Colorectal Cancer Prevention: How to Lower Your Risk and Stay Healthy

Understanding Colorectal Cancer and Why Prevention Matters

What Is Colorectal Cancer?

Colorectal cancer, also known as colon cancer and rectal cancer, is a leading cause of cancer-related death in the United States (1). The good news is that it is largely preventable with the right measures. By making simple changes to your lifestyle, such as maintaining a healthy diet, exercising regularly, and staying on top of screenings, you can lower your risk and live healthier and longer.

Colorectal cancer begins silently in the colon or rectum. The colon absorbs water and nutrients from food, while the rectum stores waste before it is expelled from the body. Cells in the colon and rectum can mutate and start to grow abnormally, especially as you age. In the early stages, these cells usually form a harmless mass called a polyp. At this stage, polyps can be easily removed. If polyps remain undetected, however, they can grow uncontrollably into tumors and become cancerous. Common symptoms at this stage include blood in the stool, frequent, loose bowel movements, and unexplained weight loss.

Why Start Colorectal Cancer Screening Early?

Colorectal cancer is one of the most common causes of cancer deaths in the US because it often develops without noticeable symptoms in its early stages. A delayed diagnosis means that many people may not seek treatment until the cancer has advanced and spread to other parts of the body, such as the liver and lungs. By the time symptoms like changes in bowel habits, unexplained weight loss, or blood in the stool appear, treatment of colorectal cancer can become more difficult or impossible (2).

Early detection and intervention are key to effective treatment. Focusing on prevention through screenings and healthy lifestyle choices can significantly reduce the risk of colorectal cancer. Regular screenings help identify and remove precancerous polyps before they can develop into cancer. By detecting and removing these polyps early, many cases of colorectal cancer can be prevented, leading to better outcomes and lower treatment costs in the long run. This is why the best time to take action to prevent colorectal cancer is now!

How to Prevent Colorectal Cancer

Early Detection through Screening Tests

Screening tests allow doctors to find colorectal cancer or precancerous polyps before symptoms appear. By detecting it early, treatment can begin before the polyp has a chance to develop into cancer, or if there is already cancer, prevent it from spreading. This strategy improves the chances of successful treatment and reduces the need for more aggressive care plans.

Healthy Lifestyle Choices to Reduce Cancer Risk

Colorectal cancer risk can also be reduced through lifestyle changes. Research shows that by taking actions early and making simple, mindful changes to your daily habits, you can significantly reduce the chances of developing the cancer or prevent colorectal cancer from occurring altogether (3).

A balanced diet and regular physical activity are both ways that can help lower your risk. Eating a nutrient-rich diet rich in fruit, vegetables, and whole grains will provide the fiber your digestive system needs to function optimally. Studies have linked a diet high in fiber lowers the risk of colorectal cancer, as fiber helps keep the digestive system running smoothly, supporting the growth of good gut bacteria (4). Clinical trials also show that red meat like pork and beef and processed meat like sausages and cold cuts increase the risk of colorectal cancer. Physical activity plays a role in preventing colorectal cancer too, as regular exercise improves gut motility and supports overall well-being.

Reducing or eliminating alcohol consumption and tobacco use are also important steps in lowering your risks. Drinking alcohol has been associated with poor liver and colon health (5). Smoking also introduces harmful chemicals into the body and significantly increases your risk of developing colorectal cancer (6). Research shows that "current smoking was associated with a 59% increased risk of colorectal cancer, while former smoking was associated with a 19% increased risk" (7). Quitting smoking can even reduce your risk of colorectal cancer by 40%, which is why it is one of the most effective actions you can take to protect you and your family's health.

Screening Tests for Colorectal Cancer Prevention

People at average risk are recommended to start regular screening at age 45 (8). If you have a family history of colorectal cancer, inflammatory bowel disease, or other risk factors, your doctor may recommend starting screening at an earlier age. Screening tests come in several types. The goal of them is to find precancerous polyps before they develop into cancer or, if cancer already exists, to identify it in its earliest stages. By detecting these issues early, screenings can help find the best treatment available to you and start the care you need early.

Colonoscopy

A colonoscopy is the most sensitive test to screen for colon cancer and/or rectal cancer. During this procedure, a long, flexible tube with a tiny video camera at the tip, is used to see the inside of the entire colon and rectum. This allows close examination of the area for any abnormalities. If small polyps are found, they can be removed during the procedure.

