Colorectal Cancer

Issue

Vol. 2 No. 3 (2025)

Date Log

Submitted
March 7, 2025
Accepted
June 23, 2025
Published
July 9, 2025

Colorectal Cancer Demystified | Signs, Risk Factors & How Early Detection Saves Lives

https://doi.org/10.69512/ajphi.v2i3.95
Rochana Acharya, MD
Department of Internal Medicine, Cleveland Clinic Foundation, OH, USA
https://orcid.org/0000-0001-7293-8207
Dipendra Kandel, MD
Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal
https://orcid.org/0000-0001-7790-1278
Aakriti Karki, MD
Jalalabad Ragib Rabeya Medical College and Hospital, Sylhet, Bangladesh
https://orcid.org/0009-0007-4024-1617
Gauri Adhikari, MD
Department of Internal Medicine, Washington University/Consortium at Missouri Baptist Medical Center, MO, USA
https://orcid.org/0000-0002-4250-9839

Corresponding Author(s) : Rochana Acharya, MD

rochanaacharya2054@gmail.com

The American Journal of Patient Health Info, Vol. 2 No. 3 (2025)

Abstract


  1. Colorectal cancer is the second deadliest cancer in the world.

  2. Colon cancer is rising in people under 50, and most don’t feel sick when they’re diagnosed.

  3. Colon cancer can show warning signs like painless blood in stool, sudden weight loss, tiredness, weakness, and changes in bathroom habits—especially important to notice in older adults.

  4. You should start getting checked for colon cancer at age 45. If someone in your family had it or you have other risks, your doctor might want you to start earlier.

