• Age. Colorectal cancer can occur at any age, but the great majority of cases occur in people over the age of 50.
• Intestinal polyps. A history of developing polyps, small, noncancerous growths on the inner wall of the colon and rectum, is considered a key risk factor for colorectal cancer. Polyps begin as benign growths and are fairly common in people over 50. Most colorectal cancers begin as polyps, although not all polyps become cancerous, and pre-cancerous polyps can be safely removed if detected in time.
• Inflammatory colon diseases. A history of disorders such as ulcerative colitis and Crohn's disease can place you at a higher risk. Women who have had ovarian, uterus or breast cancer have an increased risk. And anyone who has already experienced colorectal cancer has an increased risk of recurrence.
• Family history. If you have members of your immediate family (parents, siblings or children) who have had colorectal cancer, you're considered to be at a higher risk of developing it yourself, especially if the family member's cancer developed at a young age or if multiple members have had it. In addition, a family history of several other rare disorders can place you at a higher risk. These include familial adenomatous polyposis, Gardner's syndrome and non-polyposis colorectal cancer.
• Diet. A diet that is low in fiber and high in fats and calories is believed to increase the risk of developing colorectal cancer. Numerous studies have indicated that people who eat high fiber foods, such as whole-grain breads and fresh fruits and vegetables are less likely to develop the disease than people who don't. In addition, fruits and vegetables are considered to contain antioxidants and other substances that protect again cancer.
• Lifestyle. Smoking and drinking alcohol in excess are factors that can increase your risk of colorectal cancer.

• A change in bowel habits. This can include diarrhea, constipation, a feeling that the bowel does not completely empty, or stools that become narrower than usual.
• Rectal bleeding or blood in the stools on multiple occasions - The blood may be either bright red or very dark, or even give the appearance of black stools.
• Abdominal discomfort. This can include cramps, gas pains and bloating.
• Other symptoms - Other symptoms may include constant fatigue, vomiting and unexplained weight loss.

• Some polyps will never become cancerous.
• They are almost never cancerous as they first develop.
• Enough of them can become cancerous over a period of several years that doctors take them very seriously. Most colon cancers develop from polyps, so detecting them is an extremely important step in preventing colorectal cancer or detecting it early when it is treatable.

• Hyperplastic polyps, usually quite small and rarely a risk factor for colorectal cancer.
• Adenomas, which have the potential to become cancerous. Your surgeon usually will remove these during colonoscopy or sigmoidoscopy procedures - two forms of endoscopic examination utilizing flexible fiber optic tubes - to both eliminate the risk factor they represent and to have them analyzed by a pathologist for their cancerous or benign nature.

• Digital rectal exam. This is an examination in which the doctor inserts a gloved finger into your rectum to feel for polyps or other abnormal areas in the first few inches of your lower rectum.
• Fecal Occult Blood Test. This is a simple test that checks for hidden (or occult) blood in your stool. At the time of your doctor's examination you will be given a kit containing a special paper to take home and mail back to the doctor's office with a tiny sample of stool. If blood is present, it can detect it. However, not all cancers cause bleeding, and non-cancer-related problems such as hemorrhoids can.
• Barium Enema. This is a diagnostic radiology procedure in which barium is used as a contrast agent to obtain an image of the entire lower intestine. The barium coats the lining of the intestine to create a silhouette that can be captured on an x-ray.
• Sigmoidoscopy. This test uses a flexible fiber-optic tube to examine your sigmoid colon and rectum. Approximately half of all colorectal cancers are found in these areas, constituting about the last two feet of your lower intestine. Sigmoidoscopy and barium enemas are often both done to complement each other.
• Colonoscopy. This procedure is similar to sigmoidoscopy, except that it uses a longer flexible fiber-optic tube to examine the entire length of the colon and rectum. It's considered the most effective of the available tests. In addition, using snips operated through a channel in the tube, your doctor can remove any polyps or other suspect tissue found during the examination for biopsy. While the procedure takes about 30 minutes, a mild sedative is used and discomfort is minor.

• Stage 0 indicates that the cancer is in a very early stage and is found only in the innermost lining, or mucosa, of the colon or rectum.
• Stage I indicates that the cancer has grown beyond the colon's innermost lining to deeper layers but has not spread to or beyond the outer wall.
• Stage II is defined as cancer that has grown through the wall of the colon to nearby tissue but not reached the lymph nodes - glands the size and shape of small kidney beans that are found throughout the body and that are part of your body's immune system.
• Stage III indicates that the cancer has reached your lymph nodes but has not spread to other parts of your body.
• Stage IV indicates that the cancer has spread to other parts of your body, most likely the liver and/or lungs.

• Surgery. In the surgical option, the doctor will remove as much tissue as necessary, depending on the extent of the cancerous mass. If it is at a very early stage, it may be possible to just remove the abnormal tissue through a local incision, using an endoscope without having to make an open incision through the abdominal wall. Cancer located in a polyp is often removed this way.

• Chemotherapy. In this option, drugs, or chemicals, are used to kill cancer cells, often as a follow-up therapy after surgery. Chemotherapy is a systemic treatment - that is, it relies on drugs traveling by way of the bloodstream to reach and attack cancerous cells throughout the body. As a result, it is most likely to be used for Stage IV cancers in which cancerous colorectal cells have spread to other parts of the body. For some cases of rectal cancer, it is used along with radiation therapy. Anti-cancer drugs are usually introduced into the body by injection directly into a vein but some are given in the form of oral medications.
• Radiation Therapy. Radiation therapy focuses high-speed x-rays on cancer cells to kill them. It is usually utilized in conjunction with surgery or chemotherapy. Since it affects cells within a limited area, it is most often employed to treat rectal cancer. It may be used before surgery to shrink a tumor or afterwards to increase the likelihood that all cancer cells have been removed or eradicated. The radiation can be generated by external machines or by tiny radioactive "seeds" placed by means of a tube directly adjacent to the cancerous tissue.

Likely sources include:

The National Cancer Institute (www.cancer.gov)
800-422-6237
TTY for hearing-impaired 1-800-332-8615

American Cancer Society (www.cancer.org)
800-227-2345