Colorectal Cancer : Marching Toward Awareness
by ABHISHEK ALUR , MD , MBA
March marks Colorectal Cancer ( CRC ) Awareness Month , providing an opportune moment for medical personnel to reflect on the incidence , prevalence and most importantly , the prevention of this very common health concern . Understanding key aspects of CRC can empower health care professionals to increase screening and educate patients on risk reduction .
CRC affects millions of people globally and is the third leading cause of cancer-related death in the U . S . In the early 2010s , the overall incidence of CRC was 40.3 ( 45.9 for men and 34.6 for women ) per 100,000 individuals . 1 With better screening and surveillance , however , the most recent incidence rate reported by the American Cancer Society ( ACS ) was 35.9 overall per 100,000 individuals . 2 Although the overall incidence of CRC has declined in those individuals above the age of 50 , incidence rates have doubled in 20- to 49-year-old individuals . 3 The risk of CRC increases rapidly with age with highest incidence rates in individuals ages 50 and older due to increased detection of CRC with colonoscopy screenings . 2 Interestingly , American Indian and Alaska Native individuals have the highest incidence rate of CRC followed by non-Hispanic Black individuals , Caucasians , Hispanic individuals and Asian Americans , respectively . The ACS projected that in the year 2023 , over 150,000 individuals would be diagnosed with CRC with one-third of them dying from the disease . 2
Several risk factors contribute to the development of CRC , ranging from age and family history to lifestyle choices . Advanced age is a well-established risk factor , but incidence continues to decline in older people due to earlier screening . The strongest risk factor has to do with family history of the disease . Those with first-degree family members with CRC are at 2 to 4 times higher risk of developing CRC compared to people without the family history . 2 This risk factor is exacerbated when the first-degree family member with CRC is below the age of 50 and when multiple relatives are affected . 2 Increased body mass index ( greater than 30 ), decreased physical activity , cigarette smoking and certain diets like increased red meat intake and lack of fruit are associated with an increased risk of CRC . 4
Current screening recommendations are pivotal in detecting ( continued on page 18 )
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