  5. Early diagnosis and proper management of colorectal cancer can lead to successful treatment and complete recovery.

Keywords

Colonoscopy Colorectal cancer Screening Hematochezia Tumor resection Bleeding Per Rectum
Acharya, MD, R., Kandel, MD, D., Karki, MD, A., & Adhikari, MD, G. (2025). Colorectal Cancer Demystified | Signs, Risk Factors & How Early Detection Saves Lives. The American Journal of Patient Health Info, 2(3). https://doi.org/10.69512/ajphi.v2i3.95
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References
  1. Hossain MdS, Karuniawati H, Jairoun AA, Urbi Z, Ooi DJ, John A, et al. Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies. Cancers (Basel) 2022;14:1732. Available from: https://pubmed.ncbi.nlm.nih.gov/35406504/
  2. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol 2019;14:89–103. Available from: https://pubmed.ncbi.nlm.nih.gov/31616522/
  3. Skalitzky MK, Zhou PP, Goffredo P, Guyton K, Sherman SK, Gribovskaja-Rupp I, et al. Characteristics and symptomatology of colorectal cancer in the young. Surgery 2023;173:1137–43. Available from: https://pubmed.ncbi.nlm.nih.gov/36872174/
  4. Holtedahl K, Borgquist L, Donker GA, Buntinx F, Weller D, Campbell C, et al. Symptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary care. BMC Fam Pract 2021;22:148. Available from: https://pubmed.ncbi.nlm.nih.gov/34238248/
  5. Sawicki T, Ruszkowska M, Danielewicz A, Niedźwiedzka E, Arłukowicz T, Przybyłowicz KE. A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis. Cancers (Basel) 2021;13:2025. Available from: https://pubmed.ncbi.nlm.nih.gov/33922197/
  6. Lewandowska A, Rudzki G, Lewandowski T, Stryjkowska-Góra A, Rudzki S. Risk Factors for the Diagnosis of Colorectal Cancer. Cancer Control 2022;29:10732748211056692–10732748211056692. Available from: https://pubmed.ncbi.nlm.nih.gov/35000418/
  7. Amersi F, Agustin M, Ko CY. Colorectal cancer: epidemiology, risk factors, and health services. Clin Colon Rectal Surg 2005;18:133–40. Available from: https://pubmed.ncbi.nlm.nih.gov/20011296/
  8. Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB, Davis EM, et al. Screening for Colorectal Cancer. JAMA 2021;325:1965. Available from: https://jamanetwork.com/journals/jama/fullarticle/2779985
  9. Fritz CDL, Otegbeye EE, Zong X, Demb J, Nickel KB, Olsen MA, et al. Red-flag signs and symptoms for earlier diagnosis of early-onset colorectal cancer. JNCI: Journal of the National Cancer Institute 2023;115:909–16. Available from: https://pubmed.ncbi.nlm.nih.gov/37138415/
  10. Simon K. Colorectal cancer development and advances in screening. Clin Interv Aging 2016;11:967–76. Available from: https://pubmed.ncbi.nlm.nih.gov/27486317/
  11. Demb J, Kolb JM, Dounel J, Fritz CDL, Advani SM, Cao Y, et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer. JAMA Netw Open 2024;7:e2413157. Available from: https://pubmed.ncbi.nlm.nih.gov/38787555/
  12. USPSTF. Colorectal cancer: Screening [Internet]. U.S. Preventive Services Task Force. 2021. Available from: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
  13. Shaukat A, Kahi CJ, Burke CA, Rabeneck L, Sauer BG, Rex DK. ACG Clinical Guidelines: Colorectal Cancer Screening 2021. American Journal of Gastroenterology 2021;116:458–79. Available from: https://pubmed.ncbi.nlm.nih.gov/33657038/
  14. Liu Z, Zhang Y, Niu Y, Li K, Liu X, Chen H, et al. A systematic review and meta-analysis of diagnostic and prognostic serum biomarkers of colorectal cancer. PLoS One 2014;9:e103910–e103910. Available from: https://pubmed.ncbi.nlm.nih.gov/25105762/
  15. Virdee PS, Marian IR, Mansouri A, Elhussein L, Kirtley S, Holt T, et al. The Full Blood Count Blood Test for Colorectal Cancer Detection: A Systematic Review, Meta-Analysis, and Critical Appraisal. Cancers (Basel) 2020;12:2348. Available from: https://pubmed.ncbi.nlm.nih.gov/32825191/
  16. Gimeno-García AZ, Quintero E. Role of colonoscopy in colorectal cancer screening: Available evidence. Best Practice & Research Clinical Gastroenterology 2023;66:101838. Available from: https://www.sciencedirect.com/science/article/pii/S1521691823000185
  17. Kolligs FT. Diagnostics and Epidemiology of Colorectal Cancer. Visc Med 2016;32:158–64. Available from: https://pubmed.ncbi.nlm.nih.gov/27493942/
  18. Stintzing S. Management of colorectal cancer. F1000Prime Rep 2014;6:108. Available from: https://pubmed.ncbi.nlm.nih.gov/25580262/
  19. Adebayo AS, Agbaje K, Adesina SK, Olajubutu O. Colorectal Cancer: Disease Process, Current Treatment Options, and Future Perspectives. Pharmaceutics 2023;15:2620. Available from: https://pubmed.ncbi.nlm.nih.gov/38004598/
  20. Aprile G, Rihawi K, De Carlo E, Sonis ST. Treatment-related gastrointestinal toxicities and advanced colorectal or pancreatic cancer: A critical update. World J Gastroenterol 2015;21:11793–803. Available from: https://pubmed.ncbi.nlm.nih.gov/26557003/
  21. Research and policy | World Cancer Research Fund [Internet]. World Cancer Research Fund. 2024. Available from: https://www.wcrf.org/research-policy/
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Rochana Acharyaa, Dipendra Kandelb, Aakriti Karkic, Gauri Adhikarid

a Department of Internal Medicine, Cleveland Clinic Foundation, OH, USA

b Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal

c Jalalabad Ragib Rabeya Medical College and Hospital, Sylhet, Bangladesh

d Department of Internal Medicine, Washington University/Consortium at Missouri Baptist Medical Center, MO, USA

Edited on: March 15, 2024

Last Edited

Background

Colorectal cancer (CRC) remains one of the leading causes of cancer-related deaths worldwide, yet it is highly preventable and treatable when detected early. In 2020, nearly 1.93 million people around the world were diagnosed with colorectal cancer, which is a cancer in the colon or rectum. This type of cancer made up 10% of all new cancer cases. [1,2]

Colorectal cancer remains a major health concern, with its symptoms varying based on tumor location and patient age. While it is more common in adults more than 70 years old, an increasing number of individuals less than 50 years old are being diagnosed, often without noticeable symptoms. This highlights the importance of early screening and awareness, as timely detection significantly improves treatment outcomes. [3,4]

Epidemiology: Who is Most Affected?

