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Study Found that Cigarette Smoking May Increase the Risk of Colorectal Cancer Incidence In a Japanese Population

A study conducted by researchers in Japan found that cigarette smoking may increase the risk of colorectal cancer (CRC) incidence in a Japanese population While smoking has been associated with an increased risk of CRC among Western populations, it has not been investigated as a risk factor in Asian populations prior to this study, according to the authors.

 

Statistics show that 60% of CRC cases occur in developed countries and CRC incidence continues to increase rapidly in Asia. Specifically, Japan experienced an increase in cases from 1978 to 1993 and has remained stable since then but is still among the top 10 countries with the highest incidence of CRC. A separate Japanese study found a gender-based difference in CRC incidence, with men being more susceptible to rectal cancer and women being more susceptible to colon cancer:

 

Colon cancer:

  • Men: 65.7%
  • Women: 75.4%

Rectal cancer:

  • Men: 34.3%
  • Women: 27.0%

 

It is hypothesized that environmental and lifestyle factors, such as smoking, can increase the risk of CRC. In Japan, for instance, 80% of men and 20% of women were smokers in the 1950s. However, a significant reduction was observed in smoking rates by 2017: only 32% of men and 9% of women were smokers. The age-standardized CRC incidence rate was 22.2 in 1978 and 38.9 in 2018.

 

Tobacco use can cause many different cancers, including mouth, larynx, lung, kidney, liver, and many more . In 2014, the U.S. Surgeon General’s report added CRC to the list of tobacco-related cancers. However, there are some issues with this:

  • Evidence supporting the claim that the use of tobacco is associated with the development of colon cancer has been derived mainly from Western populations while data from Asian populations are conflicting. More research is needed on this association in Asian populations.
  • Meta-analysis by geographic region did not find a significant association between smoking and CRC in Asian studies

The Japanese study aimed to investigate the correlation of smoking and CRC incidence in Asian populations.

 

Researchers used original data from major cohort studies performed by the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan. The following criteria  were used when examining these studies for this analysis:

 

  • Population-based cohort studies conducted in Japan
  • Studies initiated between the mid-1980s and mid-1990s
  • Studies with more than 30,000 participants
  • Studies that acquired information on health-related lifestyles
  • Studies that followed the incidence of CRC

 

A self-administered questionnaire at the baseline survey determined if each participant was a smoker and classified them into one of three groups: never smoker, former smoker, or current smoker. Participants were followed-up for CRC incidence from the baseline study until the date of CRC diagnosis, migration out of the study area, death or the end of follow-up, whichever was first. The end of the follow-up period was between December 31, 1992 and December 31, 2014.

 

The study found that men who were ever, current or former smokers had a statistically significant higher risk of CRC than never smokers. Ever and current smoking increased the risk of both colon and rectal cancer, while former smokers had an increased risk of colon cancer.

Women who were ever, current or former smokers did not have an increased risk of CRC, but a significantly greater risk of distal colon cancer. Women who were heavily exposed to smoking had an increased risk of CRC.

 

Colon cancer is one of the most preventable diseases through screening methods and avoiding risk factors such as smoking , obesity, and poor diet. The American Cancer Society recommends getting screened at age 45 or younger if you have a family history of CRC.

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Colon and Rectal Cancer Can Be a Reality For Gen-X, Millennials, and Gen-Z

Colon cancer and rectal cancer, commonly grouped together as colorectal cancer (CRC), is on the rise among individuals under the age of 50, with the most notable increase observed amongst individuals aged 20-39 years, according to the American Cancer Society.

Recently, award-winning actor and “Black Panther” star, Chadwick Boseman, lost his 4-year long battle to colon cancer at age 43. Boseman’s tragic death provides an opportunity to convey the urgent message of how colon cancer can impact a young person’s health, even if they are younger than the suggested screening age for those at average risk–usually 50 years.

Colon and rectal cancer remain the third most commonly diagnosed cancer in the U.S., and the fourth most commonly diagnosed cancer globally. In 2020, an estimated one million lives will be lost to CRC across the globe.

The main difference between colon cancer and rectal cancer is the location of the cancerous lesion(s). The last 12 centimeters of the large intestine is identified as the rectum, while the rest of the large intestine is classified as the colon. Differentiating between the two requires the help of a doctor and advanced imaging technology. Identifying whether a person has colon or rectal cancer is also important to identify the treatment strategy needed to fight the cancer.

