A crucial conversation: Colorectal cancer awareness, early detection and advancing care

The global burden of colorectal cancer: a call for action

Colorectal cancer (CRC), the third most commonly diagnosed cancer worldwide, poses a significant public health challenge. Its incidence is projected to surge dramatically, from 1.9 million cases globally in 2020 to an estimated 3.1 million by 2040. While it can affect anyone, statistics show that worldwide it is more common in men than women. CRC has traditionally been associated with older adults (with a median age at diagnosis around 66), but there's a concerning and growing trend of diagnoses in younger populations. In the U.S., CRC is now the number one cause of cancer-related mortality for adults under 50 years of age. This means a better understanding of CRC and vigilance is needed across all age groups, as risk is no longer confined by age.

Understanding CRC begins with knowing what it is: a cancer that often starts as abnormal growths, called polyps, in the colon or rectum. While many polyps are benign, some can develop into cancer over time. CRC is often diagnosed in later stages, when the disease is more progressed, as symptoms are sometimes vague, non-specific, or even absent, leading to misdiagnosis or a delay in seeking care. This is further exacerbated by low screening rates.

“The single most important thing people can do is listen to their bodies. Don't dismiss persistent changes like rectal bleeding, a noticeable shift in bowel habits (constipation or diarrhea that doesn't resolve), unexplained abdominal pain or cramping or sudden, unintentional weight loss,” says Jonathan Mizrahi, MD, gastrointestinal medical oncologist, Ochsner MD Anderson Cancer Center*. “It's easy to rationalize these signs away or even face misdiagnosis, but your intuition is a powerful guide. Don't hesitate to be your own champion, speaking up and seeking the answers you need if something truly doesn't feel right.”

The power of early detection: why every year counts

The impact an early diagnosis can have in CRC outcomes cannot be overstated. Consider these stark figures: five-year survival rates are significantly higher for localized CRC (92%), meaning the cancer cells are confined to the colon or rectum, compared to distant CRC (16%), where cancer cells have spread to your liver, lungs or other areas further from your colon. This dramatic difference underscores the fact that when the disease is caught early, CRC may be more treatable.

This becomes even more urgent when we consider the emerging reality of CRC in younger individuals. While over half of CRC cases are associated with modifiable factors, such as smoking, unhealthy diet and physical inactivity, there are many cases and deaths that could be prevented by regular screening. The American Cancer Society recommends people at average risk receive regular screening for CRC starting at age 45. Those who have risk factors, such as family history of CRC or personal history of inflammatory bowel disease, may need to start screening even earlier and more often.

"Half of all people diagnosed before age 50 are 45-49 years old. Yet screening prevalence in this age group is just 37%,” says Dr. Mizrahi. “The alarmingly low rate reflects several persistent challenges: less perceived risk, concerns about invasiveness of tests, limited access to or inconvenience of testing and financial factors. This underscores the need for greater awareness, not just among the public, but within the medical community, to look for risk factors and educate patients about routine screenings. Early detection remains our most powerful tool against this disease, regardless of age."

Advancing treatment options: hope on the horizon

The landscape of CRC treatment is continually evolving, offering hopeful options for patients. Current approaches encompass a range of strategies, often used in combination, including:

• Surgery to remove cancerous tissue
• Targeted therapy, which focuses on specific cancer cell characteristics
• Chemotherapy to destroy cancer cells
• Radiation therapy to target and shrink tumors
• Immunotherapy, which uses the body's own immune system to fight cancer

“Treating colorectal cancer, particularly in advanced stages, remains complex, and there is still significant unmet need for patients," says Andrew Witriol, vice president, U.S. Oncology Marketing, Bristol Myers Squibb. “At Bristol Myers Squibb, we are focused on advancing the science to better understand this disease and explore new approaches that may help improve outcomes over time. This commitment reflects our broader goal of continuing to innovate responsibly and contribute to progress for patients facing colorectal cancer.”

Awareness, early detection and continuous treatment innovation are our strongest allies in the fight against CRC. Every piece of knowledge gained, every conversation had and every screening undertaken contributes to a future with improved outcomes.

Learn more about CRC here and find additional resources here.

*Dr. Mizrahi was not compensated by Bristol Myers Squibb for his participation in this article. Dr. Mizrahi has an ongoing professional relationship with Bristol Myers Squibb.