Colorectal cancer develops due to a combination of genetic, lifestyle, and environmental factors. Understanding these factors can help in early detection and prevention. Colorectal cancer incidence shows notable differences based on gender and geography. It is more common in men than in women, a disparity believed to be influenced by lifestyle factors such as higher rates of smoking and alcohol consumption among men, as well as differences in diet and occupational exposures. [2] Geographically, colorectal cancer occurs more frequently in developed countries than in developing ones. This trend is attributed to lifestyle and environmental factors prevalent in higher-income nations, such as diets high in red and processed meats, sedentary behaviors, obesity, and longer life expectancy, which increase cumulative risk. In contrast, developing countries traditionally have had lower incidence rates, though these are rising with urbanization and Westernization of lifestyles.

Figure 1.

Some risk factors for colorectal cancer are things you can’t change, like being over 50 years old, having family members with cancer, or belonging to certain groups like Black, American Indian, or Alaskan Native people. [5] These might happen because of genes, diet, or healthcare differences. If cancer runs in your family, your doctor may suggest starting tests earlier or doing genetic checks.

But there are also things you can change to lower your risk. [6] Eating less red and processed meat, and more fruits, vegetables, and fiber helps keep your gut healthy. Staying active, keeping a healthy weight, avoiding too much alcohol, and not smoking can also protect you. Having long-term stomach problems like Crohn’s disease can raise your risk too. Knowing these risks and making healthy choices can help you stay safe and well. [7]

Early Signs of Colorectal Cancer: Why Symptoms Often Go Undetected?

In the early stages of colorectal cancer, symptoms can be minimal or even completely absent, making it hard to notice the disease until it has progressed. Here are seven common symptoms of colon cancer you need to know.

Figure 2.

  • Changes in Bowel Habits: This can include unexplained constipation that doesn’t improve with diet or laxatives or chronic diarrhea that lasts for several weeks. Another symptom to watch for is a change in stool consistency or shape, such as stools becoming unusually thin or "pencil-like," which may suggest a narrowing of the colon caused by a tumor or blockage. [8,9]
  • Blood in the Stool: You might notice bright red blood on the toilet paper or in the toilet bowl. In younger people, this can sometimes be from hemorrhoids or small tears, especially if there's pain while passing stool. But if you're over 50 and see painless bleeding, it could be a warning sign of colon cancer, and you should see a doctor right away. Also, if your stool looks dark or black, it might mean there's old blood from higher up in your digestive system, and that also needs medical attention. [8]
  • Abdominal Discomfort: Colorectal cancer may cause persistent cramps or aches in the lower abdomen that do not fully resolve, even with over-the-counter medications. If you experience ongoing abdominal discomfort along with other symptoms of CRC, it is important to consult a doctor. [8]
  • Unexplained Weight Loss: If you're losing weight drastically, even if you are eating healthy, it could be due to an alteration in your digestive and metabolic system caused by cancer. So, if there is unexplained massive weight loss in a short period, then you should consult a physician immediately. [10,11]
  • Blood Loss Causing Low Iron Levels: When we lose blood over a long time, like the blood lost in stool in colorectal cancer, we also lose iron because iron is part of our blood. Without enough iron, the body can’t make healthy red blood cells. This leads to iron deficiency anemia, which can make you pale and feel tired, weak, and short of breath. [10]
  • Feeling of Incomplete Evacuation: You may feel like your bowels haven’t fully emptied after a bowel movement. While this can result from common digestive issues, persistent or unexplained symptoms should be evaluated by a doctor as they could indicate colon cancer. [10]
  • Fatigue and Weakness: Chronic blood loss from colorectal cancer can cause anemia, leading to persistent tiredness, weakness, and lack of energy. This symptom often develops gradually and may be overlooked, but can be a key early sign, especially when combined with other symptoms like changes in bowel habits or unexplained weight loss.