Colon cancer has about a 2% risk of recurrence. Rectal cancer, on the other hand, has about a 20% chance of recurrence due to the absence of a protective layer called the serosa that exists in the colon. Rectal cancer even poses a greater risk of spreading to surrounding organs—a process known as metastasis. Metasis can complicate treatment as the cancerous cells break away from the original tumor and travel to other areas in the body, most commonly the liver. This process will also advance the cancer to stage IV, the most aggressive stage.

Recent trends indicating the steepest increase in incidence rates amongst younger age groups means young adults should pay careful attention to their gastrointestinal health. Though older age and aging are risk factors for CRC, colon and rectal cancers can both be attributed to varying lifestyle influences including diet, exercise, and alcohol consumption. Specifically, a low-fat diet high in fiber, fruits, and vegetables is best recommended for reducing the onset of colon and rectal cancer. Additionally, a colonoscopy is best recommended for identifying colon and rectal cancer and is often called the “gold standard,” due to the ability to prevent 90% of CRCs.

Most importantly, visit a doctor if any of the following symptoms occur as they may be a sign of CRC:

  • Sudden or unexpected weight loss
  • Abnormal bowel movements that last for more than a few days
  • Bloody or dark stools
  • Cramping or pain in the abdomen
  • Weakness or fatigue

Prevention and detection are simultaneous in most cases, which is why it is important to “check your butt” as early as you can!

 

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Difference Between Colon Cancer and Rectal Cancer

When reading about colon and rectal cancer, it can quickly become confusing as to which one is which and what the difference between them is. It becomes even more difficult to understand when you throw colorectal cancer into the mix. So what is the difference between all of these terms? Are there different screening and treatment methods for each of them? You’re about to find out, here is the definitive guide on the differences between colon and rectal cancer.

How to Distinguish Colon Cancer From Rectal Cancer and Vice Versa

Many references make the difference between colon and rectal cancer sound complicated and hard to identify, but in reality, they are quite distinct. Although both diseases share many common factors, there is a primary distinction that can be used to tell them apart. That distinction is the exact location in which the cancer began. If the origin point of the cancer is in the rectum, then it is considered to be rectal cancer and referred to as such. If on the other hand, the point of origin is farther up the large intestine, it will be designated as colon cancer.

It might seem strange to think of it in this way, but it’s important to note that the rectum comprises the last 12 centimeters of the colon. The rectum and the large intestine while separate, are still essentially parts of the same organ. As such, they are very much connected so if cancer starts in the rectum, it will inevitably spread throughout the rest of your colon if it’s not detected on time and properly treated.

So what about colorectal cancer? Is that a type of colon cancer or rectal cancer. Truth be told, it is neither and it is both. Colorectal cancer is a broad term that can be used to refer to both colon and rectal cancer. Although colon and rectal cancer are not the exact same disease, they are still referred to as colorectal cancer as a group.

What Are the Symptoms

Both colon and rectal cancer share several common symptoms that are remarkably similar. If you’re experiencing any of these symptoms, it’s imperative that you tell your Doctor and schedule a thorough screening test like a colonoscopy.

Seeing red, black. Dark-colored spots in your stool are a potential symptom of colon and or rectal cancer. Any of these colors, when present in stool can indicate that there is blood in the stool which is something that you should tell your Doctor about right away.

Constipation, diarrhea, gas, stomach pain are also potential warning signs that you should tell your Doctor about especially when accompanied by fatigue.

Treatment for Colorectal Cancer

When it comes to treating colon cancer versus rectal cancer there are some important differences that are worth noting. Although these types of cancers are similar, the treatment strategy is somewhat unique.

Rectal cancer is considered more dangerous because of its proximity to neighboring organs. To that effect, rectal cancer treatments typically start off with chemotherapy or targeted radiation.

Colon cancer, on the other hand, is generally treated by performing surgery. Although the treatment for colon cancer usually starts with surgery it is often necessary to follow up with chemotherapy to eradicate the disease more thoroughly.

Although the treatments for colon and rectal cancer may differ, the fact that preventative screenings are key to early detection remains the same. By screening for them both, colon and rectal cancer will be easier to fight when you have the strategic advantage of early detection.

