Colorectal cancer

For cancer of the anus, see Anal cancer.
"Intestinal cancer" redirects here. For cancer of the small intestine, see Small intestine cancer.

Colorectal cancer
Other names
  • Colon cancer
  • rectal cancer
  • bowel cancer
Location and appearance of two example colorectal tumors
SpecialtyGastroenterology General surgery Oncology
Symptoms
CausesLifestyle factors and genetic disorders[2][3]
Risk factors
Diagnostic methodTissue biopsy during a sigmoidoscopy or colonoscopy[1]
PreventionScreening from age of 45 to 75
Treatment
PrognosisFive-year survival rate 65% (US)[6]
Frequency9.4 million (2015)[7]
Deaths551,000 (2018)[8]

Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine).[5] Signs and symptoms may include blood in the stool, a change in bowel movements, weight loss, abdominal pain and fatigue.[9] Most colorectal cancers are due to lifestyle factors and genetic disorders.[2][3] Risk factors include diet, obesity, smoking, and lack of physical activity.[2] Dietary factors that increase the risk include red meat, processed meat, and alcohol.[2][4] Another risk factor is inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis.[2] Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer; however, these represent less than 5% of cases.[2][3] It typically starts as a benign tumor, often in the form of a polyp, which over time becomes cancerous.[2]

Colorectal cancer may be diagnosed by obtaining a sample of the colon during a sigmoidoscopy or colonoscopy.[1] This is then followed by medical imaging to determine whether the disease has spread.[5] Screening is effective for preventing and decreasing deaths from colorectal cancer.[10] Screening, by one of a number of methods, is recommended starting from the age of 45 to 75. It was recommended starting at age 50 but it was changed to 45 due to increasing amount of colon cancers.[10][11] During colonoscopy, small polyps may be removed if found.[2] If a large polyp or tumor is found, a biopsy may be performed to check if it is cancerous. Aspirin and other non-steroidal anti-inflammatory drugs decrease the risk of pain during polyp excision.[2][12] Their general use is not recommended for this purpose, however, due to side effects.[13]

Treatments used for colorectal cancer may include some combination of surgery, radiation therapy, chemotherapy, and targeted therapy.[5] Cancers that are confined within the wall of the colon may be curable with surgery, while cancer that has spread widely is usually not curable, with management being directed towards improving quality of life and symptoms.[5] The five-year survival rate in the United States was around 65% in 2014.[6] The individual likelihood of survival depends on how advanced the cancer is, whether or not all the cancer can be removed with surgery, and the person's overall health.[1] Globally, colorectal cancer is the third most common type of cancer, making up about 10% of all cases.[14] In 2018, there were 1.09 million new cases and 551,000 deaths from the disease.[8] It is more common in developed countries, where more than 65% of cases are found.[2] It is less common in women than men.[2]

  1. ^ a b c d "General Information About Colon Cancer". NCI. May 12, 2014. Archived from the original on July 4, 2014. Retrieved June 29, 2014.
  2. ^ a b c d e f g h i j k l Bosman FT (2014). "Chapter 5.5: Colorectal Cancer". In Stewart BW, Wild CP (eds.). World Cancer Report. the International Agency for Research on Cancer, World Health Organization. pp. 392–402. ISBN 978-92-832-0443-5.
  3. ^ a b c "Colorectal Cancer Prevention (PDQ®)". National Cancer Institute. February 27, 2014. Archived from the original on July 5, 2014. Retrieved June 29, 2014.
  4. ^ a b Theodoratou E, Timofeeva M, Li X, Meng X, Ioannidis JP (August 2017). "Nature, Nurture, and Cancer Risks: Genetic and Nutritional Contributions to Cancer". Annual Review of Nutrition (Review). 37: 293–320. doi:10.1146/annurev-nutr-071715-051004. PMC 6143166. PMID 28826375.
  5. ^ a b c d e "Colon Cancer Treatment (PDQ®)". NCI. May 12, 2014. Archived from the original on July 5, 2014. Retrieved June 29, 2014.
  6. ^ a b "SEER Stat Fact Sheets: Colon and Rectum Cancer". NCI. Archived from the original on June 24, 2014. Retrieved June 18, 2014.
  7. ^ Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  8. ^ a b Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (November 2018). "Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries". CA: A Cancer Journal for Clinicians. 68 (6): 394–424. doi:10.3322/caac.21492. PMID 30207593. S2CID 52188256.
  9. ^ "Colorectal Cancer Signs and Symptoms | Signs of Colorectal Cancer". www.cancer.org. Retrieved February 8, 2023.
  10. ^ a b Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW, García FA, et al. (June 2016). "Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement". JAMA. 315 (23): 2564–2575. doi:10.1001/jama.2016.5989. PMID 27304597.
  11. ^ "First Colonoscopies Now Recommended at Age 45". ThedaCare. Retrieved December 30, 2022.
  12. ^ Thorat MA, Cuzick J (December 2013). "Role of aspirin in cancer prevention". Current Oncology Reports. 15 (6): 533–540. doi:10.1007/s11912-013-0351-3. PMID 24114189. S2CID 40187047.
  13. ^ "Routine aspirin or nonsteroidal anti-inflammatory drugs for the primary prevention of colorectal cancer: recommendation statement". American Family Physician. 76 (1): 109–113. July 2007. PMID 17668849. Archived from the original on July 14, 2014.
  14. ^ Forman D, Ferlay J (2014). "Chapter 1.1: The global and regional burden of cancer". In Stewart BW, Wild CP (eds.). World Cancer Report. the International Agency for Research on Cancer, World Health Organization. pp. 16–53. ISBN 978-92-832-0443-5.