About colorectal cancer
Colorectal cancer begins when healthy cells in the lining of the colon or rectum change and grow uncontrollably, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. These changes usually take years to develop. However, when a person has an uncommon inherited syndrome (see Risk Factors and Prevention), changes can occur within months to years. Both genetic and environmental factors can cause the changes.
Anatomy of the colon and rectum
The colon and rectum make up the large intestine, which plays an important role in the body's ability to process waste. The colon makes up the first five to six feet of the large intestine, and the rectum makes up the last six inches, ending at the anus.
The colon has four sections. The ascending colon is the portion that extends from a pouch called the cecum, the beginning of the large intestine into which the small intestine empties, on the right side of the abdomen. The transverse colon crosses the top of the abdomen. The descending colon takes waste down the left side. Finally, the sigmoid colon at the bottom takes waste a few more inches, down to the rectum. Waste leaves the body through the anus.
About colorectal polyps
Colorectal cancer most often begins as a polyp, a noncancerous growth that may develop on the inner wall of the colon or rectum as people get older. If not treated or removed, a polyp can become a potentially life-threatening cancer. Recognizing and removing precancerous polyps can prevent colorectal cancer.
There are several forms of polyps. Adenomatous polyps, or adenomas, are growths that may become cancerous and can be found with a colonoscopy (see Risk Factors and Prevention). Polyps are most easily found during colonoscopy because they usually bulge into the colon, forming a mound on the wall of the colon that can be found by the doctor.
About 10% of colon polyps are flat and hard to find with a colonoscopy unless a dye is used to highlight them. These flat polyps have a high risk of becoming cancerous, regardless of their size.
Types of colorectal cancer
Colorectal cancer can begin in either the colon or the rectum. Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer.
Most colon and rectal cancers are a type of tumor called adenocarcinoma, which is cancer of the cells that line the inside tissue of the colon and rectum. This section specifically covers adenocarcinoma. Other types of cancer that occur far less often but can begin in the colon or rectum include carcinoid tumor, gastrointestinal stromal tumor (GIST), small cell carcinoma, and lymphoma.
Normal colon tissueClick to Enlarge
Colon adenoma (polyp)Click to Enlarge
Colon adenocarcinomaClick to Enlarge
These images used with permission by the College of American Pathologists.
Looking for More of an Overview?
If you would like additional introductory information, explore these related items. Please note these links will take you to other sections on Cancer.Net:
ASCO Answers Fact Sheet: Read a one-page fact sheet (available as a PDF) that offers an easy-to-print introduction to this type of cancer.
ASCO Answers Guide: This 44-page booklet (available as a PDF) helps newly diagnosed patients better understand their disease and treatment options, as well as keep track of the specifics of their individual cancer care plan.
Cancer.Net Patient Education Video: View a short video led by an ASCO expert in this type of cancer that provides basic information and areas of research.
The next section in this guide is Statistics and it helps explain how many people are diagnosed with this disease and general survival rates. Or, use the menu on the side of your screen to choose another section to continue reading this guide.