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Medically reviewed and verified by Kate Burke, MD, MHA
Colon cancer is one of the most common cancers in the United States, with an estimated 106,000 new cases in 2024. With advances in screening rates and a better understanding of risk factors, diagnosis rates have actually dropped since the mid-1980s! Unfortunately, this trend is mostly among older adults. In people under 55, the rates have been going up for the last few decades. Colon cancer is a serious health risk, and catching it early is the most effective way to treat it. People with ulcerative colitis are at a higher risk of colon cancer. Here is an overview from PatientsLikeMe on colon cancer, its risks, its connection to ulcerative colitis, and ways to prevent and treat this disease.
The Risk of Colon Cancer
Colorectal cancer is one of the most common cancers in the United States. According to the American Cancer Society, in 2024:
- Colon cancer will account for approximately 106,590 new cases (54,210 in men and 52,380 in women).
- Rectal cancer will account for around 46,220 new cases (27,330 in men and 18,890 in women).
The difference between colon and rectal cancer is where the cancer starts in the large intestine. Colon cancer starts in the colon, which is the longest part of the large intestine. Rectal cancer starts in the rectum, which is the last few inches of the large intestine. Colorectal cancer is a catchall term that includes both types.
The lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women. Risk does vary depending on factors like genetics and lifestyle. Overall diagnosis rates for older adults have been declining because of better screening and healthy lifestyle changes. However, among people under the age of 55, diagnosis rates have been increasing by 1–2% each year since the mid-1990s.
Colorectal cancer remains the second leading cause of cancer deaths in the U.S., projected to cause about 53,010 deaths in 2024. Improved treatments and early detection have helped reduce death rates among older adults, but rates are increasing in younger people by about 1% per year.
What Causes Colon Cancer?
Colon cancer starts when cells in the colon develop changes, or mutations, in their DNA. These mutations make cells grow and divide uncontrollably, leading to the formation of tumors. If untreated, the cancerous cells can spread to other parts of the body.
Some common risk factors are:
- Age: Most cases are in people over the age of 50.
- Diet: A low-fiber, high-fat diet, especially one heavy in red or processed meats, may add to colon cancer risk. Studies are ongoing about the exact role of diet in colorectal cancer.
- Family history: Having relatives with colon cancer increases risk.
- Chronic conditions: Diseases like ulcerative colitis or Crohn’s disease raise the likelihood of colon cancer.
- Lifestyle factors: Lack of physical activity, obesity, smoking, and heavy alcohol use also increase risk.
Symptoms
Colon cancer may not cause symptoms in its early stages. However, as it progresses, symptoms may include:
- Changes in bowel habits, such as diarrhea or constipation.
- Blood in the stool or rectal bleeding.
- Abdominal pain, cramping, or bloating.
- Weakness or fatigue
- Unexplained weight loss.
If you have any of these, talk to a doctor immediately.
Colon Cancer and UC
People with ulcerative colitis are at a higher risk of getting colon cancer. Chronic inflammation caused by UC damages the colon lining, which makes it more likely for abnormal cells to form and lead to cancer. The risk of colon cancer in UC patients increases with the duration of the disease:
- 2% after 10 years
- 8% after 20 years
- 18% after 30 years
Fortunately, advances in medical treatments and regular check-ups have reduced the cancer risk for UC patients. Colonoscopy screenings and medications help stop precancerous changes in the colon.
Prevention and Early Detection
The best way to prevent colon cancer is to check for it early. Regular screenings for most people should begin at age 45, but people with UC or a family history of colorectal cancer may need earlier and more frequent testing. The recommendation now is for people who have had UC for 8 or more years to get a colonoscopy with multiple biopsies every 1 to 2 years. That means screening should start 8 years after diagnosis, regardless of age.
Healthy lifestyle changes can also reduce your risk! Adding fruits, vegetables, and whole grains into meals can help. Regularly exercise for at least 30 minutes a few times per week. When it comes to alcohol and tobacco, less is more. Tobacco use should be stopped altogether, while alcohol should be limited. Obesity is a known risk factor for colon cancer, so keeping a healthy weight can help too.
Treatment Options
How doctors treat colon cancer depends on the stage of the disease.
- Surgery: A surgeon can remove cancerous tumors and nearby lymph nodes. The type depends on the stage, location and goal of the surgery. The main types are polypectomy, colectomy, and colostomy.
- Chemotherapy: Here, doctors use drugs to destroy cancer cells. This is often done after surgery or for more advanced cases.
- Radiation therapy: This treatment targets cancer cells with high-energy rays. It is more commonly done for rectal cancer.
- Targeted therapy: Targeted therapy drugs focus on specific molecules involved in cancer growth. They are sometimes used when chemotherapy drugs are not effective, or in combination with another drug.
- Immunotherapy: This treatment tries to boost the body’s immune system to fight cancer instead of targeting and destroying the cancer cells.
Colon cancer is a common but largely preventable disease! Screening, early detection, and healthy lifestyle changes can lower your risk. For people with ulcerative colitis, regular monitoring and medical management are important as you are at a higher risk of developing colon cancer. By staying informed and proactive, you can protect your health and well-being.
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