Colorectal Cancer Awareness

“Knowing

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Genetic Risk and Colorectal Cancer

Screening

cancer saves lives. But what if you had a crystal ball that tells whether you and your family are more likely to face the disease?

Unfortunately, we don’t have a crystal ball — or its medical equivalent — quite yet, but you can get some insight by knowing your family medical history and whether you have any hereditary genetic conditions like Lynch or FAP syndromes that may increase your risk of colorectal cancer.

How is cancer caused genetically?

While there is still much to learn about this disease, we know it is caused by gene mutations, or changes, that result in cells growing out of control. As you age, gene mutations accumulate, and this is why colorectal cancer most often happens in people over age 50. In most cases, the gene mutations leading to cancer happen at random, although they can be helped along by carcinogens, like the chemicals in cigarette smoke.

Yet, in about 25% of cases, patients have a family history of

the disease, signaling a possible genetic condition that causes mutations and increases the likelihood of colorectal cancer at a younger age.

Genetic mutations that increase the risk of cancer can be inherited from parents. Inherited genetic mutations play a role in 5-10% of all cancer cases, including colorectal cancer. Researchers have found more than 50 hereditary cancer syndromes overall. Fortunately, a number of these inherited conditions can be identified through genetic testing, and the results can be life-saving.

The genetic risks of colorectal cancer

Knowing whether you’re at increased risk of genetic mutations that can cause colorectal cancer can help you take precautions to avoid the disease. These are the inherited genetic syndromes relevant to colorectal cancer:

• Familial adenomatous polyposis (FAP), attenuated FAP (AFAP), and Gardner syndrome

• Lynch syndrome (hereditary non-polyposis colon cancer, or HNPCC)

• Peutz-Jeghers syndrome

• MYH-associated polyposis (MAP)

• Li-Fraumeni syndrome

Am I at risk?

There are three subgroups of risk for cancer: sporadic, familial, and hereditary. If you fall into the sporadic group, which means you have no family history of cancer or inherited genetic predisposition, you have about a 1 in 23 chance of getting colorectal cancer. If you have familial risk, meaning an immediate family member has the disease, your lifetime risk increases to 10-20%. Those who have the highest lifetime risk of colorectal cancer are in the hereditary subgroup. Depending on the particular

genetic syndrome, the chances of getting colorectal cancer may be 30-100%.

Special genetic tests can find gene mutations linked to these inherited syndromes.

A healthcare provider can help you identify your risk and which type of genetic tests, if any, may be useful. Genetic testing is typically conducted with either a blood or saliva draw and completed in a lab.

Next steps

Colorectal cancer is one of the most preventable and treatable forms of cancer when it’s found early. Screening is the most important thing you can do to prevent colorectal cancer because it finds cancer in the early stages, before it even has the chance to grow or develop.

Talk to your healthcare provider about which screening methods are right for you and when you should begin screening.

The Colorectal Cancer Alliance, the world’s leading nonprofit organization dedicated to ending colorectal cancer, recently launched Project Cure CRC. The initiative reflects the Alliance’s renewed effort to fund $100 million in expedited, novel colorectal cancer research over the next two years to help improve treatment options and outcomes, and put an end to the disease. To learn more, visit colorectalcancer.org/cure.

Written by Colorectal Cancer Alliance

Is It Hemorrhoids, Colorectal Cancer, or Something Else?

Even though some of the symptoms of hemorrhoids and colorectal cancer (CRC) are similar, it’s important to understand that they are two different conditions. Hemorrhoids by themselves are not a sign of CRC, but it is vital to know the similarities and differences so you can stay in control of your health.

Both hemorrhoids and colorectal cancer can cause bleeding from the anus. Bleeding caused by hemorrhoids is usually bright red and occurs during or after a bowel movement. CRC-related bleeding can be either dark or bright red and can occur at any time.

Persistent bowel discomfort may be another symptom that is hard to differentiate. While it may be a sign of either hemorrhoids or CRC, it could also be caused by inflammatory bowel disease or a variety of other medical conditions. The only way to be certain is to speak to your healthcare provider right away.

Untreated hemorrhoids can lead to infection and other health complications, while untreated CRC can lead to the spreading of cancer and even death. The good news is that both hemorrhoids and CRC are highly treatable.

