The American Cancer Society produces two in-depth reports about colorectal cancer in the United States every three years. The just-released editions, published Monday, highlight the progress that has been made in the fight against colon cancer and the challenges that remain.

Rebecca Siegel Photo

In this interview, Rebecca Siegel, MPH, director of surveillance information at the American Cancer Society, gives insights into what the key takeaways are from Colorectal Cancer Facts & Figures 2014-2016 and Colorectal Cancer Statistics, 2014.

Q. What is the most striking finding from Colorectal Cancer Facts & Figures 2014-2016 and Colorectal Cancer Statistics, 2014?

A. We were surprised by the 30% drop in colorectal cancer incidence rates in adults 50 and older over just one decade. This large drop is most likely due to increased colonoscopy screening since 2000, although incidence rates have been decreasing since the mid-1980s.

Q. The reports note that although the colon cancer rate has declined dramatically for those aged 50 and older, the opposite is the case for those who are younger. For this age group, colon cancer is on the rise. Why is this happening?

A. We don’t really know. There is speculation that it may be related to the obesity epidemic and/or unhealthy dietary patterns that have developed among young people over the past few decades, but more research is needed to answer this question with certainty.

Q. Which group (or groups) of people did you find are struggling the most with colon cancer – and why?

A. Black Americans are more likely to develop the disease and much more likely to die from it. One of the main reasons for this is that blacks are more likely to be poor. Poverty is related to a higher risk of colorectal cancer incidence and death because poor people are more likely to be overweight because they have less access to healthy foods and less opportunity for exercise. They also have less access to screening tests, which prevent colorectal cancer as well as detecting it early when it is more curable. Poor people also have less access to high quality treatment.

Q. What have you found are the most significant modifiable risk factors for colorectal cancer?

A. People can do a lot to reduce their risk of getting colorectal cancer. In addition to getting screened regularly, you can reduce your risk by 1) achieving and maintaining a healthy weight 2) being physically active 3) eating a diet high in fruits, vegetables, and whole grains 4) getting the recommended amount of calcium 5) not smoking and 6) limiting alcohol consumption.

Q. When your next report comes out – 3 years from now – what do you predict will change the most about colorectal cancer trends in the United States?

A. My guess is that screening rates will have jumped higher, hopefully close to the American Cancer Society’s goal of 80%, and that both incidence and death rates will have continued to decline rapidly. But, it’s important to realize that the changes we make today, by getting screened and making behavioral changes to reduce cancer risk, won’t be reflected in population cancer rates immediately because colorectal cancer takes 10 to 20 years to develop.