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Colon Cancer

Colon cancer (also called colorectal cancer) is cancer that starts in the colon (the large intestine or bowel) or rectum. It often starts with small bumps or growths called polyps.

Colon cancer is the second-leading cause of cancer death in New York City, after lung cancer. It is most often found in people aged 45 and older.

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Risk Factors and Prevention

Risk Factors

You are more likely to get colon cancer if you:

  • Are older (the older you get, the higher your risk)
  • Had colon cancer or polyps previously, or if you have a family history of colon cancer
  • Have certain inherited risks, such as familial adenomatous polyposis or Lynch syndrome
  • Have ulcerative colitis or Crohn's disease
  • Have type 2 diabetes
  • Do not exercise regularly
  • Have obesity
  • Drink alcohol
  • Smoke

People with risk factors do not always get colon cancer, and people without risk factors can still get it. We do not know why some people get colon cancer and some do not.

Talk to your healthcare provider about your risks. Be sure to tell them if you have a family history of colon cancer.

Reduce Your Risk

To lower your risk of colon cancer:

  • Eat fewer processed meats, such as hot dogs and deli meats
  • If you smoke, make a plan to quit
  • Exercise regularly
  • Reduce the amount and how often you drink alcohol

A healthy eating pattern that includes fruits, vegetables, and whole grains may also decrease your risk.

Symptoms

Possible Signs of Colon Cancer

These are possible symptoms of colon cancer. See your provider if you have any of these symptoms. Do not wait until your next screening.

These symptoms do not always mean you have cancer. Your provider can help you figure out what is wrong. If it does turn out to be cancer, starting treatment will give you the best chance of getting better.

  • Blood in your stool (feces) or in the toilet after a bowel movement
  • Stool that looks dark red or black
  • Diarrhea or constipation that does not go away
  • A change in the shape of your stool
  • A feeling that your bowel does not empty completely
  • Pain in your belly that keeps coming back or does not go away
  • Loss of appetite or unexplained weight loss
  • Feeling unusually tired or weak

Screening

Screening Options

Routine screenings can prevent colon cancer or help find it early, when it is easier to treat. There are several different types of screenings. Ask your provider about which option might be right for you.

Colonoscopy

For a colonoscopy, a health care provider uses a tube with a small camera at one end to look inside your colon, check for cancer, and detect and remove polyps. Having a colonoscopy requires a special diet the day before and medication to clean out the colon. A colonoscopy has a low risk of complications and is usually painless.

For people who are not at increased risk, a colonoscopy is done once every 10 years. If you have risk factors, ask your provider if you need a colonoscopy more often.

Stool-Based Test

Stool-based tests can be done at home by collecting a stool (feces) sample using a test kit and sending the kit to a lab. This test requires little or no preparation and has no health risk. If the result is not normal, you will need a follow-up colonoscopy.

Stool-based tests are an option for people who are not at high risk of colon cancer.

Stool-based tests are done every one to three years, depending on which time you choose.

Other Options

A new blood test, called a cell-free DNA test, is available to help find colon cancer early. However, this test is not very good at finding polyps. Colonoscopy and stool-based tests are preferred for screening.

Steps for Screening

  1. Talk to your health care provider about your risk of colon cancer. Many people should start screening at age 45. You may need to start earlier if you are at increased risk, for example, due to colon cancer in your family, or if you have ulcerative colitis or Crohn’s disease.
  2. Ask about your screening options and discuss the risks and benefits.
  3. Work with your provider to be sure your insurance covers the test you choose.
  4. Schedule and complete your colon cancer screening test.
  5. If your test result is not normal, follow your provider’s advice for next steps.
  6. Find out when your next screening test is due, and mark it on your calendar.

Payment

Most insurance plans, including Medicaid and Medicare, cover colon cancer screenings. However, coverage can vary. Consult with your health care provider and insurer about coverage before your screening test.

If you do not have insurance, you may be eligible to sign up for low- or no-cost health insurance. You can also get free assistance signing up for a plan.

If you do not have a health care provider, you can call 311 to find a New York City Health + Hospitals clinic near you.

If you cannot get insurance, or if your insurance does not cover screening, you can:

Additional Resources

Information About Screening

Choosing a Colon Cancer Screening Test

Completing a Stool-Based Test

Preparing for a Colonoscopy

Additional Resources for Health Care Providers

Additional materials and resources for health care providers can be found at Cancer — Resources for Providers. Patient education materials linked in the sections above can be printed out, or you can order copies through the Provider Access Line.

More Information