This section has been reviewed and approved by the Cancer.Net Editorial Board, 12/10
Colorectal cancer begins when normal cells in the lining of the colon or rectum begin to change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body). These changes usually take years to develop; however, in some cases, when a person has an inherited syndrome, 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 and 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 detected with a colonoscopy (see Risk Factors and Prevention). Polyps are most easily found during a colonoscopy because they usually bulge into the colon, forming a mound on the wall of the colon that can be detected by the doctor.
About 10% of colon polyps are flat and hard to detect through 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 frequently but can begin in the colon or rectum include carcinoid tumor, gastrointestinal stromal tumor (GIST), and lymphoma.