Colorectal Cancer Awareness Month – What Gets In The Way?

March 3, 2024
written by:Claire Brandon, M.D.

March marks the start of colorectal cancer awareness month. According to the American Cancer Society, in the United States, colorectal cancer is the third most commonly diagnosed cancer in both men and women in the U.S., excluding skin cancers. The number of individuals affected annually varies slightly from year to year due to changes in risk factors, screening rates, and improvements in detection and treatment methods.

Risking factors of Cancer

It is surprising that colorectal cancer remains such an issue in the United States because we have a significant ability to screen for this. In recent years, there has been a concerning trend of increasing rates of colon cancer among younger adults, particularly those under the age of 50. Certain risk factors seem to be playing more of a role. Let’s take a look at a few of these risks.

Shift in Screening Guidelines: 

Historically, screening for colon cancer typically began at age 50 for average-risk individuals. However, recognizing the rising incidence among younger adults, some organizations, such as the American Cancer Society, have updated their guidelines to recommend that screening begin at age 45 for individuals at average risk.

Obesity and Lifestyle Factors: 

Obesity, sedentary lifestyles, and poor dietary habits have been linked to an increased risk of colon cancer. These factors are more prevalent in younger generations, which may contribute to the rising rates of colon cancer among younger adults.

Changes in Microbiome and Environmental Factors: 

Research suggests that changes in the gut microbiome and exposure to environmental factors, such as certain dietary components and chemicals, may play a role in the development of colon cancer. Changes in these factors over time could potentially contribute to shifts in the age of onset.

Genetic Factors and Hereditary Syndromes: 

While most cases of colon cancer are sporadic, a small percentage are associated with inherited genetic mutations that predispose individuals to develop the disease at a younger age. Increased awareness and genetic testing for hereditary syndromes, such as Lynch syndrome and familial adenomatous polyposis (FAP), may lead to more diagnoses among younger adults.

why does anxiety come up?

But something is getting in the way of screenings. Cancer and screening for colorectal cancer can provoke anxiety. This couldn’t be at a worse time when you see these increasing diagnosis rates. So why does anxiety come up?

  • Fear of the Unknown: Many people feel anxious about medical procedures they haven’t experienced before. 
  • Discomfort or Pain: While sedation is typically used during a colonoscopy to minimize discomfort, some people worry about potential pain or discomfort during or after the procedure. 
  • Embarrassment: Colonoscopies involve examining the colon, which can feel invasive or embarrassing for some individuals. The preparation for the procedure, which often involves fasting and taking laxatives to clear the colon, can also be uncomfortable and embarrassing.
  • Fear of Complications: Although complications from colonoscopies are rare, some people worry about potential risks such as bleeding, perforation of the colon, or adverse reactions to sedation.
  • Fear of Findings: There’s often anxiety surrounding the possibility of finding polyps or other abnormalities during the colonoscopy. While most polyps are benign, the fear of a cancer diagnosis can be a significant source of anxiety for many individuals.
  • Cultural Factors: In some cultures, there may be stigma or taboo surrounding discussions of bowel health or undergoing medical procedures related to the colon, which can contribute to anxiety.

Conclusion

If you have these kinds of feelings, it’s valuable to speak with your doctor about it so that they can help remove these fears. They have definitely heard them before and want you to feel comfortable with the procedure. 

We know for sure that there needs to be more research and more discussions openly about screening for colorectal cancer. The one thing you have control over is getting your screening and being as healthy as you can. Get the screening, be aware of any possible symptoms, and take care of your health.

Claire Brandon, M.D.

Dr. Brandon is a dual board-certified psychiatrist in both adult psychiatry and consultation-liaison psychiatry (treatment of psychiatric illness in medically ill adults). She completed her residency and fellowship training at Mount Sinai Hospital in New York City and did a second fellowship in public psychiatry at New York University in New York City

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