Alternate Names: Cancer - intestine; Colorectal cancer; Intestinal cancer; Bowel cancer; Cancer - colon

Causes and Risks:

There is no single cause of colon cancer. Factors associated with colon cancer are colorectal polyps, cancer elsewhere in the body, a family history of colon cancer, ulcerative colitis, inflammatory bowel disease, and immunodeficiency disorders.

Dietary factors associated with colon cancer are a high-meat, high-fat, low-fiber diet.

Cancer of the colon and rectum accounts for 11% of cancer deaths. It is the third most common cancer in adults.

Prevention:

Lower your risk factors where possible.Colon cancer can be prevented if polyps that lead to the cancer are detected and removed.If colon cancer is detected in its early stages, it is up to 90% curable.

Beginning at age 50, get screening tests to allow early detection.Ifone of yourfirst-degree relatives has had colon cancer, you should start getting screened 10 years prior to the age your relative was diagnosed. This will helpidentify pre-cancerous polyps.

The four common screening tests and recommended frequency of use are:

1. Fecal Occult Blood Test (annually)
2. Sigmoidoscopy (every 5 years)
3. Double Barium Contrast Enema (every 5 years)
4. Colonoscopy (every 10 years)

The colonoscopy is the most useful, but most invasive test. New tests using CAT scans to do a "virtual" colonoscopy are being developed. These are less invasive, but one must subsequently undergo a colonoscopy if a suspicious lesion is seen.

Symptoms:

• Diarrhea, constipation, or other change in bowel habits lasting 10 days or more
• Blood in the stool or darker stools
• Unexplained anemia
• Abdominal pain and tenderness in the lower abdomen
• Intestinal obstruction
• Weight loss with no known reason
• Stools narrower than usual
• Constant tiredness

Note: Most colon cancers have no symptoms.  Hidden blood in the stool is often the first, and in many cases the only, warning sign.

Additional symptoms that may be associated with this disease include:

• Anal lump
• Abdominal fullness, gaseous

Signs and Tests: A rectal examination may reveal a rectal mass. A fecal occult blood test is positive. A colonoscopy with biopsy shows cancer. A sigmoidoscopy with biopsy shows cancer.

Treatment:

Treatment depends partly on the "stage" of the cancer. This means how far the tumor has spread through the layers of the intestine, from the innermost lining to outside theintestinal wall and beyond:

• Stage 0: Very early cancer on the innermost layer
• Stage I: Tumor in theinner layers of the colon
• Stage II: Tumor in the outer layers of the colon and/or nearby tissue
• Stage III: Tumor that has spread to the Lymph Nodes
• Stage IV: Tumor that has spread to distant organs

Support Groups: The stress ofcolon cancercan often be helped by joining a support groupwhere members share common experiences and problems. See cancer - support group.

Prognosis:

Stage I, II and III cancers are considered curable, based on the chance of living at least 5 years after diagnosis. In most cases stage IV cancer is incurable.

Stage I has a 90% 5-year survival. Stage II has a 75% 5-year survival, Stage III a 40% - 60% 5-year survival, and Stage IV an 8% 5-year survival, highlighting the importance of early detection. Colorectal cancer rarely recurs after 5 years, thus most patients who live 5 years are considered cured.

Complications:

• Recurrence of carcinoma
• Metastasis to other organs or tissues

Call for an appointment with your health care provider if your bowel habits changefor 10 days or longer.

If you notice blood in the stool, either visible or detected through use of a home fecal occult blood test, seekimmediate medical attention by a gastroenterologist (a doctor that specializes in diseases of the digestive tract).

Call for an appointment if you have risk factors for colon cancer and you have not had a physical examination recently.