Cancer is a disease process during which abnormal cells grow uncontrollably in the body. Colon cancer, also known as colorectal cancer, is cancer that starts in the colon or rectum. The colon and rectum are both parts of the digestive system.
The main purposes of the colon are to absorb water and make stool. The colon then delivers this stool to the rectum. The colon has four parts. The ascending colon extends upwards from the right side of the abdomen. The transverse colon extends from the right to left abdomen. The descending colon extends down the left side of the abdomen. Finally, the sigmoid colon curves towards the center of the body and downward. The sigmoid colon is connected to the rectum, which connects to the anus.
Colon cancer begins when normal cells in the inner lining of the colon or rectum transition into abnormal cells. These abnormal cells grow to form a small lump of cells known as a polyp. There are different types of polyps, and only some are at risk of becoming cancer. The most common type of polyp is an adenoma, also known as a tubular adenoma.
Approximately 25% of all individuals have adenomas, and although adenomas have the potential to become cancer, only about one in ten will. The larger the adenoma, the more risk it carries to become cancerous.
Fortunately, the transition from adenoma to colon cancer is slow (10 to 20 years). In many cases, screening can lead to the detection and removal of polyps before they become cancer. A screening test is a preventive test aimed to detect a medical condition or disease in an early stage and before symptoms begin.
Adults at average risk of developing colon cancer should begin routine screening at age 50.
African Americans have higher risk of colon and rectal cancer and should begin screening at age 45.
Individuals with a family history of colon cancer must also start screening earlier.
UCLA Health strongly recommends that adults at average risk of developing colon cancer begin screening at age 50. Screening starting at age 50 is also supported by several professional medical societies, including the United States Preventative Service Task Force (USPSTF). Some organizations, including the American Cancer Society (ACS), recommend that average-risk adults begin screening at age 45. However, there is currently no scientific data to support screening average-risk individuals before age 50.
The American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), and American Society for Gastrointestinal Endoscopy (ASGE) all suggest that African Americans begin screening at age 45 given higher rates of colon cancer and deaths in this group.
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