The Big Picture

There you have it, whether you’re medically interested in it or if you’re trying to win an argument on the subject at dinner, you now know the exact difference between colon and rectal cancer. In all seriousness, it really is important that you learn the difference early on so that if you suspect that you have one or the other, you won’t lose time reading information that pertains to the wrong one.

When it comes to any type of cancer be it colon, rectal, or any other type of cancer, preventative screenings are crucial. The more aggressively you screen for it, the less likely it is that you will have much or any trouble defeating it should you receive a diagnosis.

Names and semantics aside, colon, rectal, and colorectal cancer can be defeated, especially when you are screening for them. Preventative screenings are your best defense against any of these cancers and can buy you decades of life that would otherwise have been lost unnecessarily to the disease. Instead of letting colorectal cancer sneak up on you, turn the tables and sneak up on it instead with preventative screenings!

 

 

 

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Can Your Gum Health Predict Colon Cancer?

Recent findings in a study published by American Association for Cancer Research (AACR) suggest that the presence of periodontal disease is associated with a slightly higher risk of developing colorectal precursor lesions, which include serrated polyps and adenomas.

Data on tooth loss and periodontal disease was obtained from the Nurses’ Health Study (1992-2002) and the Health Professionals Follow-up Study (1992-2010). 17,904 women and 24,582 men were included in the sample size of the study. Data regarding polyp diagnosis was obtained through self-reported questionnaires and later confirmed through medical records. The data were also adjusted for smoking and other related risk factors that lead to periodontal disease and colorectal cancer. The study found that:

  • Individuals with periodontal disease had about a 17% increased risk of developing serrated polyps
  • Individuals with periodontal disease had about an 11% increased risk of developing conventional adenomas
  • Individuals who have lost four or more teeth presented a 20% increased risk of developing serrated polyps

Though the research furthers scientific understanding of the interaction of oral health and gut health, additional research is needed to explore the extent of the correlation and how this influences the risk of colorectal cancer for a definitive conclusion. A previous study published by the International Journal of Cancer suggests that the correlation between periodontal disease and carcinogenesis in the gut may be attributed to the increase in systemic inflammation, thus increasing immune dysregulation and affecting gut microbiota. The study also mentions that positive associations between periodontal disease and other forms of cancers such as lung, breast, and pancreatic cancer have been reported.

Colorectal cancer is largely preventable given that precursor lesions can be detected and removed. Individuals should regularly monitor their oral health and speak to their medical providers about family history regarding periodontal disease and colorectal cancer to prevent early onset of colorectal cancer.

 

 

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Colon Cancer Screening Guidelines

When it comes to colon cancer screenings, it pays to be informed. The more information you have on it, the more well prepared you will be. You’ll also have less stress because you will know more about what to expect. Here are some helpful colon cancer screening guidelines to help familiarize yourself with the details so that you can make decisions in confidence.

Understanding Colon Cancer

When considering colon cancer screening guidelines, it’s important to understand how colon cancer works. This disease can develop along any of the 5 sections of the colon which include the transverse colon, ascending colon, descending colon, sigmoid colon, and rectum. That’s a lot of ground to cover, which is why colonoscopies are so popular as a screening method for colon cancer. Colonoscopies are arguably one of the most thorough and effective types of colon cancer screenings available.

What are the Risks?

The risk of forgoing colon cancer screenings goes up over time. By going to your screenings without fail, the risks will be much lower and you will not have to worry as much. It’s important to note that colon cancer screenings should not be looked at as a bad thing. Although it is perfectly natural to be nervous about being screened and hearing the results it’s important to remember that

Early Warning Signs to Watch Out For

In addition to going to your regular screenings, there are some early warning signs to watch out for that can help you detect colon cancer before it has a chance to dig in. One of the most visually apparent of these early warning signs is sudden and unexplained weight loss. This doesn’t mean that you have to worry about colon cancer every time you lose a pound or two. Generally, a loss of 10 pounds over a period of 6 months would warrant a thorough screening like a colonoscopy.

Alternatively, if you know that someone in your family has contracted colon cancer before, you need to tell your Doctor so that they can set up an appropriately aggressive screening schedule. Having a family member with colon cancer is one of the earliest warning signs of all and it’s one that you should take especially seriously. Don’t panic or fret, just be mindful that you’ll have to undergo colon cancer screenings much earlier and more frequently than others.