CRC has high survivorship rates if detected early, and hemorrhoids can be easily treated with over-the-counter medications or simple procedures. It is imperative that you speak to your doctor if experiencing symptoms of either condition.

Breaking down stigmas

We understand that talking about your bowels can be uncomfortable. Still, we know that the consequences of leaving symptoms unaddressed can be life-threatening.

Hemorrhoids are a highly common condition experienced by millions of people each year. Additionally, colorectal cancer is the fourth most diagnosed cancer in the United States. It’s about time we broke down the stigma of talking about things that are all too commonplace.

While hemorrhoids are not a sign of CRC, some signs and symptoms of both may overlap, making it important to seek medical care right away. Read on for symptoms of each.

What are hemorrhoids?

Hemorrhoids are a common condition that affect about half of all people by age 50. Although hemorrhoids are usually harmless, some worry that they may be a sign of colorectal cancer. While certain symptoms of hemorrhoids and colorectal cancer do overlap, it’s important to know how they are different, and how to take care of our bodies if experiencing symptoms.

Also known as piles, hemorrhoids occur when blood vessels in the anus and/or lower rectum become swollen and inflamed. They can occur both internally and externally.

The most common causes of hemorrhoids include:

• Weakening tissues that occur with age

• Straining during bowel movements

• Chronic constipation or diarrhea

• Frequently lifting heavy objects

• Sitting for long periods of time

• Low-fiber diets

• Pregnancy

• Obesity

Hemorrhoids cause a variety of symptoms, including:

• Lumps near your anus

• Anal ache or pain

• Rectal bleeding

• Rectal itching

• Discomfort

While hemorrhoids can be uncomfortable, they are usually not serious. Hemorrhoids can be treated with lifestyle changes, over-thecounter medications, and — in rare cases — medical procedures.

What is colorectal cancer?

CRC is a type of cancer that affects the colon or rectum. It usually starts from a growth or polyp, developing into cancer over time. CRC is a serious condition that can be life-threatening if not detected and treated early.

Most cases of CRC occur in people ages 45 and older, but the disease is increasingly affecting younger people. Each year, about 150,000 Americans are diagnosed with this disease and more than 50,000 die.

Colorectal cancer may develop without symptoms, or symptoms may include:

• Persistent abdominal discomfort

• Unexplained weight loss

• Changing bowel habits

• Weakness or fatigue

• Rectal bleeding

Unlike most cancers, CRC is often preventable with screening and highly treatable when detected early.

Written by Colorectal Cancer Alliance

Partnering with the Colorectal Cancer Alliance and Lead From Behind is another way I can let people, especially Black Americans who are at greater risk, know that colon cancer is preventable and there are a variety of screening options.

Dak Prescott Joins Ryan Reynolds’ Maximum Effort and the Colorectal Cancer Alliance to “Lead From Behind”

Dallas Cowboys quarterback Dak Prescott has teamed up with the nation’s leading nonprofit dedicated to colon cancer, the Colorectal Cancer Alliance, and Ryan Reynolds’ creative agency, Maximum Effort, to Lead From Behind.

Lead From Behind is a series of unique and creative videos featuring celebrities in sports and entertainment spreading awareness that colon cancer is “The Preventable Cancer” and that there are a variety of screening options available.

Prescott, whose mother died from colon cancer in 2013, joined the Lead From Behind initiative to tackle the important topic with “Sh*t Talk,” an entertaining video to reduce the stigma and break down the barriers to screening — that thing that almost no one wants to talk about, let alone do. In the video, Prescott turned talking sh*t into a positive and underscored the importance of screening for colon cancer prevention.

“Losing my mother to colon cancer was devastating, and no one should have to go through that,” Prescott said. “That’s why I started the colon cancer screening and research pillar of my Faith Fight Finish Foundation. Partnering with the Colorectal Cancer Alliance and Lead From Behind is another way I can let people, especially Black Americans who are at greater risk, know that colon cancer is preventable and there are a variety of screening options.”

The Colorectal Cancer Alliance and its

celebrity partners — including Prescott, Ryan Reynolds, Rob McElhenney, and Terry Crews — encourage people to visit LeadFromBehind.org to view and share the video on their social channels, and tag someone they love who should get screened. The site also offers a helpful screening tool, which provides more information on an individual’s risk factors, potential symptoms, and screening choices.

