Though colon cancer remains one of the leading causes of cancer death in America, the good news is the overall rates have been declining among patients who are over 50 years old. But recent studies, including one in the February 2017 issue of the Journal of the National Cancer Institute, have shown a rise in colorectal cancer among patients between 20 and 30 years old.
And the actual diagnosis is just part of the problem. “Another issue is these younger patients with colorectal cancer run the risk of getting diagnosed later in the course of their disease when the cancer may be untreatable,” Cedrek McFadden, M.D., double board certified colorectal surgeon and clinical assistant professor of surgery at the University of South Carolina School of Medicine, said in an interview with The Cheat Sheet. “This happens because doctors don’t typically consider colorectal cancers high in their diagnosis for symptoms at such a young age.” Instead, they may assume symptoms may be related to hemorrhoids.
Most people are supposed to start screenings around age 50, however, several risk factors may encourage your doctor to recommend you start earlier. Here are eight colon cancer risks to keep on your radar.
While it is possible for colon cancer to occur at any age, your chances of developing it increase dramatically after the age of 45. According to Cancer Treatment Centers of America, 95% of all colorectal cancers occur in patients older than 45. Dr. Thomas Imperiale, a gastroenterologist for Indiana University Health, tells us the risk just about doubles each decade going forward from age 50 to 80. The number one way you can protect yourself is to get screened regularly after age 50, unless you have a family or personal history that requires you to get screened sooner.
2. Race or ethnicity
Though researchers are still trying to determine the reasons why, race does seem to play a role in risk for colon cancer. African Americans have the highest risk of developing colorectal cancer — 20% higher than non-African Americans, McFadden says. “The reason for this finding is unclear, but possible causes include biologic or genetic links or even lower screening rates,” he added. According to Cancer.Net, this increased risk is evident for both black men and women. Because of this increased risk, screening for African Americans may begin at age 45.
3. Personal or family history
Having a personal or family history of colorectal cancer or colorectal polyps may increase a patient’s risk, according to Cancer Treatment Centers of America. Because of this, patients must undergo aggressive and more frequent screening. “More specifically, patients who have a previous personal history of genetic inherited syndromes, such as FAP, familial adenomatous polyposis, or Lynch syndrome, just to name a few, have an exponentially high risk when compared to the average population in developing colon cancer along with high risk of developing another type of cancer elsewhere in the body,” said Samir Shah, M.D., who specializes in colon cancer and colorectal surgery.
4. Inflammatory intestinal conditions
Individuals with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, may develop chronic inflammation of the large intestine, which Cancer.Net says increases their risk of colorectal cancer. “Extensive colitis from these diseases can increase the risk five- to 15-fold compared to the general population,” McFadden said. He advises patients with these diseases to work with their primary care provider to ensure they have access to more intense colonoscopies that can fully evaluate the presence of precancerous polyps.
For unknown reasons, men have a slightly higher risk of developing colon cancer than women. According to Imperiale, it’s about 80% higher than women at the same age, which could be due to a number of undocumented and under-researched factors like lifestyle or diet tendencies. Still, the recommended age for screening is 50. So, regardless of your gender, you should speak with your doctor about when you should begin annual screenings.
Being overweight and living a sedentary lifestyle increases a person’s risk for cancer and diseases of all kinds, including colon cancer. “There may be an increased risk with weight gain between early adulthood and midlife as opposed to between midlife and older adulthood,” explained McFadden. “Clearly, maintaining a healthy weight is beneficial to the patient in decreasing the risk of colorectal cancer.”
Similarly to living an active lifestyle, maintaining a healthy diet is an important tool in combating cancer and diseases of all kinds. While it can’t totally prevent a diagnoses, it can significantly decrease your risk. “Patients who consume a diet that is high in fat and low in fiber are at increased risk of developing colon cancer,” Shah said, adding fruits, vegetables, whole grains, nuts, and beans are great food choices. Also, the federal dietary guidelines recommend women eat 25 grams of fiber per day, and men should aim for 35 grams.
It’s also important to cut down your intake of processed and red meat, which is associated with increased risk of colorectal cancer. “Barbecuing and pan frying may also contribute to the risk because of produced carcinogens from the cooking process,” Mcfadden explained. He suggests patients limit their consumption of processed and red meat to just one or two times per week.
8. Smoking and heavy alcohol use
Studies have linked heavy smoking to an increased risk of colon cancer, and an increased risk of dying from the disease. Heavy or excessive alcohol use also increases a patient’s risk for several gastrointestinal cancers, including colon cancer, Anton Bilchik, M.D., chief of gastrointestinal research at John Wayne Cancer Institute at Providence Saint John’s Health Center, said in an interview with The Cheat Sheet.
Additionally, cigarette smoking may increase a patient’s risk of colon polyps, too. “Both smoking and drinking should be avoided and alcohol only [consumed] in moderation — no more than one or two drinks per day,” Bilchik said.
How to get checked or screened for colon cancer
A colonoscopy is the most common type of screening. Another choice is testing fecal DNA for microscopic blood, which would warrant a colonoscopic evaluation. “Other options of screening include a flexible sigmoidoscopy, which is a visual examination of the rectum and lower portion of the colon,” Shah explained. You can also get a partial colonoscopy.
“Patients who are hesitant for any camera or colonoscopic evaluation can undergo a radiological evaluation via a double contrast barium enema, or barium X-ray. Other radiological options include a CT colonography or ‘virtual colonography,’ where patients have their entire colon assessed via computer-generated 3D images,” Shah said. “Any suspicious lesions on the radiology examinations would warrant a formal colonoscopic evaluation.”
What you should know about getting checked out
Due to lack of awareness or fear of getting a colonoscopy, many patients neglect getting checked out. Some patients may even be simply embarrassed. But getting screened for colon cancer is the number one way to prevent it. “Colonoscopic evaluation is generally painless and normally done under mild-sedation, so most patients don’t feel or recall anything,” Shah said. The bowel prep required the day before is sometimes uncomfortable. The majority, however, have no issues.
“Patients performing an adequate bowel prep to get cleaned the night before is crucial because this will allow the doctor to get a good look at the lining of the colon and rectum and therefore less lesions or polyps are missed,” Shah said. “An inadequate bowel prep can lead to missed lesions or a need to repeat the procedure.”
Costs are another concern many patients have when it comes to getting screened for colon cancer, however it’s important to note that most costs for colorectal cancer screenings, including colonoscopies, are covered by most health plans.