Typically it is recommended that anyone that has a family member with colon cancer should be screened before the age of 45 rather than after reaching the age of 45. This will give you a much higher chance of catching any signs of colon cancer early and nipping it in the bud before it can do any damage.

Regardless of whether your family has a history of colon cancer or not, if you are diagnosed with having a large polyp or several polyps, you should have a colonoscopy. If adenomatous polyps with a low-grade abnormality are discovered over the course of your colonoscopy it is highly recommended that you have another colonoscopy in 5 years’ time.

Additional Screening Guidelines and Things to Watch Out for

For those of you who have had colorectal surgery, you will need to have a colonoscopy 3 years from the date of your surgery and then another colonoscopy 5 years after that. This will help ensure that you won’t be in for any unwelcome surprises and will catch it early enough to defeat with ease should it ever return.

Generally the very young are not require to be screened for colon cancer unless they have something concerning in their family medical history such as familial adenomatous polyposis. It is recommended that individuals with a family history of familial adenomatous polyposis should have either an annual flexible sigmoidoscopy or a colonoscopy between the ages of 10 and 12. Given the young age of such patients, a full colonoscopy might be more risk than it’s worth in this case as sigmoidoscopies are considerably less invasive.

Finally, anyone with hereditary nonpolyposis colon cancer in their family should be screened for colon cancer by age 20-25 or 2 years before their immediate family member’s colon cancer diagnosis, whichever comes first.

When it Comes to Colon Cancer it Pays to be Aggressive

The single best weapon against colon cancer is to be aggressive about screenings and preventative medicine. Colon cancer has a bad habit of sneaking up on people which is why it’s so important to remain vigilant.

Remember, if you catch it early, you won’t have nearly as hard of a time getting rid of it and won’t have to worry about it as much. You have the power to stop colon cancer in its tracks, as long as you keep getting screened for it.

 

 

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New Screening Strategies From the AGA

A recently published white paper by the American Gastroenterological Association (AGA) titled “Roadmap for the Future of Colorectal Cancer Screening in the United States” states that the development of structured organized screening programs is vital to achieving target colorectal cancer (CRC) screening rates and reductions in CRC morbidity and mortality. The paper includes information shared at the AGA’s Center for GI Innovation and Technology’s consensus conference in December 2018, which outlined the following priorities:

  • Identify barriers to screening uptake
  • Assess the efficacy of available screening diagnostic methods
  • Consider the potential integration of novel diagnostic approaches into screening and surveillance paradigms

 

The paper highlights the following strategies:

Modifications to CRC Screening to Improve Uptake and Outcomes

Although over 1,700 organizations across the 50 states signed onto the “80% by 2018” initiative announced by the National Colorectal Cancer Round Table (NCCRT) in 2014, one-quarter of eligible Americans are yet to undergo CRC screening. Organized screening offers an opportunity for screening improvements by the use of multiple strategies, such as defined target populations, timely access and follow-up, and systematic opportunities for shared decision-making between patients and clinicians. It can also improve efficiency by incorporating noninvasive testing such as annual mailed fecal immunochemical (FIT) tests and colonoscopy alternatives like stool testing. Multiple studies have shown that offering stool testing as an option, in addition to colonoscopy, increases screening uptake, however a diagnostic colonoscopy is still necessary to confirm positive noninvasive test results.

Racial, socioeconomic, and geographic health care disparities also limit screening efficacy. African American and Hispanic American communities and individuals in rural areas in particular face screening barriers, accounting for 42% of the disparity in CRC incidence and 19% of the disparity in CRC mortality between black and white individuals.

The following strategies were discussed to resolve these issues:

  • Incorporate adjunct noninvasive testing to improve screening rates
  • Minimize the ineffective practice of performing re-screening and surveillance colonoscopy sooner than recommended by guidelines
  • Reconsider surveillance strategies for individuals with a history of adenomatous polyps to prevent constraining colonoscopy resources

 

Continued Development of Noninvasive and Minimally Invasive screening Tests

The paper states than an ideal, noninvasive test would “identify lesions with high short-term potential to progress to CRC and should do so with high sensitivity and specificity in a convenient, low-risk, low-cost, and operator-independent manner” that is easy to complete and should achieve high uptake among individuals who are eligible for screening. While an ideal test is yet to be developed, the FIT test and a blood test currently face the least resistance from patients. The researchers propose the development of a noninvasive test that is capable of detecting advanced adenomas and advanced serrated lesions while also being minimally invasive and easy-to-use with a one-time sensitivity and specificity of a minimum of 90%.

