March 2017
In This Issue
Colorectal Cancer Awareness

Institute Happenings 

Upcoming Events 
  Recent Blogs 
Dear Friends,

This month, the Women’s Health Research Institute recognizes March as National Colorectal Cancer Awareness Month. In this issue, we will discuss key information regarding colorectal cancer, explore sex-differences in colorectal cancer detection and diagnosis, and provide links to additional resources both at Northwestern and beyond.

Nicole C. Woitowich, PhD
Director of Science Outreach and Education 
Colorectal Cancer: The Basics  
Colorectal cancer, or cancer of the colon or rectum, is one of the most common types of cancers diagnosed in the United States, leading fourth behind breast, lung, and prostate cancer [1]. The colon and rectum form the lower part of the digestive tract and are involved in stool formation and excretion. Specialized cells which line the colon and rectum, which aid in water absorption and mucus secretion, tend to divide much faster than other cells in the body. This increased “turnover” rate can cause cells to become cancerous if cell division is not properly controlled.

Typically, colorectal cancer affects individuals later in life. The average age at the time of diagnosis is between 65 and 74 years old [1]. The good news is that thanks to improved patient education and screening measures the 5-year survival rates for colorectal cancer have been improving steadily since the early 1980s [1]. One of the key factors in the early detection and diagnosis of colorectal cancer is routine screening. The U.S. Preventative Services Task Force recommends that individuals begin screening for colorectal cancer at the age of 50 and continuing through age 75.  Screening methods may include a fecal occult blood test, which examines stool samples for the presence of blood, or a colonoscopy or sigmoidoscopy in which a camera is used to visualize changes in the lining of the colon or rectum. Screening methods can also identify regions that are precancerous, meaning that they display abnormal growth but have not turned into cancer. Thus, it is important to undergo routine screening even though you feel healthy and do not have any symptoms.

Some individuals may be at greater risk for developing colorectal cancer than others [3]. For example, individuals who suffer from irritable bowel diseases such as Crohn’s disease or ulcerative colitis may be at increased risk. Likewise, those with a family history of colorectal cancer or polyps may need to undergo more frequent screening. Also, certain lifestyle factors may lead to an increased risk of developing colorectal cancer. These may include:
  • Obesity
  • Alcohol consumption
  • Tobacco use
  • A diet low in fiber

In addition to routine screening tests, it is important to be aware of the signs and symptoms of colorectal cancer which can include: Blood in your stool, stomach aches and pains that do not go away, or unexplained weight loss. If you experience any of these symptoms, please contact your healthcare provider to discuss them in further detail. 

Sex Differences in Colorectal Cancer 
On average, men are more likely to develop colorectal cancer than women [1,4]. This may indicate that female sex provides a protective benefit against colorectal cancer [4]. Some studies suggest that post-menopausal women who take hormone replacement therapy lower their risk of developing colorectal cancer [5] or improve their survival if diagnosed [6]. Although more recent evidence fails to find a link [7]. More research is needed to explore the impact of the female sex hormones, estrogen and progesterone, on colorectal cancer.

Interestingly, the screening and detection of colorectal cancer may differ between men and women. One study found that the fecal occult blood test, a commonly used screening tool, had a higher sensitivity for detecting colorectal cancer in men than women [8]. Furthermore, a recent study found that sigmoidoscopies may be less effective at detecting colorectal cancer in women older than 60 due to differences in the anatomical location of cancerous lesions between men and women [9]. Thus, clinicians should be aware of these differences when selecting the appropriate screening tools for their patients.

For more information regarding colorectal cancer please consider visiting the following sites:
National Cancer Institute 
Centers for Disease Control
American Cancer Society
Northwestern University Robert H. Lurie Comprehensive Cancer Center

4. Majek et al, PLoS One. 2013 Jul 5;8(7):e68077.
5.  Chelbowski et al., N Engl J Med. 2004 Mar 4;350(10):991-1004.
6.  Chan et al., J Clin Oncol. 2006 Dec 20;24(36):5680-6.
7.  Manson et al., 2013 Oct 2;310(13):1353-68. 
8. Brenner et al,. Am J Gastroenterol. 2010 Nov;105(11):2457-64.
9.  Holme et al., BMJ. 2017 Jan 13;356:i6673. 
Institute Happenings
The Women's Health Research Institute was featured in the February issue of The Biochemist, the monthly magazine of the Biochemical Society. WHRI Director, Dr. Teresa Woodruff, and WHRI Director of Science Outreach and Education, Dr. Nicole Woitowich, discuss the impact of Northwestern University's Sex Inclusion Toolbox on the promotion of sex-inclusive science both locally and abroad! 

Upcoming Events 
March 21st: Women's Health Research Monthly Forum 

"Depression in Women: 7 Strategies to Improve Treatment Outcomes" 

Dr. Katherine Wisner
12:00PM - 1:00PM
Prentice Women's Hospital, 250 E. Superior Street, 3rd Floor Conference Room L South
This continuing nursing education activity has been approved for 1.0 contact hour by the Ohio Nurses Association (OBN-001-91), an accredited approver of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.  Approval valid through 02/23/2019 - ONA Approval #20553, ONA-CE Assigned Approval Number.

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