The preparation for the colonoscopy includes drinking clear fluids and taking laxatives to clear the stool from the colon. During the procedure, the patient will be under low sedation, hence does not feel pain, and often does not remember the procedure occurring at all. The procedure takes about 30-60 minutes total. After, you will need someone to drive you home as you recover from the sedative.

If your results are normal and you are at average risk, then your next colon cancer screening is recommended at 10 years. If abnormal tissue like polyps are detected or if you are at higher risk, your doctor will provide more information on when you need to return for repeat colonoscopies.

Stool Based Tests

Several stool-based tests exist to screen for cancer: the Fecal Immunochemical Test (FIT), Cologuard, and the Fecal Occult Blood Test (FOBT). These tests are non-invasive screening options that check for blood and cancer cells in the stool. You collect a stool sample at home for it to be sent to a lab for analysis. You will receive a stool collection kit with detailed instructions on how to collect the sample using the materials provided for each of these methods. Make sure to follow these instructions closely.

The FIT, for example, uses antibodies to detect blood in your stool. It is sensitive to human hemoglobin and does not typically react to blood from other sources in your diet. If your result comes out negative, it suggests that no blood was found in the stool. A positive result does not necessarily mean that you have cancer, as blood can come from other sources, such as hemorrhoids. Your doctor would need further diagnostic information, usually by referring you to get a colonoscopy. 

Stool-based tests are recommended for individuals at average risk; they are done at more regular intervals than colonoscopies because they are less sensitive. Usually, this is every 1-3 years depending on the test. Always discuss with your provider about the best screening programs for you.

Other Tests

A flexible sigmoidoscopy is similar to a colonoscopy, but it only looks at the lower portion of the colon and rectum and, therefore is less sensitive (not as effective) at picking up cancers.

Blood-based screening tests for colon cancer screening have recently come onto the scene. It is easy to collect, given just the need for blood work. However, it is not as accurate as our other tests, and for the time is inconsistently covered by insurance, meaning patients would need to pay out of pocket for this test.

Where to Find Colorectal Cancer Screenings and Resources

The Charles B. Wang Community Health Center provides screenings, resources, and support to any patient who has concerns about colorectal cancer. We offer stool-based tests for eligible individuals and can coordinate specialist referrals for screening colonoscopy. Through special initiatives, we can offer free or very low-cost cancer screening to most patients regardless of whether or not they have insurance.

We are open 7 days a week at our Manhattan and Queens locations and are committed to offering high-quality and affordable health care to all. A Sliding Fee Discount program based on family size and income is available to those without health insurance or underinsured. Find an Internal Medicine provider or call either (212) 379-6998 (Manhattan) or (718) 587-1111 (Flushing, Queens) to schedule your health appointment today!

FAQs:

1. What are the early signs of colorectal cancer?

Early signs of colorectal cancer can be subtle. However, being aware of potential symptoms can help a patient with early detection. If you experience increased loose bowel movements, rectal bleeding or blood in stool, abdominal pain, and unexplained weight loss, or get full quickly, it would be a good idea to consult a healthcare provider for clinical evaluation and more information on colorectal cancer prevention.

2. How often should I have a colorectal cancer screening?

For most people at average risk, a colonoscopy is recommended every 10 years starting at age 45, or stool-based tests 1-3 years depending on which test is used. The frequency of screenings may vary depending on the patient's personal risk factors. Talk to your doctor to determine the best screening schedule for you.

3. Can younger people get colorectal cancer?

While the risk increases with age, colorectal cancer is becoming more common in younger adults, especially those under 50. Certain risk factors, including diet, family history, and genetic conditions, can increase the likelihood of younger individuals developing colorectal cancer. For more information, schedule an appointment with the Charles B. Wang Community Health Center.

Sources

1. https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html
2. https://www.cancer.org/cancer/latest-news/signs-and-symptoms-of-colon-cancer.html
3. https://www.ncbi.nlm.nih.gov/books/NBK585999/
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC10255454/
5. https://coloncancerfoundation.org/alcohol-destroying-your-liver-and-colon-increasing-your-risk-of-early-crc/
6. https://www.cancer.gov/types/colorectal/hp/colorectal-prevention-pdq
7. https://www.nature.com/articles/s41416-020-0803-0
8. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html