 

Improved Personal Risk Assessment for Optimal Programmatic Screening

Current risk assessment guidelines focus on familial and personal colorectal neoplasia risk, but do not acknowledge additional factors such as sex, race, smoking, body mass index, and environmental factors. Family history can be challenging to obtain due to a lack of patient awareness and the health care provider’s limited ability to derive and record the information. The researchers have proposed using patient portals with integrated electronic health record to ensure updated and accurate family health history data and to allow health care providers the ability to accurately assess the patient’s risk by looking at the data in the portal, irrespective of their geographic location. Improved personal risk assessment would help health care professionals select the appropriate CRC screening test method. For example, individuals with a higher risk of advanced adenoma or CRC would be directed to a colonoscopy, while individuals with a lower risk would be directed to a less-invasive screening method.

 

Although initiatives like the 80% by 2018 proposed by the NCCRT are a good step towards increased screening rates, the development of organized screening programs is necessary to further these efforts even more. The desired goal of these screening efforts is testing that is available to at-risk individuals, noninvasive testing methods that are highly accurate and easy to use, increased screening uptake, and reduction in CRC incidence.

 

 

 

 

 

 

 

 

 

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Do Young Diabetes Patients Need Early CRC Screening?

A large cohort study that evaluated Swedish family inpatient and outpatient cancer registries found that those who had diabetes had an increased risk of colorectal cancer (CRC)—the magnitude of risk was similar to having a family history of CRC.

The study had a long timeline and follow-up was conducted between 1964-2015. The 12,614,256 individuals included in the study were born after 1931; 559,375 of them had diabetes and 162,226 had CRC. The authors queried the risk of developing CRC among those who had diabetes and found that:

  • 9-fold greater risk of CRC before 50 years among those diagnosed with diabetes before 50 years (range, 1.6-2.3)
  • 9-fold higher risk of CRC before age 50 years among those diagnosed with diabetes before 50 years who also had a family history of CRC (range, 4.1-12)
  • Lifetime risk of CRC before age 50 years among diabetic patients (0.4%) was similar to those with just a family history of CRC (0.5%). It was double that of the average population (0.2%).

This study confirms the positive association between early-onset diabetes and early-onset CRC and makes a case for earlier CRC screening among young adults with diabetes.

Results from the South Australian Young Onset (SAYO) CRC study identified a similar correlation between personal and family history of diabetes and CRC risk. The study cohort included 50 unrelated young adults up to age 55 years diagnosed with CRC (23-54 years), and 253 controls without CRC (18-54 years). Personal and family history of diabetes was documented in this entire population. The study found:

  • 24% of CRC patients also suffered from type II diabetes compared with 5% of the control group
  • 51% of young adults with CRC had at least one first-degree relative with type II diabetes
  • All patients with a personal history of type II diabetes also had first-degree relatives with type II diabetes
  • 44% of CRC patients under 45 years and 60% of CRC patients 45-54 years had a first-degree relative with type II diabetes

These findings create a very strong case for raising awareness among young adults with diabetes of their increased risk of early-onset CRC, especially if there is a family history of diabetes, so they can initiate CRC screening earlier than the USPSTF recommendation of 50 years.

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Incidents of Chronic Conditions Linked to Higher Risk of Colorectal Cancer are Increasing

A recent report by Blue Cross Blue Shield examined the rate of colorectal cancer diagnoses among people with chronic conditions and those over the age of 50, both of which are at an increased risk of colorectal cancer (CRC). Chronic conditions associated with an increased risk of CRC have risen significantly among millennials, or those aged 22-37 years, between 2014 and 2018:

  • Crohn’s disease and ulcerative colitis increased by 14%
  • Type I and type II diabetes increased by 35%
  • Diagnosed obesity increased by 100%

A study found that those who are obese are 30% more likely to develop CRC than those who are not.

