Colorectal Cancer Toolkit

Colorectal cancer is cancer that starts in either the colon or the rectum. Colon cancer and rectal cancer have many features in common.

Colorectal cancer is the third most commonly diagnosed cancer and cause of cancer-related death among both males and females. In 2011, the American Cancer Society estimated that 3,290 Hoosiers were diagnosed with colorectal cancer and 1,090 died because of the disease. The chances of developing colorectal cancer at some point in one’s life are one in 19 for females and one in 20 for males. In Indiana African Americans have higher colorectal cancer incidence and mortality than whites, and males have higher rates than females.

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Who gets Colorectal Cancer Most Often?

Sex and age are the two greatest risk factors for developing colorectal cancer. During 2004-2008, colorectal cancer incidence rates were 36 percent higher among Indiana males than females. Additionally, during 2008, 92 percent of cases were diagnosed among Indiana residents ages 50 and older.

Some additional risk factors for colorectal cancer include:

  • Personal or family history. Risk is increased by having certain inherited genetic conditions, a personal or family history of colorectal cancer or polyps, or a personal history of chronic inflammatory bowel disease.
  • Race. In Indiana, during 2004-2008, African Americans, compared to whites, had a 21 percent higher incidence rate and a 37 percent higher mortality rate.
  • Diabetes. Studies have also found that individuals with type 2 diabetes are at higher risk.
  • Modifiable risk factors. Obesity, physical inactivity, a diet high in red or processed meat, alcohol consumption, long-term smoking, and possibly inadequate intake of fruits and vegetables increases a person’s risk. 

Common Signs and Symptoms of Colorectal Cancer

During early stages of colorectal cancer there are no symptoms. Late state signs and symptoms include:

  • Rectal bleeding
  • Blood in stool
  • Change in bowel habits
  • Cramping pain in lower abdomen
  • Weakness
  • Extreme fatigue

Early Detection

Colorectal cancer incidence rates have been decreasing for most of the past two decades in the United States. The decline accelerated from 1998 to 2007, which has largely been attributed to increases in the use of colorectal cancer screening tests that allow the detection and removal of symptomless colorectal polyps before they progress to cancer. A similar trend has been seen in Indiana.

Advanced disease might cause rectal bleeding, blood in the stool, a change in bowel habits, and cramping pain in the lower abdomen. In some cases, blood loss from the cancer leads to anemia, causing symptoms such as weakness and excessive fatigue.

Beginning at age 50, both men and women with average risk for colorectal cancer should follow one of these testing schedules:

  • Tests that find polyps and cancer – for example a colonoscopy every ten years, or a flexible sigmoidoscopy, double-contrast barium enema, or CT colonography every five years. If any of these three tests are positive, a colonoscopy should be done.
  • Tests that primarily find cancer – yearly fecal occult blood test or fecal immunochemical test, or a stool DNA test can detect cancer. If any of these three tests are positive, a colonoscopy should be done.

Individuals who have an increased risk of developing the disease should talk to their health care provider about whether earlier or more intensive screening is needed.

In recent years, an increase in colorectal cancer incidence among younger adults has been identified in the United States. Therefore, timely evaluation of symptoms consistent with colorectal cancer in adults under age 50 is especially important.


You can take charge of your own health! Some behaviors that can help reduce your risk include:

  • Obtaining regular screenings
  • Maintaining a healthy weight throughout life
  • Adopting a physically active lifestyle
  • Limiting consumption of alcohol
  • Consuming a healthy diet that emphasizes plant sources, supports a healthy weight, includes five or more servings of a variety of vegetables and fruit each day, includes whole grains in preferences to processed grains, and has minimal processed and red meats.

Additionally, there are some factors that help prevent colorectal cancer. Consumption of milk and calcium and higher blood levels of vitamin D appear to decrease risk. Moreover, studies suggest that regular use of non-steroidal anti-inflammatory drugs, such as aspirin, and menopausal hormone therapy also reduce colorectal cancer risk. However, these drugs and therapies are not recommended for the prevention of colorectal cancer because they can have serious adverse health effects.



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