March Is Colorectal Cancer Awareness Month

March Is Colorectal Cancer Awareness Month

By Jenifer Dumire, BSN, RN, CVRN-BC, BHCN, CGRA High Risk & Genetic Navigator at Midland Health

Colorectal cancer is more common than many people may realize. Lifetime risk of developing colorectal cancer is 1 in 24 in men and 1 in 26 for women. So, think of being in a room with 100 people and ¼ of those in the room will have colon cancer sometime in their lifetime.

The good news about colon cancer is that it tends to be a very slow growing cancer and always progresses in a linear fashion. In other words, it always starts out with pre-cancerous polys and then advances to adenomas and finally full-blown colon cancer. This process usually takes about 10 years, and this is why a person who has a colonoscopy without polyps can wait 10 years for their next screening. However, if polyps are found, a colonoscopy should be done in 3 years to make sure that there are no new polyps. Colonoscopy is the golden standard for screening because no other test can detect if there are polyps. Other tests can only detect DNA changes that might indicate pre-cancerous or cancerous cells that are already there.

However, there are certain gene mutations that keep the DNA from repairing itself when it should and can increase a person’s risk for colon cancer. Mutations in these genes can also cause the 10-year process discussed earlier to happen in a much shorter time period.

Lynch Syndrome is a mutation in one of the genes, that when they are not working properly increase a person’s risk for colon cancer. Statistics show that about 1 in 279 of the general population carry a mutation associated with Lynch Syndrome. Estimating the population of Midland to be around 140,000, there would be approximately 500 people carrying the Lynch Syndrome mutation. The problem is that national statistics estimate that up to 90% of people who carry a Lynch Syndrome mutation remain undiagnosed. It continues to be the most undetected of all cancer mutations. This is for a variety of reasons, lack of education and availability of genetic testing being at the forefront of these reasons.

A family history of cancers caused by Lynch syndrome, including colon cancer, stomach cancer, ovarian cancer, pancreatic cancer, kidney cancer, bladder cancer, ureteral cancer, brain cancer, small bowel cancer, gallbladder cancer, bile duct cancer and skin cancer would be an indicator that genetic testing was appropriate. This is especially true if these cancers occurred at an early age (before age 50) or across multiple generations. When diagnosed with one of these gene mutations in the Lynch Syndrome family, more frequent screenings including a colonoscopy more often (sometimes as often as every 1-2 years) might be warranted.

If any of this sounds familiar to you, I urge you to have a discussion with your doctor about the need for genetic testing.

As with all cancer, remember early detection is the key to survival with colorectal cancer.