Colon Cancer: Symptoms, Risk Factors & Screening Options

Colon cancer (colorectal cancer) is a disease that develops in the colon or rectum and often begins as small growths called polyps. It may not cause symptoms in its early stages, which is why routine screening is so important. Average-risk adults should begin screening at age 45, while those with a family history or other risk factors may need to start earlier. Common symptoms can include changes in bowel habits, blood in the stool, abdominal pain, fatigue, or unexplained weight loss. When detected early through screening, colon cancer is highly treatable and often preventable.
 

According to the latest available estimates from the American Cancer Society, more than 154,000 people in the U.S. are diagnosed with colorectal cancer each year, and over 52,000 people die from the disease.

Colorectal cancer, often called colon cancer, is the second leading cause of cancer-related deaths in the United States despite the fact that it is largely preventable.

Colorectal cancer affects both men and women equally, yet awareness regarding its preventability and early detection remains surprisingly low. As a gastroenterology team deeply committed to promoting awareness and understanding of digestive health, we recognize the critical importance of shedding light on this prevalent and potentially life-threatening condition.

What is Colon Cancer?

Colon cancer starts in the colon. It usually begins as a small noncancerous growth on the surface of the colon called a colon polyp. Over time, some of these polyps can turn into cancer. 

Risk and Causes of Colon Cancer

Colon cancer is one of the most common cancers worldwide and affects people across ages and communities. Age remains an important factor—risk rises as we get older, so it’s critical to pair awareness with on-time screening. Unfortunately, there's a concerning trend of increasing diagnoses among younger adults since the 1990s.  In response, experts lowered the recommended screening age from 50 to 45.

We are not sure exactly what causes colon cancer, but certain risk factors are associated with the disease.  Lifestyle choices play a meaningful role: diets high in processed and red meats and low in fruits, vegetables, and fiber are associated with higher risk; excess body weight, physical inactivity, tobacco smoking, and alcohol use also increase risk. On the other hand, maintaining a healthy weight, being active, not smoking, moderating alcohol, and choosing a dietary pattern rich in plants can help lower risk.

Some people have a higher chance of developing colon cancer. This includes individuals with a family history of colon cancer or colon polyps, a personal history of precancerous colon polyps, African Americans, some Jewish groups, those with a history of inflammatory bowel diseases such as Crohn's disease, ulcerative colitis, or hereditary colorectal cancer syndromes, and those with a history of abdominal or pelvic radiation treatment. People in this group should speak with their primary care doctor about starting screening earlier than age 45 and testing more often.

What Are Some Screening Options?

For individuals at average risk, screening should begin at age 45. However, those at increased or high risk, such as those with a family history of colon cancer or certain genetic conditions, may need to start screening earlier, undergo more frequent screening, and possibly require specialized tests.

Now, let's delve into the various screening methods available for colorectal cancer:

Colonoscopy

This gold-standard screening tool involves a thorough examination of the entire colon using a flexible, illuminated tube equipped with a camera. During the procedure, patients receive medication to induce relaxation and comfort. If polyps are discovered, they can be removed on the spot, potentially avoiding the progression to cancer. A thoroughly pre-cleansed colon ensures the best visualization and increases the likelihood of detecting and removing polyps, so some colonoscopy preparation is required before a colonoscopy. Following the procedure, patients require a companion to accompany them home, and if no abnormalities are found, a repeat colonoscopy is typically scheduled in 10 years for average-risk individuals.

Stool DNA Test (Cologuard)

Cologuard is a noninvasive, at-home stool DNA test for individuals 45 years of age and older who are at average risk for colorectal cancer (CRC). It is designed for those with no symptoms, no family history of colon cancer, and no history of inflammatory bowel disease (IBD) or polyps. Unlike colonoscopy, this non-invasive test analyzes stool samples for DNA changes indicative of colon cancer. It can be performed at home without any preparation. However, it is less effective at detecting precancerous polyps and may yield false-positive results, necessitating follow-up with a colonoscopy.

Fecal Occult Blood Test (FOBT)

FOBT involves testing stool samples for hidden blood, which can signal the presence of certain abnormalities and can yield false-positive results due to dietary or medication influences.
 

Selecting the most appropriate screening method hinges upon individual risk factors, preferences, and health care provider guidance. We urge you to engage in open dialogue with your primary care physician to navigate these options.

Colorectal cancer screening is a critical tool in fighting colon cancer and maintaining overall health. As advocates for digestive health and proactive health care, the team at Elliot Gastroenterology remains steadfast in our commitment to combating colorectal cancer. Through education, vigilant screening initiatives, and personalized treatment plans, we look towards a future where colorectal cancer is significantly reduced and for the most part, prevented. 

What are treatment options for colon cancer?

Treatment is personalized. Factors including cancer stage, tumor location, and patient health status determine the most effective method of treatment. These treatments can include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy.

The Most Important Step is the Next One

Colon cancer is largely preventable, highly treatable when found early, and best detected through regular screening and informed conversations about your individual risk. If you have questions about when to begin screening or which test is right for you, we encourage you to speak with your primary care provider—they are your best partner in deciding your next steps. For patients in Manchester and southern New Hampshire, Elliot Health System’s Gastroenterology and Cancer Care teams provide comprehensive screening, diagnosis, and coordinated treatment close to home. Working together, we can reduce the impact of colorectal cancer and protect your long‑term health.

Need a primary care provider?  Elliot Provider Match offers a quick and easy way to connect with expert primary care providers near you. Our team will help find a PCP who meets your and your family’s unique needs. Call our team at 603-663-4567, Monday-Friday 8 a.m. – 5 p.m.

Learn more

By Dr. Arathi Komarla, Nicole Jimenez, APRN, and Brittany Boutin, RN of Elliot Gastroenterology