43 years old. The news of his death was a surprise to many.

Colorectal cancer is the third leading cause of cancer death in men and women in the United States. Close to 150K Americans will receive a new diagnosis of colorectal cancer by the time the year is over, and about 50K will succumb to the disease.

What is Colorectal Cancer?

Colorectal cancer includes cancers in the colon or rectum.  Colorectal cancer almost always begins as a polyp, or noncancerous growth that can develop into a malignant or cancerous polyp. These polyps can take many years, sometimes even 10 or 15 years, to become malignant. This means that if caught in the early stage, polyps can be removed before they even become malignant. Polyps and colon cancer can be detected through screening, including colonoscopies and FIT tests.  Colonoscopies are the gold standard of screening because polyps can be both seen and removed during colonoscopy.

Risk Factors and Prevention

Colorectal cancer represents about 8 percent of all new cancer diagnoses in the United States. This type of cancer is a bit more common in men than women, but in both, the lifetime risk falls between 4 and 5 percent. The risk is two to three times higher in those with a family history of polyps or colon cancer. In both men and women, colorectal cancer is most common in adults over the age of 50, which is why screening in average-risk adults typically starts at age 45. However, some individuals are at higher than average risk based on health history. Lifestyle factors can increase one’s risk as well.

  • African Americans are statistically at a higher risk than other races
  • Individuals with a family history of colorectal cancer or colon polyps are at increased risk
  • Individuals who have one of the below health conditions are at increased risk:
    • Ulcerative Colitis
    • Crohn’s Disease
  • Smoking, alcohol use, weight, diet and age can impact risk

Those with increased risk of developing colorectal cancer may begin screening at a younger age, at their doctor’s advice.

While the risk of colorectal cancer generally increases as you get older, in recent years, there has been an uptick in colorectal cancer diagnoses in younger adults under the age of 50. 

“Research is underway to better understand the reason for the increase in colorectal cancer cases in adults under 50; however, diet, overall health, lifestyle and the environment may certainly be factors,” explains Harvey Guttmann, MD, chief, Gastroenterology Division, Abington – Jefferson Health.  “These days, we all live very fast-paced lives. Realistically, this means that we are eating more on the go and eating homemade, wholesome meals less often. A diet that is rich in fruits, vegetables, whole grains and proteins is important. You should also limit your sugar and red meat intake, alcohol use and avoid smoking to lower your risk of developing colorectal cancer, and other cancers, too.”

Dr. Guttmann explains that while all of these aspects individually may not cause colorectal cancer, together, they can impact your body’s microbiome, or, the bacteria in the colon, which indirectly effects overall health – risk for cancer, depression, heart disease and more. “A healthy diet and lifestyle is important for so many reasons,” Dr. Guttmann reiterates.

Signs and Symptoms

Often, early stage colorectal cancer does not have symptoms. The symptoms usually become more prominent as the cancer progresses.

The most common symptoms can include:

  • Abdominal pain
  • Anemia
  • Visible bleeding from the rectum
  • Microscopic blood in stool
  • Dark or black stool
  • Change in bowel movements
  • Constipation
  • Diarrhea
  • Decreased appetite
  • Unintentional weight loss

It’s important to note that symptoms vary based on the location of the cancer. “For instance, in younger people, we tend to see an increase in colorectal cancer lower in the colon and rectum, which means that those individuals will have more symptoms like changes in bowel habits, abdominal pain and most notably, rectal bleeding,” Dr. Guttmann explains.  “But, depending on the specific location of the cancer, symptoms can be different and more or less apparent. If the cancer is on the right side of the colon, symptoms may be more subtle.”

The symptoms of colorectal cancer can be similar to symptoms of a generally sensitive digestive system, irritable bowel syndrome or inflammatory bowel disease. The bleeding associated with colorectal cancer can sometimes be mistaken for hemorrhoid bleeding.  For these reasons, it is important to take notice of any changes in your body and health, and to avoid self-diagnosis. If symptoms arise and continue for more than a few weeks, see a doctor.


While the symptoms of colorectal cancer are not always detectable in the early stages, colorectal cancer is preventable through screening. Colonoscopies, which are routinely suggested for average-risk adults beginning at age 45, can detect polyps in their early growth stages, before they are cancerous. Detected polyps can be removed, preventing them from becoming colorectal cancer.

At-home Fecal Immunochemical Test (FIT Test) kits are another screening method used to identify and remove polyps before they become a health risk. This test is used as an alternative to a colonoscopy, but is less sensitive and specific than colonoscopy, and needs to be performed on a yearly basis as well to be most beneficial.

Individuals who are at increased risk due to family history or personal health conditions should be screened more often and beginning at a younger age.

If you are an average-risk adult under the traditional colorectal cancer screening age, it is important to be tuned in to your body and health status. If you experience ongoing symptoms that might suggest colorectal cancer, contact your doctor for consultation and possible evaluation. 

Find a Doctor

It’s important to see a primary care physician regularly to maintain your health, but it’s especially important to schedule a visit with your primary care physician or a specialist if you are experiencing these symptoms. To find a doctor, call Abington – Jefferson Health’s Physician Referral Service at 215-481-6334 or search online.

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