It is the 4th most commonly diagnosed cancer and the 3rd leading cause of cancer death in the United States [ACS]. The majority (60%) of these cancers and deaths could be prevented by applying existing knowledge about cancer prevention, increasing the use of screening tests, and ensuring that all patients receive timely, standard treatment with removal of polyps by colonoscopy [MEE].

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Colorectal cancer (CRC)

• Colorectal cancer (CRC) is a disease in which (malignant) cancer cells form within the tissues of the rectum or colon.

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Symptoms

• Changes in bowel habits
• Bloody stool (very bright or very dark red blood)
• Diarrhea
• Narrow stools
• Constipation, or feeling that the bowel does not empty all the way
• Frequent pains, cramps, bloating, or feeling of fullness
• Unexplained weight loss
• Unexplained tiredness
• Vomiting

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Key statistics

• Prevalence

- In the United States, colorectal cancer represents 8% of all new cancer diagnoses (135,000 new cases annually) [SEE].

- The lifetime risk of developing colorectal cancer is 1 in 21 for men and 1 in 23 for women [ANS].

 • Deaths from colorectal cancer

- CRC is the 3rd leading cause of cancer-related deaths among men and women in the United States [ACS].

- In 2017, an estimated 50,000 deaths were attributed to CRC, nearly 10,000 more than female breast cancer – the most commonly diagnosed cancer in the United States [SEE].

- The American Cancer Society estimates CRC will cause another 50,630 deaths in 2018 [ACS].

- Overall, only 64.9% of CRC patients will survive 5 years from diagnosis [SEE].

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Regular screening is one of the most powerful weapons for prevention. Regular screening has the potential to prevent colorectal cancer by detecting precancerous polyps in the colon and rectum. How? Because most polyps can be found and removed by colonoscopy before they develop into cancer. Early detection and ease of use are key distinguishing factors for a screening test in the prevention of colorectal cancer.

Who should be screened?

• The United States Multi-Society Task Force (MSTF) on CRC recommend routine screening to begin at 50 years old in average-risk individuals

- Individuals at high risk of developing CRC, such as those with family history of the disease, should undergo screening, beginning 10 years younger than the age at which the youngest first-degree relative was diagnosed or age 40, whichever is earlier [REX].

- Recommendations include either an annual non-invasive screening test or colonoscopy every 5 or 10 years for high risk and average risk individuals, respectively [REX].

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Why is screening important?

• Over half of all CRC patients present with advanced disease. 6 out of 10 CRC deaths are attributable to non-use of screening as recommended by US national guidelines [MEE]  

- Early CRC is often asymptomatic [ACS].

- Approximately 55% of CRC detections are made once the tumor has spread beyond it’s original site or formed distant metastases [SIE].

- Only 59% of those eligible for routine CRC screening ever undergo appropriate testing [ACS].

- The 5-year survival rate for patients diagnosed with distant disease is 14% [SEE].

• Routine screening can prevent CRC through the detection and removal of pre-cancerous growths

- The slow course of growth from pre-cancerous polyp to invasive cancer provides a unique opportunity for the prevention and early detection of CRC [ACS].

- Among the population eligible for routine screening (≥50 years old), CRC incidence decreased by 32% between 2000–2013, while a 22% increase was observed in young adults (>50 years) over the same period [SIE].

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