The Importance of Early Screening for Colorectal Cancer

Screening for colorectal cancer is a powerful tool that can save lives by catching the disease early, often before symptoms appear. Early detection allows doctors to find and remove precancerous polyps, preventing cancer from developing in the first place. Recent changes in screening guidelines reflect growing evidence that colorectal cancer is increasingly affecting younger adults. For example, the U.S. Preventive Services Task Force (USPSTF) now recommends that average-risk adults begin screening at age 45, instead of 50. This shift aims to detect cancer earlier in people who may otherwise be overlooked, improving survival rates and reducing treatment complexity. Regular screening through methods like colonoscopy, stool tests, or sigmoidoscopy is key to beating colorectal cancer before it progresses. When detected early, colorectal cancer is highly treatable and has a good chance of being cured. Screening for colorectal cancer is a proactive step that can make all the difference. [12]

Who Should Get Screened for Colorectal Cancer? Understanding Screening Guidelines and Risk Factors

Screening guidelines recommend that individuals at average risk for colorectal cancer start regular screening at age 45. Average risk means no personal history of colorectal cancer, inflammatory bowel disease, or precancerous colon polyps, and no known family history of hereditary colorectal cancer syndromes. However, for those with higher risk, such as a family history of colorectal cancer or inherited genetic conditions like Lynch syndrome or familial adenomatous polyposis, screening should begin earlier and may need to be more frequent. It’s important to discuss your personal and family medical history with a healthcare provider to determine the best screening plan tailored to your risk. [13,14]

Screening Methods for Colorectal Cancer

There are several ways to screen for colorectal cancer, each with its own benefits. The Fecal Occult Blood Test (FOBT) is a simple, non-invasive test that checks for hidden blood in the stool, which can be an early sign of cancer.

Figure 3.

The fecal immunochemical test (FIT) is similar but more accurate because it specifically detects blood from the lower digestive tract. FIT is easy to do at home, requires no dietary restrictions, and is highly effective at detecting early cancer. [13]

The colonoscopy is considered the gold standard for colorectal cancer screening. It allows doctors to view the entire colon and rectum directly with a camera, making it possible to detect and remove polyps or abnormal growths during the same procedure. This not only helps diagnose cancer early but can also prevent it by removing precancerous polyps. Though it requires preparation and sedation, its thoroughness and ability to treat abnormalities immediately make it the most comprehensive screening tool. [12]

A less extensive option is the sigmoidoscopy, which examines only the lower part of the colon (the sigmoid colon). It is less invasive and quicker than a colonoscopy but doesn’t provide a full view of the colon. [12]

The frequency of screening depends on the method used and individual risk. A colonoscopy is usually recommended every 10 years for people at average risk because of its thoroughness and preventive capabilities. Stool-based tests like FOBT and FIT are done annually, offering a convenient and non-invasive way to regularly monitor for signs of cancer. [12,13]

How is Colon Cancer Diagnosed? Key Tests and What They Reveal

Doctors use several tests to detect and diagnose colon cancer.

Figure 4.