“I’d like to thank Dak for joining Rob McElhenney, Terry Crews, and me in helping raise awareness for dropping your drawers,” Reynolds said. “This is a highly preventable cancer, and the more we advocate for and destigmatize the colorectal screening process, the more real lives are saved.”

The preventable cancer

Colon cancer is the second-deadliest cancer in the United States, yet it is highly treatable and preventable with screening. Depending on a person’s risk factors and preferences, there are different choices for screening, including easyto-use at-home tests and colonoscopy.

Cologuard is an at-home test that detects DNA and blood in the stool, and is available for adults 45 and older at average risk. A fecal immunochemical test (FIT) is an at-home

test that detects blood in the stool, and a colonoscopy is a medical procedure that uses a camera to examine the colon.

Colon cancer has a greater than 90% survival rate with early detection and treatment. Disparities limit access to equitable screening and treatment for many, particularly Black and other demographics of Americans who are disproportionately underserved and overburdened by the disease. Black Americans are 15% more likely than non-Hispanic whites to get colorectal cancer and 35% more likely to die from it.

In an effort to decrease disparities and improve outcomes among those with significant barriers to quality care, the Colorectal Cancer Alliance is launching a Health Equity Fund. The Health Equity Fund will aim to increase the Alliance’s impact by offering free or low-cost screening options to more Americans in need, expanding financial assistance for patients during treatment, enabling innovative research to identify reasons for and solutions to disparities, and connecting those most in need with high-quality and potentially lifesaving screening and treatment options.

Written by Colorectal Cancer Alliance

Dak Prescott | Photo courtesy of Colorectal Cancer Alliance

Empowering Colorectal Cancer Prevention: How AI Is Revolutionizing Colonoscopy

Colorectal cancer (CRC) is the third most common cancer diagnosed in the United States and the second leading cause of cancer deaths globally.1 With increasing cases among people under 502 , it’s more important than ever to prioritize screening and early detection.

This is where the GI Genius™ intelligent endoscopy system steps in, harnessing the power of artificial intelligence (AI) to revolutionize early detection.

A wake-up call for prevention

Despite the urgent need for regular CRC screening, misconceptions about age and gender persist. According to a recent Medtronic-sponsored survey of 1,000 U.S. female adults 18 and older, 1 in 3 women (30%) mistakenly believe colonoscopies aren’t recommended until age 50 or older3, despite the recommended screening age now being 45.

Dr. Austin Chiang, chief medical officer of Medtronic’s Endoscopy Operating Unit, explains: “It’s concerning to see these misconceptions. CRC is the second deadliest cancer worldwide and affects men and women equally. Early detection is critical, which is why it’s so important to understand the risks and get screened.”

Introducing the GI Genius™ system

The GI Genius™ system acts like a second set of eyes for doctors. It uses advanced AI software to highlight suspected polyps in real-time during a colonoscopy, helping gastroenterologists detect lesions they might otherwise miss.4

Ken Washington, senior vice president and chief technology and innovation officer at Medtronic, explains: “Imagine teaching a child to recognize different types of fruit. You show them apples, bananas, oranges, and over time, they learn to identify each correctly. Our AI algorithm learns similarly, recognizing patterns in over 13 million images to identify polyps with high precision.”

How the GI Genius™ system works

A colonoscopy with the GI Genius™ system begins like any other. The colonoscope captures images inside the colon, and the GI Genius™ system instantly analyzes each frame to identify suspected abnormalities like polyps or adenomas. When a suspected lesion is detected, it’s surrounded by a green box on the screen, alerting the doctor to assess the detection. The results are remarkable:

• Increased detection: The GI Genius™ system increases adenoma detection rates by 14.4%.5

• Reduced miss rate: Miss rates for adenomas and polyps drop by up to 50%.6

• High precision: Less than 1% false positives.7

Dr. Chiang likens the GI Genius™ system to “spellcheck,” saying, “It’s like having an extra set of eyes, empowering doctors to detect and address even the most subtle unwanted growths.”

A brighter future with AI

The future of preventative healthcare is bright, and AI plays a pivotal role in early detection.

