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Colorectal Cancer

Mohammed Nasir Uddin

Colon Cancer occurs when cells in your colon (large intestine) grow uncontrollably. Treatment may vary depending on the type and stage of the cancer.

Colon cancer is a type of cancer that begins in the colon (large intestine).

It is often referred to as colorectal cancer. Colorectal cancer is actually a group of cancers that includes colon cancer and rectal cancer, which begins in the rectum.

According to the Centers for Disease Control and Prevention (CDC), colorectal cancer is the fourth most common type of cancer in the United States.

The American Cancer Society (ACS) estimates that 1 in 24 men and 1 in 26 women will be diagnosed with colorectal cancer in their lifetime.

Approximately 70% of colorectal cancers (7 out of 10 cases) start in the colon.

Learn more about colon cancer stages, causes, risk factors, and resources for support.

Types of Colon Cancer

Colon cancer has several types depending on the kind of cancer cells and the part of the digestive tract affected.

According to ACS, the most common type of colon cancer is adenocarcinoma, which begins in the mucus-producing cells of the colon or rectum.

Less common types include:

  • Lymphomas

  • Carcinoids

  • Sarcomas

  • Gastrointestinal stromal tumors (GISTs)

Stages of Colon Cancer

Doctors use staging to understand the extent of cancer and its spread. Staging helps determine the proper treatment plan and predict long-term outcomes.

  • Stage 0: Carcinoma in situ, where cancer is limited to the inner layer of the colon.

  • Stage 1: Cancer has grown into the colon’s mucosa or muscle but has not spread to lymph nodes or other areas.

  • Stage 2: Cancer has spread through the colon wall or nearby tissues but not to lymph nodes.

  • Stage 3: Cancer has reached lymph nodes but not distant parts of the body.

  • Stage 4: Cancer has spread to distant organs like the liver or lungs.

Symptoms of Colon Cancer

Early colon cancer often shows no symptoms. When symptoms appear, they may include:

  • Constipation

  • Diarrhea

  • Blood in stool

  • Changes in stool color

  • Changes in stool shape (e.g., narrow stool)

  • Rectal bleeding

  • Unexplained weight loss

  • Abdominal pain

  • Excessive fatigue

  • Feeling of incomplete bowel movement (tenesmus)

Since these symptoms can also occur with other common conditions, see a doctor if they persist for three weeks or longer.

Diagnosis of Colon Cancer

Early detection improves treatment success.

Because symptoms may not appear early, regular screening like colonoscopy is important.

In the U.S., screening for colon cancer is recommended starting at age 45.

Doctors will review your medical and family history and perform a physical exam. Screening tests include:

  • Fecal tests: Guaiac-based fecal occult blood test (gFOBT) and fecal immunochemical test (FIT), yearly.

  • Sigmoidoscopy: Every 5 years.

  • Virtual colonoscopy (CT colonography): Every 5 years.

  • Colonoscopy: Every 10 years.

The Guardant Health Shield Blood Test was FDA-approved in July 2024 for colorectal cancer screening.

High-risk individuals may need more frequent screening.

At-Home Tests

Some home tests can detect blood in stool, an important sign of colon cancer:

  • LetsGetChecked Colon Cancer Screening Test

  • Everlywell FIT Colon Cancer Screening Test

  • Second Generation FIT (Fecal Immunochemical Test)

Treatment of Colon Cancer

Treatment depends on the cancer stage, type, and spread.

  • Stages 0, 1, and 2: Surgery can often remove cancerous polyps. Smaller, localized polyps increase the chances of full recovery.

If cancer has spread, treatments may include:

  • Colostomy

  • Chemotherapy

  • Ablation therapy

  • Targeted therapy

  • Immunotherapy

Causes of Colon Cancer

The exact cause is not fully known, but several factors can increase risk.

Genetics: Colon cancer can result from inherited or acquired genetic mutations. These mutations increase risk but do not guarantee cancer.

Some genetic conditions include:

  • Familial Adenomatous Polyposis (FAP)

  • Gardner’s Syndrome

  • Lynch Syndrome

  • Cystic Fibrosis

Mutations can cause abnormal cell growth in the colon lining, forming polyps. Polyps are usually harmless but can turn cancerous if untreated, so removal is preventive.

Risk Factors You Cannot Change

Some risk factors are non-modifiable, such as age, race, and family history:

  • Age 50 or older

  • Previous colon polyps or bowel disease

  • Family history of colorectal cancer

  • Specific genetic syndromes like FAP

  • Inflammatory bowel disease (IBD)

  • Abdominal radiation or gallbladder surgery

  • Ashkenazi Jewish ancestry

  • Higher incidence in American Indian, Alaskan Native, and Black populations, partly due to healthcare disparities

Prevention

While family history or age cannot be changed, lifestyle changes can reduce risk:

  • Avoid processed foods (hot dogs, deli meats)

  • Eat more vegetables

  • Reduce fat and red meat intake

  • Exercise regularly

  • Maintain healthy weight

  • Quit smoking

  • Limit alcohol

  • Reduce stress

  • Control diabetes

  • Begin colonoscopy or other screenings at age 45

Life Expectancy

Early detection improves treatment success. Five-year survival rates are a common measure:

Cancer Stage Five-Year Survival (%)
Stage 0 & 1 91
Stage 2 & 3 73
Stage 4 13
Overall 63

New treatments continue to improve survival. However, cases in people under 50 have increased 2.4% per year from 2012 to 2021.

Support Resources

Emotional and social support is vital. Talk openly with your care team and family, and seek help if needed.

Some support options:

  • Colorectal Cancer Alliance Helpline: 877-422-2030

  • Colorectal Cancer Support Group Live Chat: Weekdays 12–1 PM EST

  • Blue Hope Nation: Facebook group for patients and families

  • CancerCare: Oncology social worker-led support groups

  • Fight Colorectal Cancer: Videos, podcasts, and resource library

FAQs

Can colon cancer be cured?
If detected early, surgery can remove cancerous polyps completely.

Does colon cancer spread quickly?
Growth and spread vary per person. Typically, colorectal cancer develops over years, making early detection crucial.

How serious is Stage 1 colon cancer?
Many have no symptoms at Stage 1. Some may notice changes in bowel habits, rectal bleeding, fatigue, or unexplained weight loss. See a doctor if these occur.

Summary

Colon cancer is a type of cancer that starts in the colon (large intestine).

It often shows no early symptoms, making detection difficult.

Regular screening helps detect colon cancer early, allowing prompt treatment and reducing complications.

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