Evidence-Based Steps to Prevent Colorectal Cancer

Who does colon cancer affect? 

Daniel Taylor, DO: Colorectal cancer is more common in males than females and found in Black Americans more often than White Americans. It can be related to inherited genetic conditions or develop spontaneously.

Mortality, or death rates, from colorectal cancer have been on the decline since the mid-1980s. The mortality rate has declined due to improved colonoscopy screening programs nationwide. However, mortality among patients under 50 years old has increased by 1% annually from 2004 to 2018. These deaths have been noticeable in White and Hispanic patients.

Why has there been an increase in early-onset colorectal cancer?

Dr. Taylor: Age is a significant factor for sporadic colorectal cancer (cancer without family history or genetic predisposition). Cases have increased between the ages of 40 and 50, leading to an unfortunate global epidemiologic trend of colorectal cancer in people under the age of 50. 

There are multiple potential reasons why early diagnoses have increased, though these causes are still being studied, including:

• Hereditary syndromes: involved in 35% of young adult colorectal cancers
• Metabolic dysregulation: obesity, fatty liver disease, sedentary behavior, red meat intake, unhealthy dietary patterns, high blood pressure, and dyslipidemia (high levels of fats in the blood) are all associated with colorectal cancer at all ages.
• Family history of colorectal cancer
• Alcohol consumption

• Vitamin D deficiency

   

Read: Ask a Doc: Debunking Colorectal Cancer Myths

What are the primary ways to prevent colon cancer?

Dr. Taylor: The best way to prevent cancer development is by eliminating risk factors. These tactics include eating a healthy diet, limiting alcohol consumption, taking necessary supplements, and maintaining physical activity.  

How can I ensure a healthy, prevention-conscious diet?

Dr. Taylor: The number one piece of advice for having a preventative diet is limiting consumption of red and processed meats. Red meat, mainly processed, is strongly correlated with cancers, especially colorectal cancer. Processed meat consumption was associated with a 6% greater breast cancer risk, a 21% greater colon cancer risk, a 22% greater rectal cancer risk, and a 12% greater lung cancer risk.

The American Institute of Cancer Research recommends no more than 18 ounces of red meat weekly. Eating less red meat or no processed red meat is beneficial.

Fiber is another significant diet recommendation. An estimated 95% of American men, women, and children do not get enough dietary fiber, so the following is recommended for adults:

• 21 grams for women older than age 50
• 25 grams for women aged 50 or younger
• 30 grams for men older than age 50
• 38 grams for men aged 50 or younger

Fiber can be found in foods such as whole grains (brown rice, oats), fruits (berries, apples), vegetables (broccoli, spinach), beans, nuts, and seeds.

Watch: The Facts and Myths of Cancer and Nutrition

How do alcohol and sugary drinks impact prevention?

Dr. Taylor: Sugar-sweetened beverages should be limited. Women who consumed at least two servings each day had more than double the risk of early-onset colorectal cancer. There’s an increase of 16% in cancer risk for every increase in servings per day.

Excessive alcohol consumption increases the risk of colorectal cancer before age 50. The dose-response association between drinking frequency and risk of early-onset colorectal cancer was significant, with a 7%, 14%, and 27% increased risk when drinking one to two, three to four, and five or more days a week, compared with non-drinkers.

Should I take any specific supplements?

Dr. Taylor: Generally, getting nutrition from various foods is better at preventing cancer than taking supplements. However, vitamin D deficiency plays a role in colorectal cancer growth, so consider the supplement if you have low levels. Consult your primary care provider about your vitamin D levels.

What is the role of physical activity?

Dr. Taylor: The benefits of physical activity are innumerable. Studies have shown that 30 minutes of moderate physical activity three times each week can bring value to many aspects of your life. Cancer reduction is one of those benefits, with a lower risk of colon and breast cancer being the most well-founded. The more physical activity, the stronger the preventative benefit.

What are secondary prevention methods?

Dr. Taylor: Staying updated on colonoscopy screenings is essential to prevention. Studies have shown that 75% of colorectal cancer deaths over six years were of people who were not up to date with screenings.

Aside from screenings, know your family medical history, personal medical history (history of colon polyps, ulcerative colitis, Crohn’s disease, cystic fibrosis, any cancer as a child or young adult), and be aware of new symptoms you develop. It’s essential to advocate for yourself. Symptoms include:

• Red blood in stool, black tarry stool (digested blood called melena)

• Iron deficiency anemia without cause

• Pencil-thin stools, persistent diarrhea, or new onset constipation

• Persistent abdominal pain

• Unexplained weight loss, fevers, or night sweats

Read: Semantic Segmentation and the Future of Colorectal Cancer Care

If you are experiencing any of these symptoms, seek medical attention immediately.

The United States Preventive Services Taskforce recommends screening from ages 45 to 75 and, in some cases, ages 76 to 85. However, if a first-degree relative had colorectal cancer (or advanced adenoma or lesions/polyps), start screening at age 40 or 10 years before that family member’s diagnosis.

Stay proactive about your colorectal health with expert screenings and cancer care at Trinity Health Michigan. 

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