“We believe in the transformative power of AI,” Washington said. “The GI Genius™ system empowers doctors to deliver equitable and unbiased healthcare, reducing variability and improving patient outcomes.”

Medtronic’s commitment to advancing AI continues with the launch of ColonPRO™ software, its fourth software update in just three years, which improves polyp detection and paves the way for expanding AI’s capabilities beyond colorectal cancer screening.8

So, if you’re 45 or older, don’t wait. Get screened. Talk to your doctor about how a colonoscopy with the GI Genius™ system can help you stay one step ahead of colorectal cancer. Because when it comes to your health, that’s not just smart. It’s Genius.

GI Genius is an adjunct to colonoscopy procedures and is not intended to replace clinical decision-making.

Written by Medtronic

References

1. Bray, F, Ferlay, J et al. Global Cancer Statistics 2018: GLOBCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. 2018. CA Cancer J Clin.; 68:394-424

2. American Cancer Society: Colorectal Cancer Facts & Figures: https://www.cancer. org/research/cancer-facts-statistics/colorectal-cancer-facts-figures.html

3. Pulse Survey. Data on File.

4. Wallace, M., Sharma, P., Bhandari, P., East, J., Antonelli, G., Hassan, C. et al. Impact of Artificial Intelligence on Miss Rate of Colorectal Neoplasia. Gastroenterology; 163;1; P295-304.E5 July 2022.

5. Repici A, Badalamenti M, Maselli R, et al. Efficacy of real-time computer-aided detection of colorectal neoplasia in a randomized trial. Gastroenterology. 2020; 159:512–520.e7.

6. Wallace MB, Sharma P, Bhandari P, et al. Impact of Artificial Intelligence on Miss Rate of Colorectal Neoplasia. Gastroenterology. 2022 Mar 11:S00165085(22)00238-4. doi: 10.1053/j.gastro.2022.03.007. Epub ahead of print. PMID: 35304117.

7. Hassan, C. Wallace, M., Sharma, P. et al. New intelligence system: first validation study versus experienced endoscopists for colorectal polyp detection. Gut. 2019. http://dx.doi.org/10.1136/gutjnl-2019-319914

8. https://nvidianews.nvidia.com/news/medtronic-and-nvidia-collaborate-tobuild-ai-platform-for-medical-devices. Published March 21, 2023. Accessed April 2, 2024.

INTERVIEW WITH Austin Chiang, M.D., M.P.H. Chief Medical Officer, Endoscopy, Medtronic

INTERVIEW WITH Ken Washington, Ph.D. SVP, Chief Technology & Innovation Officer, Medtronic

To learn more, visit Medtronic.com/ Genius

The Keys to Thriving With an Ostomy

Ostomy surgery saves lives but it’s normal to feel overwhelmed, whether it is temporary or permanent. Accepting that you’re going to the bathroom in a whole new way can take time. The emotional hurdles are often more challenging than any physical ones.

With the right knowledge and support, people don’t just survive but can thrive in life with an ostomy pouch. Here are a few things our ostomy community says leads to success.

Seek out an ostomy nurse specialist and custom-fit your pouch

Certified wound, ostomy, and continence nurses are the experts in ostomy care. They can help you find the ostomy pouching supplies that will work best for you to prevent leaks and skin irritation.

Your stoma and body contours may change over time, so it’s important to consult with one. If you don’t have a certified nurse near you, there are telehealth options at ostomy.org. Contact a medical supply company to get

your prescribed supplies and sample new ones.

Find peer support and trusted information

Ostomy nurses are wonderful but nothing can compare to talking with someone who has been through this profound change before. You are not alone.

United Ostomy Associations of America (UOAA) estimates up to 1 million people are living with an ostomy or continent diversion in the United States. UOAA has hundreds of peer support groups and also events to connect with people like you. Ask for advice on returning to work, sex, and how to talk about your ostomy with others. You’ll find that many ostomates even name their stoma and celebrate their “stomaversary.”

Our website, ostomy.org, is considered the most trusted place to find educational resources,

You don’t have to want to climb mountains or run marathons, but you should know that plenty of people living with an ostomy do. Read realistic but positive ostomate stories you can relate to.

self-advocacy tools, supply information, and details on topics like nutrition and parastomal hernias. Use this as a fact-checking resource for anything you may discover on social media.

