Causes
By Mayo Clinic staffIn most cases, it's not clear what causes colon cancer. Doctors know that colon cancer occurs when healthy cells in the colon become altered. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But sometimes this growth gets out of control — cells continue dividing even when new cells aren't needed. In the colon and rectum, this exaggerated growth may cause precancerous cells to form in the lining of your intestine. Over a long period of time — spanning up to several years — some of these areas of abnormal cells may become cancerous.
Precancerous growths in the colon
Colon cancer most often begins as clumps of precancerous cells (polyps) on the inside lining of the colon. Polyps can appear mushroom-shaped. Precancerous growths can also be flat or recessed into the wall of the colon (nonpolypoid lesions). Removing polyps and nonpolypoid lesions before they become cancerous can prevent colon cancer.
Inherited gene mutations that increase the risk of colon cancer
Inherited gene mutations that increase the risk of colon cancer can be passed through families, but these inherited genes are linked to only a small percentage of colon cancers. Inherited gene mutations don't make cancer inevitable, but they can increase an individual's risk of cancer significantly. Inherited colon cancer syndromes include:
- Familial adenomatous polyposis (FAP). FAP is a rare disorder that causes you to develop thousands of polyps in the lining of your colon and rectum. People with untreated FAP have a greatly increased risk of developing colon cancer before age 40.
- Hereditary nonpolyposis colorectal cancer (HNPCC). HNPCC, also called Lynch syndrome, increases the risk of colon cancer and other cancers. People with HNPCC tend to develop colon cancer before age 50.
Both FAP and HNPCC can be detected through genetic testing. If you're concerned about your family's history of colon cancer, talk to your doctor about whether your family history suggests you have a risk of these conditions.
- Compton C, et al. Colon cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008:1477.
- What you need to know about cancer of the colon and rectum. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/colon-and-rectal/allpages/print. Accessed June 15, 2011.
- Colon cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 15, 2011.
- Rectal cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 15, 2011.
- Colon and rectum. In: Edge SB, et al. AJCC Cancer Staging Manual. 7th ed. New York, N.Y.: Springer; 2010:143.
- Distress management. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 15, 2011.
- Colorectal cancer screening. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/guidelines_and_more/gl_os_prot/preventive_health_maintenance/colorectal_cancer_screening/colorectal_cancer_screening_6.html. Accessed June 16, 2011.
- Chan A. NSAIDs (including aspirin): Role in prevention of colorectal cancer. http://www.uptodate.com/home/index.html. Accessed June 16, 2011.
- Young MC. Colon cancer. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed June 15, 2011.


Find Mayo Clinic on