  • Blood Tests: They help provide clues about the presence and progression of the disease, but are not enough on their own to confirm cancer. For example, the carcinoembryonic antigen (CEA) test measures a protein that can be higher in people with colorectal cancer. However, elevated CEA levels can also occur in other cancers like lung, breast, or pancreatic cancer, as well as in non-cancer conditions such as inflammation or smoking. [14] Because of this, CEA is mainly used to monitor treatment response and check for cancer recurrence rather than for initial diagnosis. Your doctor may also test for specific genetic and molecular markers that assist in diagnosing colorectal cancer and planning personalized treatment. [12] Additionally, routine blood tests like the complete blood count (CBC) can reveal overall health status, including anemia, which is common in colon cancer patients due to chronic blood loss, and abnormalities in liver or kidney function that might result from cancer or its treatment. [15]
  • Colonoscopy and Biopsy: Colonoscopy is a procedure that utilizes a flexible tube with a camera that offers real-time visualization of the colon and rectum, enabling the detection of potentially cancerous polyps and tumors. If your doctor detects abnormalities, a small piece of tissue is taken to check for cancer (biopsy) during the procedure, allowing for a definitive diagnosis by examining the tissue under a microscope. These crucial steps confirm the presence of colorectal cancer, determine its type, and stage, and guide treatment decisions. [16,17]
  • Imaging: Different imaging tests are used to diagnose and monitor colorectal cancer. A Computed Tomography (CT) scan gives clear pictures of the abdomen and pelvis. It helps doctors discover the cancer stage and how well the treatment works. A Magnetic Resonance Imaging (MRI) scan provides detailed images of the pelvis, which helps in checking how far the tumor has spread and whether the lymph nodes are affected. A Positron Emission Tomography (PET) scan can find cancer that has spread to other parts of the body and shows how active the cancer is. Sometimes, PET scans are combined with CT or MRI for more accurate results. Ultrasound is often used to check rectal tumors and can also guide certain procedures. Not everyone needs all these tests; your doctor will decide which ones are best for you. [17]

Treatment of Colon Cancer

The treatment of colon cancer depends on the stage of the disease, its location, and the patient’s overall health. [18,19]

Figure 5.

  • Surgery: Surgery is the most common treatment for colon cancer at all stages, which involves removing the tumor during an operation. The type of surgery depends on the kind of cancer you have. If the cancer has spread too far and can’t be completely removed, we do surgery to relieve symptoms and prevent problems from the cancer. If the goal is to remove all the cancer, surgery can be either a small removal if the cancer is caught early or a bigger surgery if it has spread more. [18] In some cases of colon cancer, the surgeon may need to remove part or all of the colon and cannot safely reconnect the remaining sections. When this happens, they create a small opening on the belly called a stoma. Waste from the body then passes through this opening into a special bag worn outside the body. Although adjusting to a colostomy can be challenging initially, many people live full, active lives with proper care and support. [19]
  • Radiofrequency Treatment: Radiofrequency ablation employs a high-frequency electrical current to generate heat, effectively "cooking" and destroying cancerous tissue. Radiofrequency ablation (RFA) is a minimally invasive medical procedure gaining prominence in treating colorectal cancer, particularly for certain cases of liver metastases originating from colorectal cancer. RFA can be used alone or with other treatment modalities, such as surgical resection, chemotherapy, or targeted therapies.
  • Chemotherapy: Chemotherapy is a treatment that uses special medicines to kill cancer cells all over the body. It’s often used when colorectal cancer has spread or is more advanced. Sometimes chemotherapy is given before surgery to shrink tumors, after surgery to kill any leftover cancer cells, or along with other treatments like radiation. Some common chemotherapy drugs for colon cancer are called 5-fluorouracil (5-FU), oxaliplatin, and irinotecan. While chemotherapy can help slow down cancer and help people live longer, it can also cause side effects like feeling very tired, nausea, and having fewer blood cells. Doctors watch patients closely to manage these side effects. [19]
  • Radiation Therapy: High-energy X-rays or other forms of radiation are used in radiation therapy, which helps to kill or stop cancer cells' growth. External radiation therapy uses a device outside the body to direct radiation at the cancerous region. Internal radiation therapy uses catheters, seeds, wires, or needles with radioactive materials sealed inside that are inserted into or close to the malignancy.
  • Targeted Therapy: Targeted therapy is a form of medical care that isolates and destroys cancer-specific cells using medicines or other substances. Compared to chemotherapy and radiation therapy, targeted therapies often don't kill healthy cells as much and, therefore, have fewer side effects. [19]
  • Immunotherapy: Immunotherapy is a cancer treatment that activates the patient's immune system. It boosts, directs, or restores the body's natural defenses against cancer using cancer-fighting substances produced by the body or in a lab. [19]

