Colorectal Cancer Colorectal cancer develops in colon and rectal tissue of the digestive system. Your colon is the longest part of your large intestine. It absorbs water and nutrients from the food you eat. Your rectum is the lower part of your large intestine and where your body stores stool (i.e., poop). Where the cancer originates determines the type – colon or rectal cancer. When the cancer is present in both the colon and rectum, it’s called colorectal cancer. What Causes Colorectal Cancer? Cancer occurs with uncontrolled cell growth. Abnormal cells divide without stopping and invade nearby tissue. Colorectal cancer happens when there are changes in your DNA, also known as mutations or variants. Currently, there is no defined cause as to why the body does this. There are many factors that may increase your risk of developing colorectal cancer. Factors You Can Change Factors You Cannot Change Excess body fat (e.g., overweight and obesity) Age Type 2 diabetes diagnosis Racial and ethnic background Eating plans high in red and processed meats Sex at birth Eating plans with frequent fried, broiled or grilled foods If you’ve had your gallbladder removed (cholecystectomy) Low vitamin D (i.e., nutrients from food and sun exposure) Personal history of colorectal polyps, previous colorectal cancer diagnosis, inflammatory bowel disease and abdominal or pelvic radiation Tobacco, nicotine and alcohol use Family history of colorectal cancer or polyps and inherited syndromes As a Warfighter, there are additional risk factors you may face. Though you may not experience symptoms during active duty, exposure to toxic chemicals (e.g., burn pits) and engaging in certain lifestyle behaviors (e.g., smoking, excessive drinking) during your service may increase your risk after separation. What are the Symptoms? There may not be clear symptoms, especially in early stages of the disease. If you recognize any of the following, talk to your health care team. Blood in the stool Frequent gas pains, bloating, fullness and/or cramps Unexplainable weight loss Fatigue Change in bowel habits lasting more than a few days such as: Diarrhea Constipation Feeling the bowel does not fully empty The stool is a different shape than normal Screening Colorectal cancer risk increases with age. It’s recommended to screen from age 45 to 75 unless your health care provider suggests otherwise. Colonoscopy is the most commonly used screening test. Other screening tools include: Physical exam Rectal exam Blood and tissue tests Stool sample If a screening measure comes back with a diagnosis, your care team will work with you to determine the best treatment and management options. A colorectal cancer diagnosis does not automatically or immediately result in separation from military service. Depending on what stage your cancer is in and your treatment protocol, you may be able to remain on active duty. A Medical Evaluation Board (MEB) may assess your fitness for duty if the cancer stage or treatment interferes with your ability to perform your job duties. How to Prevent or Reduce Colorectal Cancer Risk Prevention techniques are directly related to the risk factors that you can change. You may still have risk factors that are out of your control, but there are actions you can take to reduce your likelihood of developing colorectal cancer. Avoid smoking Exercise regularly Manage your weight Limit or avoid alcohol, especially limiting alcohol frequency and amount per sitting Eat nutrient-dense meals Identify, screen, and remove any polyps to prevent cancer Colorectal cancer diagnosis is on the rise in individuals in their 40s. The choices you make now can reduce your risk decades from now. As a Warfighter, taking care of your health isn’t just about staying fit for service, it’s also about long-term wellbeing. No matter your length of service, staying active, limiting alcohol, avoiding smoking and eating nutrient-dense meals will benefit you! ReferencesAmerican Cancer Society - “Colorectal Cancer Risk Factors”Bytnar, J. A. et al. - “Cancer incidence in the US military: An updated analysis”Mabila, S. L., McQuistan, A. A., & Murray, J. H. - “Incidence of Colorectal Cancer Among Active Component Service Members, 2010-2022”Medline Plus - “Colorectal Cancer”
