What is colorectal cancer?
Colorectal cancer is cancer that starts in either the colon or the rectum. Colon cancer and rectal cancer have many features in common. They are discussed together here except for the section about treatment, where they are discussed separately.
The normal digestive system
Colon and rectal cancers begin in the digestive system, also called the GI (gastrointestinal) system (see the picture below). The digestive system processes food for energy, and the last part of it absorbs fluid to form solid waste (stool) that then passes from the body. In order to understand colorectal cancer, it helps to know something about the structure of the digestive system and how it works.
After food is chewed and swallowed, it travels to the stomach. There it is partly broken down and sent to the small intestine. The word "small" refers to the width of the small intestine. In fact, the small intestine is the longest part of the digestive system -- about 20 feet.
The small intestine also breaks down the food and absorbs most of the nutrients. It leads to the large intestine (also called the large bowel or colon), a muscular tube about 5 feet long. The colon absorbs water and nutrients from the food and also serves as a storage place for waste matter. The waste matter (stool) moves from the colon into the rectum, the last 6 inches of the digestive system. From there the waste passes out of the body through the opening called the anus.
The wall of the colon and rectum is made up of layers of tissues. Colorectal cancer starts in the inner layer and can grow through some or all of the other layers. The stage (extent of spread) of a cancer depends to a great degree on how deep the cancer goes into these layers.
Abnormal growths in the colon or rectum
Cancer that starts in these different areas may cause different symptoms. But colon cancer and rectal cancer have many things in common. Most colorectal cancers develop slowly over many years. We now know that most of these cancers start as a polyp -- a growth of tissue that starts in the lining and grows into the center of the colon or rectum. This tissue may or may not be cancer. A type of polyp, known as an adenoma, can become cancer. Removing a polyp early may keep it from becoming cancer.
Over 95% of colon and rectal cancers are adenocarcinomas. These are cancers that start in the cells that line the inside of the colon and rectum. There are some other, more rare, types of tumors of the colon and rectum.
The information here is only for adenocarcinomas in the colon or rectum.
Last Medical Review: 06/05/2012
Last Revised: 01/17/2013