Vital Facts on Colon Cancer: Know Your Family History, Get Screened Early

When should I get screened for colon cancer? What is my risk if a relative was diagnosed at an age younger than 50? How can such a young and physically fit person like actor Chadwick Boseman die from this disease at the age of 43?

Sarah Joseph, M.D., medical oncologist at Miami Cancer Institute

These are some of the common questions being raised worldwide with the shocking death of Black Panther star, Mr. Boseman. Primary care physicians and cancer specialists are fielding more questions than ever about colon cancer risk factors, symptoms and screening guidelines since the news broke of the actor’s death.

“Thepassing of this Hollywood star, Chadwick Boseman, has left me looking at him asa role model for our youth today, a role model to bring awareness to colorectalcancer,” says Sarah Joseph, M.D., medical oncologist at Miami Cancer Institute, with a focus on gastrointestinal cancers. 

Whathappened is a tragedy, but she said there is a “positive light” thatcan emerge from his death, as colon cancer rates among younger adults, andespecially African Americans and Hispanics, continue to rise.

(Watch video now: The Baptist Health Resource team hears from Sarah Joseph, M.D., medical oncologist at Miami Cancer Institute about colon cancer — who’s at risk, screenings and increasing rates among younger adults. Video by George Carvalho.) 

Knowing yourfamily history is crucial, she adds. If you have an immediate relative who wasdiagnosed with colon cancer, it’s vital to get screened 10 years earlier thanthe diagnosis age of the relative, she says. (For “average risk adults, theAmerican Cancer Society recommends starting regular screenings for colorectalcancer at age 45, while other guidance has kept the general average-riskrecommendation at age 50.)

“Thistragedy made me more aware of how we can bring forward awareness to our society— awareness to be screened earlier and to catch this disease in the earlycurable stages,” said Dr. Joseph.

Learn moreabout colon cancer’s genetic and non-genetic risk factors, when to get screenedand the importance of knowing your family history from Dr. Joseph in thefollowing Q&A:

What canyou tell us about rates of colorectal cancer in adults under 50?

Dr.Joseph: “AtMiami Cancer Institute, I treat colorectal cancer and many of my patients areunder the age of 50 at time of diagnosis. The American Cancer Society in 2020has average new diagnoses in the U.S. of colorectal cancer to be about 150,000cases. Of those, about 10 percent are diagnosed before the age of 50. So,that’s about a 1-in-10 rate in patients younger than 50. Over the last decade,this trend has been steadily increasing among younger adults.”

What arethe most common risk factors for colon cancers?

Dr.Joseph: “Riskfactors can be divided into in genetic and non-genetic predisposing riskfactors/ The non-genetics would be obesity, smoking, unhealthy diet — a lot ofprocessed red meats, for example. Smoking plays a huge risk factor indeveloping colorectal cancer. If we look at the genetic components of increasedrisk of colorectal cancer, we have genetic predisposing conditions. The biggestones are called Lynch Syndrome and FamilialAdenomatous Polyposis.

Why isknowing your medical family history so important when it comes to gettingscreened for colon cancer, especially for younger adults?

Dr.Joseph: “If welook at the incidence of these (genetic-predisposing conditions) in a youngerage group, the biggest telltale sign is speaking to your family and gettingthat medical history. For example, in the case of Chadwick Boseman, he wasdiagnosed in 2016 around the age of 39. So, I would tell his family members inthe future to be screened at the age of 29 — that’s 10 years earlier than 39.So, it’s always 10 years earlier than at the age of (colon cancer) diagnosis ofyour first-degree relative.”

How abouthigher risks of colorectal cancer among African-Americans and Hispanics?

Dr.Joseph: “Partlybecause of the higher colon cancer rates in the African American and Hispanicpopulations, compared to the general population, our screening guidelines havemoved down from the age of 50 to 45 for colonoscopies. For those with a familyhistory, get screened 10 years earlier than the diagnosis age of the immediaterelative.”

Whatmessage would you have for adults 50 or older, or those who are younger and atrisk, who have postponed colorectal cancer screenings because of the pandemic?

Dr.Joseph: “Interms of delaying screenings, that can adversely affect patient care. Forexample, at the time of a diagnosis with a colonoscopy, we found apre-cancerous polyp and that was removed. Patients do well. They go ahead andhave another screening colonoscopy in five to ten years. If, because of thepandemic, that is delayed by a couple of months to a year, that pre-cancerouspolyp now becomes cancerous due to the delay. That puts the patient at a higherrisk of developing cancer.”