There are several reasons for this: obese individuals tend to have inflammation caused by visceral fat, which can cause damage to the body and increase the risk of cancer. This inflammation can also cause insulin resistance, in which the body doesn’t respond properly to insulin and thus produces more to offset the loss from the resistance. Increased insulin in the body can also boost the availability of estrogen, which can lead to increased cell production and tumor growth.

Increased insulin production also affects individuals with type I & II diabetes. Hyperinsulinemia, a condition where the amount of insulin in the blood is higher than normal, can create an environment in the colon that promotes the development and growth of cancer. There are other theories that hyperglycemia, or having too much sugar in the blood, and chronic inflammation from diabetes raises the risk as well. Further research is needed to examine the link between type II diabetes and colon cancer, but it’s noted that injected insulin used to treat type II diabetes is not linked to colon cancer. The risk is from the type II diabetes itself.

Individuals who have inflammatory bowel disease (IBD), like Crohn’s disease or ulcerative colitis, are at a higher risk of CRC due to inflammation of the colon. Individuals who have had IBD for many years tend to develop dysplasia, especially if their IBD has been left untreated. Dysplasia is a condition where cells in the lining of an organ look abnormal but aren’t yet cancerous, but can develop into cancer over time. It’s important to note that IBD is different from irritable bowel syndrome (IBS), which is not linked to an increased risk of colon cancer.

When compared to those who do not have a diagnosed chronic condition, those who do had a significantly higher risk of CRC:

  • People aged 18-64 with Crohn’s disease and ulcerative colitis had an almost two-times greater risk of CRC.
  • People aged 18-64 with diabetes had a 1.7-times greater risk of CRC and tend to have a less favorable prognosis after diagnosis
  • People aged 18-64 with diagnosed obesity had a 1.3-times greater risk of CRC, with a stronger link among men

Only 31% of people under 50 with Crohn’s or ulcerative colitis have received colon cancer screenings. Data obtained from the Blue Cross Blue Shield Axis survey that examined attitudes toward colorectal screening found that 58% of 18-49 year olds with Crohn’s disease or ulcerative colitis cited knowledge barriers as the reason for not getting screened for CRC. Both age groups—over 50 years and 18-49 years—said they were unaware of the need to be screened because their primary care physician had not recommended it. 61% of study participants over the age of 50 admitted that attitudinal reasons were the main barrier to getting screened for CRC. These reasons range from being uncomfortable with the screening process to being fearful of the results. 48% of 18-49 year olds admitted that they do not believe they’re at risk for CRC, therefore they have not been screened. External barriers, such as testing costs and being too busy, accounted for 26% of reasoning for those over 50 and 25% of those aged 18-49.

Increased awareness of CRC risks and symptoms can lead to a decrease of the amount of late stage diagnoses—if diagnosed early, the 5-year survival rate for CRC is 90%. The American Cancer Society recommends that people with an increased risk of CRC should start screening before the age of 45 and be screened more often. Gastrointestinal specialists advise individuals diagnosed with Crohn’s disease to begin regular colonoscopies 15 years after diagnosis or when they reach the age of 50, whichever comes first, and should continue to get screened every one to three years. Individuals diagnosed with ulcerative colitis are advised to begin regular colonoscopies 8 years after diagnosis or at age 50, whichever comes first, and continue every one to two years.

Sources: https://www.mdanderson.org/publications/focused-on-health/how-does-obesity-cause-cancer.h27Z1591413.html

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Community Connections: Jamie Crespo

Jamie Crespo, 29

What is your experience with Colon Cancer? (Are you a patient, survivor, advocate, or caregiver?)

Both my parents were diagnosed with colon cancer in 2017.This was unexpected since cancer did not run in my immediate family. My dad showed signs of weight loss and anemia. He eventually was scheduled for a colonoscopy. In my gut feeling, I knew what the worst diagnosis would be and did not want to believe that it could be cancer. In mid-April, my parents and I found out that my dad had a large mass in his colon and needed surgery. This was the worst news that my family and I received. He was supposed to have surgery mid-summer but had a reaction to a cardiology test that pushed his surgery back to August. My dad had a colectomy to remove the part of the colon that had the mass. He stayed in the hospital for a few days. He had to undergo eleven rounds of chemotherapy with diagnosis of stage 3 colon cancer. With good news, he has been in remission since then.

