Colorectal cancer

Incidence in Minnesota:

Colorectal cancer rates are declining

In Minnesota colorectal cancer is the third most common cancer diagnosed and the third most common cause of cancer deaths in both males and females. Colorectal cancer usually develops slowly over the course of years, beginning as a polyp inside the colon or rectum.

The death rate from colorectal cancer has been dropping for more than 20 years. This is partly due to screening and partly due to treatment. Improvements in screening mean that polyps are being found and removed before they develop into cancer. Cancers diagnosed at later stages have lower survival rates than those diagnosed at an early stage.

Colorectal cancer rates vary by regions

Colorectal incidence and mortality rates are lower in the 7-county metropolitan area compared to the rest of Minnesota. These differences likely stem from: a combination of low colorectal cancer screening rates in rural areas; the availability of medical resources in urban versus rural area; and sociodemographic factors such as income and education that contribute to barriers to access to care.

From 2014 to 2016, an average of 1,234 males and 1,153 females in Minnesota were diagnosed with colorectal cancer each year. Minnesotans of different races and ethnicities have varying rates of cancer. These differences may reflect differences in risk factors as well as access to care.


Colorectal cancer cases in Minnesota

 
Age-adjusted rates of new colorectal cancer diagnosis.
 
Age-adjusted rates of new colorectal cancer diagnosis.

Since 1988, the incidence rate of colorectal cancer has decreased about 38% for all Minnesotans. Most recently, the age-adjusted incidence rate of colorectal cancer was 42.2 new cases per 100,000 males and 33.9 new cases per 100,000 females.


Colorectal cancer cases in Minnesota, by race/ethnicity

 
Age-adjusted rates of new colorectal cancer diagnosis, aggregated from 2007 to 2016.
 
Age-adjusted rates of new colorectal cancer diagnosis, aggregated from 2004 to 2013.

The figure above shows the age-adjusted incidence rate of colorectal cancer by race/ethnicity. Over the last 10 years, the rate of colorectal cancer was highest among American Indians (about 63 new cases of colorectal cancer per 100,000 American Indians) and lowest among Asian/Pacific Islanders (about 30 new cases of colorectal cancer per 100,000 Asian/Pacific Islanders).


Colorectal cancer cases in Minnesota, by age

 
Rates of new colorectal cancer diagnoses, aggregated from 2007 to 2016.
 
Rates of new colorectal cancer diagnoses, aggregated from 2004 to 2013.

Colorectal cancer rates increase with age.


What is colorectal cancer?

Colorectal cancer starts in the colon or rectum and is referred to as either colon cancer or rectal cancer depending on where the cancer starts. The colon and rectum serve together as the large intestine, part of the digestive system. Most colorectal cancers develop slowly and begin as a non-cancerous polyp on the inner lining of the colon or rectum. The most common type of colorectal cancers is an adenocarcinoma, which accounts for more than 95% of colorectal cancers.

What are risk factors for colorectal cancer?

  • Age: the risk of colorectal cancer increases with age; 90% of colorectal cancers in Minnesota are diagnosed among people 50 years of age or older.
  • Personal history of colorectal polyps or cancer.
  • A family history of colorectal cancer or polyps in close relatives (parents, siblings, or children) increases the risk of developing the disease. Certain familial and genetic diseases such as ulcerative colitis, Familial Adenomatous Polyposis (FAP), or Lynch syndrome increase the risk of colorectal cancer.
  • Inflammatory bowel disease (IBD), a condition in which the colon is inflamed over a long period of time. IBD is different from irritable bowel syndrome (IBS), a common disorder that can cause cramping, abdominal pain, and diarrhea, does not increase the risk for colorectal cancer. 
  • Not being screened is a risk factor because colorectal cancer can be prevented by removing precancerous polyps. 
  • Other risk factors include obesity, physical inactivity, smoking, heavy alcohol use, and a diet high in red meats and processed meats.

How can colorectal cancer be prevented?

Colorectal cancer screening is the best way to prevent colorectal cancer. Get screened regularly, even if you don't have symptoms. Most polyps on the colon or rectum can be found and removed before they have the chance to turn into cancer.

The American Cancer Society (ACS) and the United States Preventive Services Task Force have different recommendations for colorectal cancer screening that depend on age and family history. On May 30, 2018, the ACS updated screening guidelines for colorectal cancer by recommending that adults at average risk be screened starting at age 45. See American Cancer Society Guideline for Colorectal Cancer Screening.

In 2016, 73.5% of age-eligible Minnesotans had a current colorectal screening test (data from Behavioral Risk Factor Surveillance System). While overall screening increased, people that identify as Asian, American Indian, or Hispanic were less likely to have been screened for colorectal cancer than people that identify as white. Screening occurred more frequently in women and people aged 65 to 75, who were likely insured by Medicare.

Maintain a healthy weight, exercise, and choose a diet low in red meat and processed meat. Limit alcohol use and don't smoke.

The MDH Sage Screening Program aims to increase the proportion of people screened for breast, cervical, and colorectal cancers statewide. The program offers free colonoscopies and related services for eligible men and women (people that meet age, insurance, and income criteria).

 

Last updated May 2019. Updates are made when data become available.