Don’t limit yourself

You don’t have to want to climb mountains or run marathons, but you should know that plenty of people living with an ostomy do. Read realistic but positive ostomate stories you can relate to. If doing what you love means going out with friends and not worrying about the nearest bathroom, you may discover an ostomy is a big improvement. Everyone should expect to swim, play sports, or do whatever makes you, well, you!

Written by United Ostomy Associations of America (UOAA)

Raising ostomy awareness at UOAA’s Run for Resilience Ostomy 5k in Ohio, one of nine national and virtual events for this active community. | Photo by Valerie Mallory-Green

Major Relief: Why Elevated Ostomy Care and Support Is Critical

When Bret Cromer was a teenager — the summer before his senior year of high school — he got really sick. It seemed inexplicable at the time, given that he was an athletic student and on a relatively healthy diet. But he was making a concerning number of runs to the bathroom every day and his quality of life deteriorated swiftly.

Cromer was diagnosed with Crohn’s, a chronic inflammatory bowel disease (IBD). The remedies he initially tried weren’t working, whether those were prescription drugs or homeopathic solutions.

“I was losing a tremendous amount of weight,” he said, and it was only after he underwent surgery that he began to feel relief. The surgeons performed a temporary colostomy by taking out three-quarters of his large intestine — carefully diverting the system through which his digested food and intestinal waste processes and passes toward a stoma (i.e., an “opening”) on his abdominal wall and into an external pouch.

Despite some limitations (and some getting used to), the surgery had a positive impact on Cromer’s life, and he was able to head off to college. After graduation, however, the Crohn’s started to manifest itself again.

Over the next decade, he had two more surgeries, culminating in a procedure that fully removed his large intestine. He was now a permanent “ostomate” and his life has never been better, with the surgeries allowing him to enjoy a breadth of activity — even his love of hitting the slopes to go skiing.

A booming market And Cromer is hardly alone.

According to a report by Mordor Intelligence, the global ostomy care “market size is estimated at $3.32 billion in 2024, and is expected to reach $4.12 billion by 2029, growing at a CAGR [compound annual growth rate] of 4.42% during the forecast period (2024-2029).” The metrics here factor in advances in technology and an expansion of the target patients, including both younger and geriatric populations with rising cases of IBD and colorectal cancer, “resulting in increased ostomy surgery cases.”

Continual support and resilience Today, Cromer has come full circle, as he’s now able to help guide and catalyze ostomy patients so they can flourish and pursue fulfilling lives. He’s currently the director of the Ostomy Center of Excellence at Byram Healthcare.

Established in 1968 as an ostomy supply company, Byram Healthcare is now the nation’s leading provider* of ostomy supplies. Through its Caring Touch at Home™ program, Byram has the primary goal of ensuring that people with ostomies resume a healthy, normal lifestyle.

When asked to sum up a day in his work-life for Byram, Cromer mentions how he “provides support to our ostomy re-order customer-service representatives who work with our patients; responds to escalated

customer inquiries; assists the marketing department with outreach throughout the ostomy community; helps craft strategy; and designs programs to support our current patients and foster relationships with new ones.”

One standout initiative that Cromer implemented was to ask Byram reps to wear an ostomy bag for a day. “It was optional, but the majority of our reps participated,” he said. “It really imparted a sense of humility and helped them relate more to our patients.”

Besides his work at Byram, Cromer underlines the importance of having a solid network of support. To that end, he’s a counselor at the Youth Rally, which sets up a unique camp environment “for adolescents living with conditions of the bowel and bladder” and “encourages self-confidence and independent living.” And he runs a support group that’s part of the United Ostomy Associations of America. Byram Healthcare is a proud sponsor of UOAA.

“Those are all part of the continuum of care that is needed here,” he said. “Meeting somebody who is going through something similar is essential to remaining resilient when it comes to ostomy care.”

Written by Omar Sommereyns

INTERVIEW WITH Bret Cromer Director, Ostomy Center of Excellence, Byram Healthcare

byram healthcare.com

Bret Cromer | Photo courtesy of Byram Healthcare