March is associated with many things, from a time that foreshadows spring to the “wearing of the green” on Saint Patrick’s Day. Very importantly, March is also Colorectal Cancer Awareness Month, a good time to review how to do everything possible to lower our colorectal cancer risk, as it is the third most commonly diagnosed cancer in the United States among men and women, and the second leading cause of cancer death for both as well.
Dr. Robert Roddenberry, Jr. serves as General Surgeon and Medical Director for General Surgery for Mission Hospital McDowell and Blue Ridge Regional Hospital. He is passionate about educating patients on colorectal cancer risk factors, prevention, and screening. “With regard to these sobering statistics, it’s a concern that the numbers have not changed dramatically over time,” he observes, “but with increased consciousness about screenings and a proactive approach being taken by patients and their primary care physicians, I’m hopeful we might see a reduction in these numbers in the next decades. As it stands now, the 2022 estimates for new diagnoses of colorectal cancer and deaths are 151,000 and 52,000, respectively.” The good news, Dr. Roddenberry explains, is that if colorectal cancer is caught early, via colonoscopy, there is good reason to hope it can be cured.
One startling reality about colorectal cancer is that during the last several decades, rates have risen by a worrisome 2.2% for people younger than 50. “We’re not sure why,” says Dr. Roddenberry, “but the shift has caused the American Cancer Society to adjust the recommended guidelines for when people should get their first colonoscopy, the colorectal cancer screening that is so important. Now we urge patients to start colonoscopies at age 45.”
Dr. Roddenberry notes that the risk factors for colorectal cancer are broken up into two categories: modifiable and non-modifiable. The former are risks that you can alter with lifestyle changes, while the latter are things a person can’t change, like their age, if they have a personal history of polyps or family history of colorectal cancer, or being African American. “The African American community is at markedly higher risk for colorectal cancer,” notes Dr. Roddenberry. “They are a full 20% more likely to be diagnosed with the disease, and their death rate is a disturbing 40% higher, so it’s critical that members of the African American community speak with their primary care providers about their risk and take every possible preventative measure.”
As for what things people can do to lower their colorectal cancer risk, Dr. Roddenberry declares that there are many. “Keeping your weight in check is important, since obesity is a risk factor. That naturally leads into the role that diet plays in prevention. You can cut your risk simply by eating a varied diet featuring plenty of fruits and vegetables and avoiding highly processed foods. Exercise is also key. We should all aim for about 150 minutes of moderate exercise per week.” This includes enjoyable activities like walking, biking, or even routine chores like mowing the lawn or cleaning the house.
Alcohol intake and tobacco use also impact colorectal cancer risk. “We know that tobacco use increases one’s risk for many types of cancer, so refraining from smoking or chewing tobacco is wise,” says Dr. Roddenberry. “So is watching alcohol consumption and keeping it to, per CDC guidelines, one drink or less per day for women and two drinks or less per day for men.”
Dr. Roddenberry mentions the fact that many have put off routine medical screenings for the past two years because of the COVID-19 pandemic. “We didn’t know quite what we were dealing with two years ago, and people were understandably hesitant. However, we know much more now about how to stay safe individually and within a healthcare facility. People should feel comfortable making their colonoscopy appointments and following through with them promptly.” The concern is that for every delayed screening, the potential exists for a person to end up with advanced disease. Timely screening catches colorectal cancer in its earliest stages so it can be treated.
Symptoms one should watch for that could indicate colorectal cancer include gastrointestinal changes such as unusual bloating or gas, and stool changes, like blood in the stool or a change in shape, such as narrow stools. “It’s important to be mindful of changes with your own body, and also to partner with your primary care provider and discuss their recommendations regarding screening and your individual risk,” says Dr. Roddenberry.
In terms of screening tools for colorectal cancer, there are several. “Two noninvasive stool sample tests are available,” Dr. Roddenberry shares. “The FIT test uncovers hidden blood in the stool, while Cologuard® reveals blood and altered DNA. While these are used for patients at average risk, the gold standard for all is still colonoscopy.”
Colonoscopy is a minimally invasive procedure that patients prepare for, starting a day or so in advance. They begin a clear liquid diet and then drink a solution that causes them to eliminate as much waste as possible, so the gastroenterologist has a clear picture when they perform the test. Colonoscopy is performed when a patient is under sedation, and the physician inserts a thin tube into the rectum with a camera on it. “This enables the doctor to see clearly the state of the colon and whether any polyps are present. If there are,” says Dr. Roddenberry, “they can be removed right there and then. Colonoscopy is so important, because it is both a screening tool and a treatment, if necessary, all in one.” Although many don’t relish the thought of having the test, it is absolutely the best colorectal cancer screening test that exists.
Since Mission Health is committed to keeping care close to home for its patients, its facilities offer Western North Carolinians diagnostic testing for colorectal cancer and the best treatment if they are diagnosed.
With more awareness around this disease, patients can take the reins with their preventive care, work with their doctors to get tested appropriately, and strive to live a healthier lifestyle. “We owe it to ourselves and our loved ones to get tested for colorectal cancer so that we can start bringing these statistics down,” says Dr. Roddenberry.