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Promoting early detection of Colorectal Cancer

Ricardo López Valle's picture
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This March we celebrate Colon Cancer Awareness and promote early detection tests.

For many people, reaching the age of 50 marks the beginning of an important stage in their lives. Many take the opportunity to reflect on their experiences, achievements, and wishes to fulfill. But we should also recognize that no matter how young and full of energy we feel, it is natural that with age certain changes occur that affect the normal functioning of our body. This is why, according to the American Cancer Society (ACS), every person should have a screening test for colorectal cancer starting at the age of 50.

Colorectal cancer is the second leading cause of cancer death in the U.S. In Puerto Rico, it is the second most common type of cancer. It is also recognized as the second leading cause of cancer death for women, as well as the third cause for men.

Like other cancers, colorectal cancer arises from abnormal cell growth.  In this case, it’s the cells from the colon (large intestine) and rectum that show abnormal growth. This cancer usually begins as a set of precancerous cells, commonly known as polyps, which form on the inner surface of the colon and rectum. Although most of these polyps often grow without a specific reason, today we know that there are several mutated genes that can be inherited and that these predispose individuals to certain colorectal cancer syndromes.

Some of the established risk factors for colorectal cancer include:

  • Being over 50 years old

  • A personal and / or family history of colon cancer or polyps

  • A history of other gastrointestinal diseases, such as Crohn's disease and ulcerative colitis

  • Being a person of African American descent

  • Eating a diet low in fiber and/or high in fat

  • Obesity

  • A sedentary lifestyle

  • Diabetes

  • Cigarette smoking

  • Drinking alcohol in excess

Colorectal cancer is highly detectable if proper medical tests are carried out. The most common screening test is the colonoscopy. In this test a colonoscope, which is essentially a thin, flexible tube with a tiny camera at its end is used. This instrument is used to view and photograph the inside of the large intestine and terminal ileum (the end of the small intestine). During a colonoscopy, the state of the colon and rectum is inspected, and you can also take tissue samples for biopsy, as well as remove evident polyps.

Another screening test includes the sigmoidoscopy (similar to colonoscopy).  However, this test can only inspect the rectum and the distal (last) segment of the colon. For those who do not want an invasive test, you may also opt to perform a test for occult blood in their feces (stool).


Areas of the colon and rectum that we can see with a colonoscope.

When there is a family history of colorectal cancer, earlier detection testing is highly encouraged. . Specifically, if there’s a first-degree relationship (mother, father, or brother/sister), and this relative was diagnosed before the age of 60 years, then it is recommended to have a colonoscopy performed every 5 years, starting at age 40. In the case a person has been diagnosed with a familial syndrome, you can also take tests to detect the specific genetic mutations.

What are the manifestations of colorectal cancer?

Some of the most common symptoms of colorectal cancer include:

  • Bleeding from the rectum

  • Blood in stool

  • Persistent abdominal pain

  • Weight-loss without intention

  • Loss of appetite

  • Sudden changes in bowel habits

However, it is important to stress that symptoms do not necessarily have to be present when suffering from this cancer. This is why screening tests are key for the prevention and management of this condition.

Due to the lack of knowledge that the general population has about colorectal cancer and its high prevalence, March has been designated  as Colorectal Cancer Awareness Month. In Puerto Rico, we have the Colorectal Cancer Coalition, which seeks to promote awareness and prevention in the Puerto Rican population. You can find more information about this condition on their web page, as well as other official websites associated with this cause.

We should not limit ourselves to the month of March to take care of our health, especially as we approach an older age. Let’s take the initiative to promote and maintain our health so that we can enjoy a sense of well-being for ourselves and our loved ones.


  1. Colorectal Cancer Coalition Puerto Rico

  2. What is colorectal cancer

  1. Puerto Rico Family Colorectal Cancer Registry

  1. Colorectal Cancer Screening for Early Detection and Surveillance 2008/02/13 / screening-for-early-detection

  1. March is colorectal cancer awareness month