Am I at Risk for Colon or Rectal Cancer?

Colorectal cancer (cancer of the bowel or rectum) has two categories of risk factors: those you can control and those you can’t. Both are important to your long-term health.

In 2017, there were an estimated 95,520 new cases of colon cancer and 39,910 cases of rectal cancer diagnosed in the U.S., according to the American Cancer Society.

“Basically, there is strong reason to control the modifiable risk factors and to be vigilant about the ones you can’t,” says Dr. Daniel Sussman, a gastroenterologist with the Sylvester Comprehensive Cancer Center and the University of Miami Health System. “We have a real opportunity to prevent colon cancer, by intervening on the changeable factors and tailoring heightened screening intervals for those with risk factors we cannot change.”

You have the power to:

1. Get screened: With regular screening, you can find cancer earlier when it’s most treatable or, in many cases, prevent it entirely.
2. Watch your weight: Keeping your weight within a healthy range lowers your risk for many cancers, including colorectal cancer.
3. Eat smart: Research shows you are at a higher risk if you consume more than three servings of processed meat like bacon, sausage and bologna and red meat a week.
4. Go for a walk: Just 30 minutes of physical activity a day can lower your risk of colon cancer and is an easy way to keep your weight down.
5. Limit booze: Limit alcohol to one drink a day. Even moderate amounts increase the risk of colon cancer.
6. Stop (or don’t start) smoking: We know smoking raises our risk of heart disease, stroke, and emphysema. It is also a major cause of at least 14 different cancers, including colon cancer.
7. Get your nutrients:

Calcium and vitamin D: Calcium and vitamin D will defend you against colon cancer. Aim for about 1200 mg. a day of calcium and 1000 IU a day of D.
Find some folate: A daily multivitamin with folate is good for nutrition and can also protect against colon cancer.
Ask about aspirin: Check with your doctor about whether taking one low-dose aspirin a day to lower the risk of a heart attack and colon cancer would be a smart move for you

Risks you can’t change

1. Your age: Risk for colon cancer goes up as you age, especially after 60.
2. Being tall: Curiously, colon cancer risk is higher in women 5’8” or taller, and for men 5’11”.
3. Having inflammatory bowel disease (IBD) or Crohn’s disease: People with these conditions have five times the risk of developing colon cancer, so screening is especially important. Controlling the inflammation associated with these conditions seems to decrease that risk.
4. Your personal history: If you’ve had polyps in the colon or rectum before, you may develop them again, and polyps are considered pre-cancers.
5. Family history: If you have a parent, sibling or child with a history of colorectal cancer.
6. Genetic conditions:

Familial adenomatous polyposis (FAP) is genetic and typically develops during a person’s mid-teens. A person is diagnosed when they develop more than 100 adenomatous colon polyps. If FAP is not recognized and treated, there is a high likelihood that a person will develop colorectal cancer.
Lynch Syndrome or hereditary non-polyposis colon cancer syndrome (HNPCC): This genetic condition may result in a high risk of colon cancer as well as other cancers: endometrial cancer, ovary, stomach, small intestine, hepatobiliary tract, upper urinary tract, brain, and skin. The increased risk for these cancers is due to a syndrome of inherited mutations that impair DNA repair.

Starting at age 50, men and women at average risk for developing colorectal cancer should undergo one of the following screening tests.

To find polyps and cancer, your doctor may recommend:

• CT colonography (virtual colonoscopy) every 5 years*
• Flexible sigmoidoscopy every 5 years*
• Colonoscopy every 10 years

Tests that mainly find cancer include:

• Fecal immunochemical test (FIT) every year*
• Guaiac-based fecal occult blood test (gFOBT) every year*
• Stool DNA test every 3 years*

*If your results are positive, your doctor will recommend that you get a colonoscopy.

Dr. Laurence Sands, chief of colon and rectal surgery at Sylvester cautions: “People at higher risk should talk to their doctor about earlier and more frequent screening. We also have genetic counseling and testing for families with inherited conditions that increase their chances for colorectal cancer.”

Written by a staff member at UMiami Health News.

Tags: colonoscopy, colorectal cancer, Dr. Daniel Sussman, Dr. Laurence Sands, Sylvester Comprehensive Cancer Center