diligent attention. Cancer SUPPORT GROUPSprovide
excellent opportunities to share experiences and
feelings in a protected setting.
Risk Factors and Preventive Measures
The most significant risk factor for colorectal can-
cer, as for many kinds of cancer, is age. Doctors
diagnose more than 90 percent of colorectal cancer
in people who are age 50 and older. Health and
medical factors that present increased risk include
- of early-onset (before age 50) colorectal cancer
among first-degree family members, notably
parents and siblings - previous diagnosis of colorectal cancer
- previous diagnosis of BREAST CANCER, endome-
trial (uterine) cancer, or OVARIAN CANCER in
women - mutations of the adenomatous polyposis coli
(APC) gene, which causes FAMILIAL ADENOMA-
TOUS POLYPOSIS(FAP), or of the gene that causes
HEREDITARY NONPOLYPOSIS COLORECTAL CANCER
(HNPCC); both mutations are rare, together
accounting for less than 3 percent of colorectal
cancers - INFLAMMATORY BOWEL DISEASE(IBD), which may
feature Crohn’s disease, ulcerative COLITIS, or
both - OBESITY, notably ABDOMINAL ADIPOSITY (excess
body fat carried around the belly)
Lifestyle factors that appear to increase the risk
for colorectal cancer include a diet high in satu-
rated fats (animal-based fats) and low in fruits and
vegetables, lack of daily physical exercise, and
smoking.
Regular screening is the most effective preven-
tive measure for colorectal cancer. Cancer experts
recommend colonoscopy as the first line of screen-
ing for colorectal cancer in most people starting at
age 50, though earlier in people with family mem-
bers who have had colorectal cancer at an earlier
age, every 10 years for people with average risk
and every 5 years for people with additional risk
factors. Research suggests such screening could
eliminate 80 to 90 percent of colorectal cancer.
Though conclusive evidence of dietary correla-
tions to risk for intestinal polyps and colorectal
cancer remains elusive, cancer experts encourage
a diet high in natural fiber (especially fresh fruits
and vegetables) and low in saturated fat. Other
lifestyle recommendations include daily physical
exercise, SMOKING CESSATION, and weight manage-
ment.
See also ADENOMA-TO-CARCINOMA TRANSITION;
CANCER PREVENTION; CANCER RISK FACTORS; CANCER
TREATMENT OPTIONS AND DECISIONS; DIET AND HEALTH;
END OF LIFE CONCERNS; FIBER AND GASTROINTESTINAL
HEALTH; INTESTINAL POLYP; SMOKING AND HEALTH; SUR-
GERY BENEFIT AND RISK ASSESSMENT; WEIGHT LOSS AND
WEIGHT MANAGEMENT.colostomy A surgically created opening (stoma)
through the abdominal wall through which the
COLONpasses fecal matter, typically accompanying
surgery to remove a diseased segment of the
colon. Though there are numerous medical rea-
sons for colostomy, among the most common are
COLORECTAL CANCER, traumatic injury, and severe
INFLAMMATORY BOWEL DISEASE (IBD). A colostomy
may be temporary when a period of nonactivity
will help the colon recover from INFECTION or
inflammatory damage or during the stages of
reconstructive surgery. A colostomy is likely to be
permanent when the surgeon must remove large
segments of bowel.
The OPERATIONis a major surgery done under
general anesthetic. Typically the person enters the
hospital the night before the scheduled OPERATION
to complete the preparations for surgery, which
usually include LAXATIVES and enemas to thor-
oughly cleanse the colon. The length of the opera-
tion depends on the extent of the procedures. The
surgeon attempts to locate the colostomy in the
lower abdomen when possible, though may place
a temporary colostomy in the upper abdomen to
rest the lower segments of the colon. Most people
remain in the hospital for five to seven days, dur-
ing which time an ostomy-care specialist provides
education and instruction about colostomy care.
HEALING after surgery takes about six to eight
weeks. Diligent WOUND CAREduring this period is
essential to reduce the risk for infection and irrita-
tion and to help the stoma heal properly.
A small plastic bag, sealed against the SKINwith
adhesive around the opening (stoma), collects
fecal matter that exits the colon through thecolostomy 31