If you or a loved one have been wondering how to better manage and prevent colon cancer, you can rest assured that you are not alone. Colon cancer will affect approximately one in 25 people¹ in the U.S. at some point in their lives, and it is the fourth leading cancer in the country today.
A family history of colon cancer increases your risk for the disease and is responsible for up to 30% of cases.²
Genetic conditions like polyposis syndromes (intestinal polyps) also add to your risk and account for about 5% of cases.
People over the age of 50, African Americans, and those with certain health conditions like diabetes and inflammatory diseases also have a higher chance of getting the disease.
While these colon cancer risk factors are largely outside of your control, the good news is that there are many positive steps you can take to help reduce your chances of contracting the disease and boost your treatment results after diagnosis.
Here are eight key colon cancer risk factors that you can control, along with some tips to help you successfully put them into practice in your daily life.
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In 2015, the International Agency for Research on Cancer (IARC) found red meat to be a carcinogen² or cancer-causing agent. It's been documented³ to damage DNA and cause mutations that can lead to the disease.
The World Cancer Research Fund data revealed that for every two slices (50 grams) of processed lunchmeat eaten per day, colorectal cancer risk increases by 18%. Red meat consumption increases that risk by 12% per 100 grams. This is why replacing red and processed meat with meals that include items like chicken, fish, and beans is so beneficial.
Of all the colon cancer causes, smoking seems to be the one with the most direct link to the disease. It's also the behavior that leads to the highest increase in risk.² A person who smokes has a 50% higher chance of developing colon cancer than nonsmokers.
Increased fiber intake has been shown⁴ to significantly reduce the risk for certain types of colon cancer. In a recent study⁵ with over 1,500 participants, colon cancer mortality rates were shown to be reduced by 18% for every five additional grams of fiber you eat per day.
Fruits and vegetables, legumes like beans and peas, whole grains, nuts, chia seeds, flax seeds, and certain fiber supplements⁶ are all great sources of dietary fiber. They're thought to have a positive balancing effect on your gut microbiome (microorganisms living in your colon and digestive tract). The Institute of Medicine recommends 19-38 grams⁷ of fiber daily, and the National Cancer Institute (NCI) recommends 2-6.5 cups⁸ of fruit and vegetables.
There are both "good" and "bad" fats in the foods we eat. Omega-3 polyunsaturated fats like those in many fish, nuts, and seeds play a role in preventing colon cancer. They work by reducing inflammation and positively influencing hormone signals to suppress colon cancer cells. Randomised controlled trials are underway to determine exactly their effect and how much is required.
Omega-3s also help you maintain a healthy body weight, which reduces your risk for colon cancer.
On the other hand, saturated fat has a potentially positive relationship⁹ to the development of colon cancer. These fats are found in foods such as ice cream, butter, red meat, and fried items. This has been proven in animal models of colon cancer and observational studies.
Between 1990 and 2005, an analysis of research that included 6,500 patients revealed¹⁰ that the risk for colon cancer increased by 15% when high amounts of alcohol were consumed versus low amounts.
The American Cancer Society (ACS) states¹¹ that alcohol affects weight, deregulates hormone responses and nutrient absorption, and damages tissues. It recommends not drinking at all as the best option or consuming no more than one drink a day for women and two drinks a day for men.
Aspirin is especially beneficial in reducing colon cancer risk² in people who maintain healthy body weight and are under age 70. It has also been shown to help increase survival rates for the disease and reduce the growth of tumors.
However, this over-the-counter medicine has some potential side effects, including bleeding of your stomach and intestinal linings. For this reason, it's recommended to check with your healthcare practitioner before taking it regularly.
Vitamin D deficiencies are common¹² in the United States, and readings below 20 nanograms per milliliter have been linked¹³ to an increase in colon cancer cases. Getting a little sunlight each day and eating Vitamin D-rich foods like salmon, eggs, and Vitamin D fortified plant-based milk can help keep your levels within a healthy range.
It's recommended to get 600 IUs of Vitamin D each day for those between the ages of 1-70, 400 IUs for children under age one, and 800 IUs for adults over age 70.
Fitting a daily walk, gardening, gym workouts, or other exercises into your daily routine has numerous benefits, including cutting your colon cancer risk by up to 25%. There's also a decreased risk of mortality after diagnosis among people who engage in regular physical activity.