Side Effects of CRC Chemotherapy Treatment

Chemotherapy for colorectal cancer can cause side effects like constipation, diarrhea, indigestion, mouth sores, nausea, and vomiting. These are common and usually manageable, but if symptoms like diarrhea or vomiting become very bad, they can cause dehydration, which is serious. That’s why drinking plenty of fluids, eating small meals, and getting enough rest are important. If side effects worsen, doctors can give medicines to help control nausea or diarrhea. [19,20]

Cancer treatments like chemotherapy can be a double-edged sword; they are powerful tools that can extend life and improve its quality by controlling or eliminating cancer. Still, they can also cause uncomfortable or even dangerous side effects. Before beginning treatment, doctors carefully consider the risks and benefits and discuss them with their patients. The main aim is to maximize survival while preserving your quality of life.

Plant-Based Diet and Colon Cancer: A Protective Connection

A plant-based diet rich in fruits, vegetables, whole grains, nuts, and legumes can help lower the risk of colon cancer. These foods are high in fiber, antioxidants, and other nutrients that support healthy digestion and protect cells from damage. Fiber, in particular, promotes regular bowel movements and nurtures beneficial gut bacteria, which are essential for colon health. Research shows that diets low in red and processed meats but high in plant-based foods are linked to a reduced risk of colorectal cancer. The American Institute for Cancer Research recommends increasing fiber intake and limiting processed meat to reduce cancer risk. [21]

Tips for Adopting a Plant-Based Diet

  • Start by adding more vegetables and fruits to every meal.
  • Choose whole grains like brown rice, quinoa, and oats over refined grains.
  • Incorporate plant proteins such as beans, lentils, tofu, and nuts.
  • Gradually reduce consumption of red and processed meats.
  • Experiment with new plant-based recipes to keep meals enjoyable and diverse.

Questions To Ask Your Doctor

  1. If I have a family history of colon cancer, when and how often should I get screening?
  2. If polyps are found during a colonoscopy, does that mean I will develop colorectal cancer?
  3. Is colorectal cancer always inherited, or can it develop without a family history?
  4. What's the risk of my children getting colon cancer?
  5. How often will I need to come in for check-ups and testing during and after treatment?
  6. Will I be able to work during my treatment and recovery?

Conflict of Interest

RA has no conflicts of interest to declare. DK is employed as a research assistant at ehealthyinfo. AK also serves as a research assistant at ehealthyinfo and is the section editor for mental health at AJPHI. GA worked as a paid research assistant for ehealthyinfo from 2023 to 2024 and is an associate editor at AJPHI.

