The colon is a six-foot long muscular tube that connects the small intestine to the rectum. The rectum is an eight inch chamber that connects the colon to the anus.
One of the most serious diseases of the colon or rectum is cancer. Cancer that begins in the colon is called colon cancer. Cancer that begins in the rectum is called rectal cancer. Cancers affecting either of these organs may also be called colorectal cancer.
Colorectal cancer occurs when some of the cells that line the colon or the rectum become abnormal and grow out of control. The abnormal growing cells create a tumor, which is the cancer.
Other diseases that can affect the colon include irritable bowel syndrome, Crohn’s disease, and ulcerative colitis.
Additional conditions of the anus and rectum include hemorrhoids and genital warts.
The Bad
Everyone is at risk for colorectal cancer. Although the exact cause is not known, there are some factors that increase a person's risk. These include:
- Age.This
is the number-one risk factor. People over
50 years of age are at a high risk for bulging tissues (polyps)
in the colon, which can lead to cancer.
- Human
Papillomavirus (HPV). HPV,
the most common sexually transmitted infection, can cause warts,
pre-cancerous lesions, and cancer of the rectum.
- Sex.
Women have a greater
risk for colon cancer while men have a greater risk for rectal
cancer.
- Alcohol.
Wine may be protective, but consuming hard liquor may increase
the risk.
- Diabetes.
People with diabetes have a 30% to 40% increased risk of developing
colon cancer.
- Diet.
Diets high in cholesterol and fat have been linked to colon
cancer. Low-fiber diets may also increase
the risk.
- Smoking.
Like lung cancer, cigarette smoking can also increase the risk
of colon cancer.
- Family history. Approximately 25% of colorectal cancers are linked to faulty genes, usually inherited from family ancestors.
The Good
When colorectal cancer is detected early, it is curable 90% of the time. Other colorectal health issues can also be managed through proper care.
Why it’s LGBT
Many of the risk factors for colorectal cancer apply to LGBTs. There is also an increased risk of cancer-causing HPV infection among LGBTs, especially those engaging in anal sex. In one study conducted by the University of California, San Francisco, anal/rectal HPV infection was documented in 65% of HIV-negative gay and bisexual men and 95% of HIV-positive gay and bisexual men.
What to Do
Work with your healthcare provider to identify problems before they happen. Talk with your healthcare provider about tests to look for colorectal problems. Also be sure to report any symptoms of colorectal problems to your health care provider. These include:
- Changes in your bowel movements
- Diarrhea or constipation
- Blood in your stool
- Stools that are narrower than normal
- Abdominal pain or discomfort, including gas, bloating, or cramps
- Unexplained weight loss and fatigue
Tools
The following tests are recommended for men and women 50 and older:
- Colonoscopy. Outpatient procedure in which a long flexible tool about ½ inch in diameter is inserted into the rectum to view the rectum and entire colon (NOTE: This is the most reliable of all the tests).
- Fecal Occult Blood Test (FOBT). Stool is tested for blood – a possible sign of colorectal cancer.
- Flexible Sigmoidoscopy. Outpatient procedure in which a special tool with a tiny camera is used to exam the lower portion of the large intestine.
- Air-contrast barium enema. A liquid called Barium is given as an enema and then air is blown in to make the barium spread over the lining of the colon, producing an outline of the colon on X-ray. This helps to reveal any irregularities in the lining, such as a polyp.
The following test is suggested by many healthcare providers caring for LGBT patients:
- Anal Pap smears. A cotton swab, like a long Q-tip, collects cells from the wall of the anus and rectum. The sample is sent to a lab where technicians look at it under a microscope. If the results are abnormal, additional tests (such as those listed above) may be necessary.