By Durado Brooks, MD
How often do you think a family conversation about cancer occurs? The truth is, not nearly often enough.
Colorectal cancer (often called simply "colon cancer") is cancer that develops in the colon or the rectum, and it's the third most common cancer in the U.S. While most people diagnosed with colon cancer do not have a family history the disease, people who have this cancer in their family have a significantly higher chance of being diagnosed. The good news is that colon cancer is one of the most preventable cancers, and this prevention can work even for people who are at high risk of the disease.
Colon cancer is preventable because it usually starts as a non-cancerous growth called a polyp. Not all polyps will progress to cancer, but for those that do the transformation usually takes a number of years. Cancer can be prevented by finding and removing these polyps with colon cancer screening tests during this transition period.
People who have a history of colon cancer or polyps in a close family member (parent, sibling, or child) may have twice the risk of developing the disease compared to those with no family history. This is especially true if cancer appears in the relative before age 60. If there are multiple family members with colon cancer, the risk may be even higher.
Polyp detection and removal is best accomplished by regular screening - recommended to start at age 50 for people at average risk for developing colon cancer. However, screening recommendations may be quite different for those with an affected relative. That's why it's so important to know your family history. Simply knowing that a relative had "cancer" is not sufficient; you need to know details:
- Where did the cancer start? Cancer of the colon is very different than cancer that starts in the stomach.
- How old was the relative was when cancer was diagnosed? Colon cancer diagnosed in an 80- year-old grandmother may not imply that the family is at higher risk, particularly if this is the only case in the family.
Family history is an important predictor of many cancers (colon, breast, prostate), as well as other diseases (diabetes, hypertension, heart disease). Many people don't appreciate the increased risk associated with a family history of these diseases, but this knowledge could be life-saving for you or for someone you love. The American Cancer Society and the National Colorectal Cancer Roundtable have developed FamilyPLZ.org to spark these discussions. FamilyPLZ provides tips, tools, and resources to educate the public on the importance of family health history, help people gather this critical information, and share it within their family and with their doctors.
So while these are not easy conversations, they are definitely worth having.
Dr. Brooks is director of prostate and colorectal cancers for the American Cancer Society.