According to the ACS¹⁴, a good exercise goal is 150-300 minutes of moderate activity or 75-150 minutes of intense activity per week.
Colon cancer starts with precancerous polyps in the large intestine that may turn cancerous and metastasize (spread), typically over 10-15 years. Because it is such a slow-growing condition, early screening is very helpful in preventing the disease, and better managing your treatment results.
Screening helps catch cancer at an earlier stage, which greatly increases the outcomes for successful treatment. The five-year colon cancer survival rates by type are:
90% for localized cases (within the large intestine)
72.7% for regional cases (spread to nearby lymph nodes)
14.7 % for distant cases (metastasized to tissues and organs)
The significantly better outcomes when colon cancer is caught early led the ACS to recommend the following colon cancer screening schedule¹⁵ for people with an average risk of colon cancer:
Annually beginning at age 45
As needed between the ages of 76-85
If no previous indicators of the disease have been found, no screening is recommended over age 85.
Screening includes at-home tests to check your stool for blood or cancer DNA, which could indicate that precancerous and cancerous colon polyps are present. It also includes three main exploratory measures: colonoscopies, sigmoidoscopies, and CT colonographies.
A stool test is typically done yearly, a colonoscopy every ten years, and a sigmoidoscopy every five years. The type of test is best discussed with your doctor.
While the ACS doesn't have specific cancer screening recommendations for those in higher-risk categories, the U.S. Multi-Society Task Force on Colorectal Cancer¹⁶ (USMTF) does provide you with some helpful guidelines:
Get tested every five years if you have a family history of the disease, starting ten years before the age of the youngest diagnosed relative or age 40, whichever is earlier.
Get tested every five years if you have an immediate family member under the age of 60 with an advanced adenoma¹⁷ (abnormal tumor) or if you have had two or more immediate family members of any age with an advanced adenoma. Again, testing should start ten years before the age of the youngest diagnosed relative or age 40, whichever is earlier.
The most common type of observational test is a colonoscopy. During the procedure, your practitioner uses a long tube-like scope with a light attached to it to explore the entire length of your colon. The scope is inserted into your rectum and colon, then inflated with air. Any abnormal polyps or growths are removed and sent off to the lab for biopsy.
Colonoscopies are considered the "gold standard" of all the tests because they're the most thorough and have helped tremendously in catching cancer before it spreads to other organs and tissues.
A flexible sigmoidoscopy is very similar to a colonoscopy, except it is only used to explore the rectum and lower colon. This makes it a gentler, less invasive option. The procedure may be suggested when common symptoms of polyps occur, such as bleeding from the rectum or changes in bowel movements.
If cancer is detected using a sigmoidoscopy, a colonoscopy is typically scheduled to determine if it is also present in other parts of the colon.
Computed tomography (CT) uses a series of x-ray pictures that are run through computer enhancement software to find any abnormalities in your colon. This procedure is referred to as a CT colonography.
If any anomalies are found, a follow-up colonoscopy is scheduled to explore further. Since the risk associated with colonoscopies, like bleeding and infection, increases with age, a CT colonography is sometimes requested as a less invasive option.
Although colon cancer can happen due to circumstances you can't change, such as your age, genetics, ethnicity, and pre-existing conditions, there is a lot you can do to reduce your risk. By tweaking your diet, engaging in a regular exercise routine, and getting regular health screenings, you have the power to significantly improve your diagnostic and treatment outcomes.
Key Statistics for Colorectal Cancer | American Cancer Society
Colorectal Cancer Facts & Figures 2020-2022 | American Cancer Society
Pattern of DNA Damage Links Colorectal Cancer and Diet High in Red Meat | NIH: National Cancer Institute
Fiber Intake and Survival After Colorectal Cancer Diagnosis | Research Gate
Fruit and Vegetable Consumption | NIH: National Cancer Institute
Alcohol Use and Cancer | American Cancer Society
Vitamin D Levels Linked to Lower Colorectal Cancer Risk | American Cancer Society
American Cancer Society Guideline for Diet and Physical Activity | American Cancer Society
American Cancer Society Guideline for Colorectal Cancer Screening | American Cancer Society
Understanding your report: Colon-Adenoma | Department of Pathology