 

While my dad was going through chemotherapy, my mom scheduled a colonoscopy that was long overdue from the beginning of the year. Unfortunately, her gastroenterologist told me he found polyps and a small mass in her colon that needed surgery to be removed. In November, she had laparoscopic colon surgery to remove the mass and was successful. She stayed in the hospital for a few days as well. Luckily, they removed everything and she did not need chemotherapy for treatment.

 

Did you have any family history of colon cancer before your parents were diagnosed?

I did have a cousin that was diagnosed before my parents.

 

Has your experience impacted your lifestyle? If yes, what are some changes you’ve made?

Exercising regularly, healthy eating habits, seeing a primary care physician yearly. 

 

Is there someone or something that you have leaned on for support during this time? How did they help you?

When my parents were both diagnosed the same year, my support group, that included my family and close friends, came to visit when my parents were in the hospital. If I needed to talk to them they were there for me. 

 

What advice would you give to others who are experiencing the same situation as you?

Definitely have a support group that you can talk to and get a colon cancer screening at age of 50 if not sooner. 

 

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Geographic Disparities in EAO-CRC Survival Among Men Linked to High Levels of Poverty

A recent study published by the American Journal of Cancer Research examined the impact of geographic disparities on the survival of men with early-age onse­­­­t colorectal cancer (EAO-CRC). The goal of the study was to identify gender-specific differences among those with EAO-CRC, while examining individual and county-level factors.

Data from the Centers for Disease Control and Prevention (CDC) and the Surveillance, Epidemiology, and End Results (SEER) were analyzed to study CRC patterns among men aged 15 to 49 years who were diagnosed between 1999 and 2017. EAO-CRC deaths were classified as deaths among US residents aged 15-54 from 1999-2017. Men aged 50-54 were included to account for patients diagnosed at age 49 with standardized 5-year follow-ups. In identifying hotspots, researchers at the CDC used the International Classification of Diseases, Tenth Revision (ICD-10) codes to identify county-level EAO-CRC frequencies,crude rates, and age-adjusted rates. U.S. counties were then classified as hotspots if they had high rates of EAO-CRC mortality as determined by geospatial analyses. The study population included Hispanic men and non-Hispanic white and black men. . Chi-square test helped determine variances in patient- and county-level characteristics between men in hotspot counties and in non-hotspot counties. Survival was estimated based on the date of diagnosis and the date of the last follow-up appointment or death.

The study identified 232 counties as EAO-CRC hotspots— a majority were located in the South, at a vast 92% or 214 of the 232 hotspot counties. The remaining 8%, or 18 of the 232 counties, were located in the Midwest. Although the average age of men diagnosed with EAO-CRC was 42.73 years, age was not a significant differential among men in the individual hotspot counties.

Men living in hotspot areas were more likely to be:

  • Non-Hispanic black
  • Less likely to be Hispanic
  • Less likely to be married or have a domestic partner

Men residing in these areas were also more likely to be diagnosed with metastatic CRC than men living in other areas.

Hotspot counties commonly shared the following characteristics compared to other counties:

  • Higher poverty rates
  • Higher rates of adult obesity
  • More physical inactivity along
  • Fewer exercise opportunities
  • Limited access to healthy foods
  • Lower college completion rates
  • Higher adult smoking rates
  • Higher uninsured rates
  • Fewer primary care physicians
  • Increased rurality
  • More violent crimes

Overall, men residing in these hotspot areas had a lower CRC survival rate than those in non-hotspot counties. Specifically, men diagnosed with EAO-CRC who lived in hotspots had a 24% increased risk of CRC-specific death than those in non-hotspot areas. Smoking was identified as a major cause of EAO-CRC mortality in hotspots, as EAO-CRC patients in these areas who smoked had a 12% higher rate of mortality than men who did not.

Implications

CRC hotspots in the U.S. tended to be associated with risk factors related to high levels of poverty. Potential explanations for these hotspots could be inadequate access to health care, a knowledge gap on CRC risks and symptoms, and high uninsured rates. The results of the study emphasize the need for increased education on symptoms, preventative measures, and treatments of CRC, especially in hotspot areas.

The article says: Study participants were NH-White, NH-Black, and Hispanic adults or adolescents aged 15-49 at primary CRC diagnosis. A total of 32,447 men in the SEER database were diagnosed with EOCRC from 1999-2016,

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