We understand that, through a large part of her life, her gynecologist may be the only physician a woman sees every year. While our focus is your reproductive health, we want you to be well-informed about other health issues you may face now or in the future. Colorectal cancer is one of these risks.
Despite the fact that these cancers are highly preventable and very treatable in earlier stages, they are the third leading cause of cancer deaths in the U.S. for both men and women. Factors that increase your risk of colon and rectal cancer include your age, personal and family medical history, and lifestyle factors.
You can take actions to reduce these risks.
Your risk of being diagnosed with colorectal cancer increases with age. The majority of colorectal cancers are found in people age 50 or older. The most important preventive action you can take is to get a colonoscopy on the schedule your doctor recommends based on your risk factors. Because the frequency of colorectal cancers in younger people has been rising, the current recommendation is that adults with no specific risk factors should begin colorectal cancer screening by age 45. Persons with certain risk factors may be advised to begin earlier and have more frequent screening.
If you have a history of inflammatory bowel disease (like Crohn’s or Ulcerative Colitis) or a history of colon polyps your risk of colorectal cancer is higher. Keep your physician informed of your medical history. Certain hereditary conditions also increase your risk of colorectal cancer. Know your family history as far as possible, and communicate it to your physician. In some families a genetic condition known as Lynch Syndrome gives individuals a much higher than normal chance of developing colorectal cancer.
WHAT IS LYNCH SYNDROME?
Persons with Lynch Syndrome have a mutation (a permanent change) in a gene usually responsible for repairing mistakes in a cell’s genetic material. When these damaged cells divide, their abnormal growth may result in a cancer. These individuals have a very high risk of developing colon cancer in their lifetime. However, most colon and rectal cancers do not occur in people with Lynch Syndrome. Only about 2 to 7% of colon cancers occur in persons with the defective gene. But if you have the gene mutation, your first degree relatives (parents, children, siblings) are also at high risk for having Lynch Syndrome.
The gene mutation that makes colon cancer more likely also affects other organs. Women with Lynch have a 40 to 60% chance of developing endometrial cancer (cancer of the uterine lining).
HOW DO YOU KNOW WHETHER YOU HAVE LYNCH SYNDROME?
If you have had an early onset colorectal or endometrial cancer (before age 50), if a close family member has been diagnosed with Lynch Syndrome, or if two or more of your close relatives have had Lynch Syndrome cancers, you should discuss genetic testing with your doctor. We are now able to test for more than 40 gene mutations in all patients at high-risk. So we now test for BOTH Lynch Syndrome genes and BRCA 1 and 2 gene mutations (for hereditary breast cancer) whenever a patient has risk factors for either situation. Genetic testing has become much more available and less expensive. The new test is available for about $150 if a patient does not have insurance that will provide coverage.
WHY IS IT IMPORTANT TO KNOW WHETHER YOU HAVE THIS GENETIC CONDITION?
Those who have Lynch Syndrome will be screened earlier and more frequently for colorectal, endometrial, and other cancers associated with Lynch Syndrome. The testing will lower their chances of developing or dying from these cancers. Besides colorectal and endometrial, other cancers associated with Lynch Syndrome include stomach, ovarian, the upper urinary system, biliary tract, small bowel, pancreas, brain, and a certain type of skin cancer. If you are diagnosed with Lynch Syndrome you can also make close family members aware of their higher risk.
WHAT ELSE CAN YOU DO?
Remember that most colorectal cancers are not associated with Lynch Syndrome. The best way to lower your risk is to follow your doctor’s recommendation for colonoscopy testing. Women should keep in mind that smoking, obesity, a diet low in fiber, fruits, and vegetables, and little physical activity also increase colon cancer risk.
During this Colon Cancer Awareness Month commit yourself to one or more lifestyle changes to lower your risk. The entire family can take a step toward better fitness while supporting colon cancer research by participating in Birmingham’s annual Rumpshaker 5k Run or 1 mile Fun Run!
Above all, keep us informed of changes in your medical or family history.