Colorectal Cancer

Colorectal cancer starts in the colon or rectum. Colon and rectal cancers begin in the digestive system, also called the gastrointestinal (GI) system.

In most cases, colon and rectal cancers develop slowly over a period of several years. Colon and rectal cancer have many features in common and are often referred to as “colorectal cancer.” Most colorectal cancers begin as polyps. Colorectal polyps are tiny, grape-like growths inside the colon or rectum that may become cancerous.

Colorectal cancer is the third most common cancer in both men and women, and the second most common cause of U.S. cancer deaths when men and women are combined. Each year, an estimated 6,600 Illinoisans will be diagnosed with colorectal cancer, and more than 2,400 people will die from it. Screening tests, including colonoscopies, are one of the best ways to prevent colorectal cancer. Screening can often find colorectal cancer early, when it is most likely to be cured.

Facts: According to the Illinois State Cancer Registry 2017 data, 3,201 new colorectal cancer cases were diagnosed in males and 2,872 colorectal cancer cases in females. Out of these cases, there were 1,146 deaths in males and 1,077 deaths in females.

The exact causes of colorectal cancer are not known. Common risk factors include:

• Family history of colorectal cancer: If you have close relatives (parent, brother, sister, or child) who have had this cancer, your risk is increased.
• Ethnic background: Jews of Eastern European descent (Ashkenazi Jews) have a higher rate of colon cancer.
• Previous colorectal cancer: Even if a colorectal cancer has been completely removed, new cancers may start in other areas of your colon and rectum.
• Polyps: Polyps are common in people older than age 50 and some become cancerous. Familial polyposis, an inherited condition, can cause hundreds of polyps to form in the colon and rectum. Unless this condition is treated, it almost always leads to cancer. Screening tests can find polyps and they can be removed before they become cancerous.
• History of bowel disease: The disease ulcerative colitis (Crohn’s disease) increases the risk of colon cancer. In this disease, the colon is inflamed over a long period of time and may have ulcers.
• Age: Colorectal cancer is more common in people older than age 50 and the risk increases with age.
• Diet: A diet high in fat, especially fat from animal sources, can increase the risk of colorectal cancer.
• Lack of exercise: People who are not physically active have a higher risk of colorectal cancer.
• Smoking: According to the American Cancer Society, smokers are 30% to 40% more likely than nonsmokers to die of colorectal cancer.
• Alcohol: Excessive use of alcohol has been linked to colorectal cancer.

There are often no symptoms of colorectal cancer in its early stage. When symptoms are present, they include one or more of the following:

• a change in bowel habits
• diarrhea, constipation or a feeling that the bowel does not empty completely
• blood (either bright red or very dark) in the stool
• stools that are narrower than usual
• general abdominal discomfort, bloating and fullness, frequent gas pains, cramps
• unexplained weight loss
• constant or unusual tiredness
• vomiting

These symptoms may be caused by advanced colorectal cancer or some other condition. It is important to report any of these symptoms to your health care provider.

• Get regular screening tests beginning at age 45. If you have a personal or family history of colorectal cancer or polyps or a personal history of another cancer or inflammatory bowel disease, talk to your doctor about being screened before age 45.
• Eat at least five servings of a variety of fruits and vegetables and whole grain foods and limit high-fat foods and red meat.
• Physical activity is also important to reduce the risk. The American Cancer Society recommends at least 30 minutes of physical activity on five or more days of the week.
• Don't smoke. Call the Illinois Tobacco Quitline for help quitting (888-QUIT-YES).

The U.S. Preventive Services Task Force recommends these tests to screen for colorectal cancer:

• High-sensitivity guaiac fecal occult blood test (HSgFOBT) or fecal immunochemical test (FIT) every year
• Stool DNA-FIT every 1-to-3 years
• Computed tomography colonography every 5 years
• Flexible sigmoidoscopy every 5 years
• Flexible sigmoidoscopy every 10 years + annual FIT
• Colonoscopy screening every 10 years

The National Colorectal Cancer Roundtable, established by the American Cancer Society (ACS) and the Centers for Disease Control and Prevention (CDC) in 1997, is a national coalition of public organizations, private organizations, voluntary organizations, and invited individuals.

The goal of the NCCRT is to increase the use of proven colorectal cancer screening tests among the entire population for whom screening is appropriate and is dedicated to reducing the incidence of and mortality from colorectal cancer in the U.S., through coordinated leadership, strategic planning, and advocacy.

Illinois was one of five states selected to participate in the Comprehensive Cancer Control National Partnership 80% by 2018 forum. The 80% by 2018 initiative brings together diverse organizations in a commitment to ensuring 80% of adults aged 50 and older are being regularly screened for colorectal cancer (CRC) by 2018. Statewide partners came together to create the Illinois Colorectal Cancer Roundtable (ILCCRT) with the shared goal of presenting evidence based strategies advancing local implementation of the state cancer plan CRC screening objectives, by collaborating with local health departments and Federally Qualified Health Centers (FQHCs). NCCRT still continues the progress of the 80% by 2018 initiative by working towards the goal and commitment of 80% in every community. 128 pledges have been made in Illinois for the 80 % in every community initiative.

The ILCCRT is a call to action to address immediate challenges and opportunities regarding colorectal cancer in the State of Illinois. It reflects the values, ideas, and actions of a determined group of people from affected communities, advocacy organizations, and health delivery services focuses on eliminating cancer. The purpose is to engage in a dialogue that leads to action on the issues; increase screening rates; advance solutions to the disease burden; and establish a centralized communication hub for the various complex problems related to colorectal cancer in the state of Illinois.

• American Cancer Society
• Centers for Disease Control and Prevention
• Clinical Trials
• Food and Drug Administration
• National Cancer Institute
• National Colorectal Cancer Roundtable

• Colorectal Cancer Roundtable Poster