Peer-Reviewed By

Bibek Karki, MD

Hurley Medical Center/Michigan State University, Flint, MI, USA

References

  1. Hossain MdS, Karuniawati H, Jairoun AA, Urbi Z, Ooi DJ, John A, et al. Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies. Cancers (Basel) 2022;14:1732. Available from: https://pubmed.ncbi.nlm.nih.gov/35406504/
  2. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol 2019;14:89–103. Available from: https://pubmed.ncbi.nlm.nih.gov/31616522/
  3. Skalitzky MK, Zhou PP, Goffredo P, Guyton K, Sherman SK, Gribovskaja-Rupp I, et al. Characteristics and symptomatology of colorectal cancer in the young. Surgery 2023;173:1137–43. Available from: https://pubmed.ncbi.nlm.nih.gov/36872174/
  4. Holtedahl K, Borgquist L, Donker GA, Buntinx F, Weller D, Campbell C, et al. Symptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary care. BMC Fam Pract 2021;22:148. Available from: https://pubmed.ncbi.nlm.nih.gov/34238248/
  5. Sawicki T, Ruszkowska M, Danielewicz A, Niedźwiedzka E, Arłukowicz T, Przybyłowicz KE. A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis. Cancers (Basel) 2021;13:2025. Available from: https://pubmed.ncbi.nlm.nih.gov/33922197/
  6. Lewandowska A, Rudzki G, Lewandowski T, Stryjkowska-Góra A, Rudzki S. Risk Factors for the Diagnosis of Colorectal Cancer. Cancer Control 2022;29:10732748211056692–10732748211056692. Available from: https://pubmed.ncbi.nlm.nih.gov/35000418/
  7. Amersi F, Agustin M, Ko CY. Colorectal cancer: epidemiology, risk factors, and health services. Clin Colon Rectal Surg 2005;18:133–40. Available from: https://pubmed.ncbi.nlm.nih.gov/20011296/
  8. Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB, Davis EM, et al. Screening for Colorectal Cancer. JAMA 2021;325:1965. Available from: https://jamanetwork.com/journals/jama/fullarticle/2779985
  9. Fritz CDL, Otegbeye EE, Zong X, Demb J, Nickel KB, Olsen MA, et al. Red-flag signs and symptoms for earlier diagnosis of early-onset colorectal cancer. JNCI: Journal of the National Cancer Institute 2023;115:909–16. Available from: https://pubmed.ncbi.nlm.nih.gov/37138415/
  10. Simon K. Colorectal cancer development and advances in screening. Clin Interv Aging 2016;11:967–76. Available from: https://pubmed.ncbi.nlm.nih.gov/27486317/
  11. Demb J, Kolb JM, Dounel J, Fritz CDL, Advani SM, Cao Y, et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer. JAMA Netw Open 2024;7:e2413157. Available from: https://pubmed.ncbi.nlm.nih.gov/38787555/
  12. USPSTF. Colorectal cancer: Screening [Internet]. U.S. Preventive Services Task Force. 2021. Available from: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
  13. Shaukat A, Kahi CJ, Burke CA, Rabeneck L, Sauer BG, Rex DK. ACG Clinical Guidelines: Colorectal Cancer Screening 2021. American Journal of Gastroenterology 2021;116:458–79. Available from: https://pubmed.ncbi.nlm.nih.gov/33657038/
  14. Liu Z, Zhang Y, Niu Y, Li K, Liu X, Chen H, et al. A systematic review and meta-analysis of diagnostic and prognostic serum biomarkers of colorectal cancer. PLoS One 2014;9:e103910–e103910. Available from: https://pubmed.ncbi.nlm.nih.gov/25105762/
  15. Virdee PS, Marian IR, Mansouri A, Elhussein L, Kirtley S, Holt T, et al. The Full Blood Count Blood Test for Colorectal Cancer Detection: A Systematic Review, Meta-Analysis, and Critical Appraisal. Cancers (Basel) 2020;12:2348. Available from: https://pubmed.ncbi.nlm.nih.gov/32825191/
  16. Gimeno-García AZ, Quintero E. Role of colonoscopy in colorectal cancer screening: Available evidence. Best Practice & Research Clinical Gastroenterology 2023;66:101838. Available from: https://www.sciencedirect.com/science/article/pii/S1521691823000185
  17. Kolligs FT. Diagnostics and Epidemiology of Colorectal Cancer. Visc Med 2016;32:158–64. Available from: https://pubmed.ncbi.nlm.nih.gov/27493942/
  18. Stintzing S. Management of colorectal cancer. F1000Prime Rep 2014;6:108. Available from: https://pubmed.ncbi.nlm.nih.gov/25580262/
  19. Adebayo AS, Agbaje K, Adesina SK, Olajubutu O. Colorectal Cancer: Disease Process, Current Treatment Options, and Future Perspectives. Pharmaceutics 2023;15:2620. Available from: https://pubmed.ncbi.nlm.nih.gov/38004598/
  20. Aprile G, Rihawi K, De Carlo E, Sonis ST. Treatment-related gastrointestinal toxicities and advanced colorectal or pancreatic cancer: A critical update. World J Gastroenterol 2015;21:11793–803. Available from: https://pubmed.ncbi.nlm.nih.gov/26557003/
  21. Research and policy | World Cancer Research Fund [Internet]. World Cancer Research Fund. 2024. Available from: https://www.wcrf.org/research-policy/

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