Colon Cancer Prevention

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Your initial step in colon cancer prevention is to talk with your doctor about when you should get screened, whether that's with a colonoscopy or at-home stool-based test. Depending on your risk factors, like your age and whether you have a family history of colon cancer or polyps, your doctor will determine when screening should begin. Maintaining a healthy weight, exercising regularly, limiting your consumption of red and processed meats, and avoiding excess alcohol intake are also important ways to lower your risk of this disease.

Screening

Screening tests for colon cancer prevention aim to find irregularities in the colon before they turn cancerous. 

The majority of people fall into the average risk category for colon cancer prevention screening and are encouraged to begin testing at age 45. That said, there is no hard and fast rule as to when to start such screening. Potential symptoms or high-risk factors for colon cancer (see below) may prompt earlier screening. 

For the average-risk individual, visual screening tests can be used to detect colon polyps and cancer: 

  • Colonoscopy performed every 10 years*
  • Computed tomography colonoscopy (virtual colonoscopy) performed every five years 
  • Flexible sigmoidoscopy performed every five years 

There are also at-home stool tests designed to detect colon cancer when it is present. These tests either check for trace amounts of blood or shed cancer cells in the stool. They include:

  • Highly sensitive fecal immunochemical test (FIT) every year
  • Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year
  • Multi-targeted stool DNA test (MT-sDNA) every three years

Either of these types of tests can be used to get screened for colon cancer, and there are pluses and minuses to each one. What's most important is that you don't wait to seek them.

*If any test other than the colonoscopy has irregular results, you will still need a colonoscopy to confirm those findings (and potentially remove any polyps or small growths, if needed).

Increased or High-Risk Screening

If you are at an increased or high risk of developing colon cancer, your screening tests will occur more frequently and before the age of 45.

According to the American Cancer Society, you are in the increased or high-risk category if you meet one or more of the following criteria:

  • You have a family history of colon cancer or certain types of polyps
  • You have a personal history of colon cancer or certain types of polyps
  • You have a personal history of inflammatory bowel disease (ulcerative colitis or Crohn's disease)
  • You have a known family history or confirmed or suspected hereditary colon cancer syndrome like familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
  • You have a personal history of getting radiation to the abdomen or pelvis area to treat prior cancer

The specific screening guidelines for increased and high-risk individuals vary depending on the above.

Genetic Counseling

People who carry genetic mutations linked to hereditary colon cancer are the most likely to develop the disease. If someone in your family has FAP or HNPCC, or if you're of Ashkenazi Jewish descent, you should seriously consider adding genetic counseling to your colon cancer prevention plan. Early screening may already have been recommended to you because of your background, but results may help hone a prevention strategy further.

Coverage

Obtaining a colon cancer screening test may be expensive, depending on your insurance coverage. While an out-of-pocket screening colonoscopy can be pricey, a yearly fecal immunochemical test to screen for blood in the stool is usually much more reasonable.

In the end, be sure to talk with your doctor to see if your insurance covers your screening tests or, if you're uninsured, how to obtain coverage. If you are at increased or high risk for colon cancer, know that some insurance companies require proof (such as genetic testing results). Such tests can be expensive and may/may not be covered under your plan, if you have one.

Weight

Chronic inflammation within the body may cause DNA damage, which can subsequently lead to cancer.  While the precise science behind this "inflammation triggering cancer" phenomenon is complex and still being teased out, reducing inflammation in your body through healthy lifestyle habits is a proactive step you can take to reduce your risk of cancer and improve your overall health.

Obesity is a condition inherently associated with inflammation. In recent years, scientists have identified an inflammatory protein, called PAR2, in the abdominal fat cells of overweight and obese people. They believe that high-fat/high-sugar diets cause changes to the cells of the immune system that trigger the production of the protein. This unique inflammatory response may contribute to weight gain by stimulating the production of certain fatty acids found in abdominal fat.

With regards to colon cancer, not only has obesity and being overweight been linked to an increased risk of developing colon cancer but so has an increase in abdominal fat (a larger waistline). So maintaining a healthy weight and avoiding weight gain, especially around your waist, may help lower your risk. 

Diet

Diet can play a significant role in your colon cancer risk, for better or for worse, both because of its ability to influence the amount of inflammation in your body and otherwise. While you can't change your age or your family medical history, you can make smart decisions about what is on your plate.

Pay Attention to the Fats You Eat

Eating healthy fats such as nut oils, flax oils, fish oils, olive oil, and canola oil can also reduce inflammation. Furthermore, be sure to limit your intake of red meat, which contains high amounts of saturated fat. You may also consider cutting out or reducing your consumption of full-fat dairy products such as butter, cream, ice cream, and cheese.

Additionally, clear the pantry of any processed foods made with trans fats or hydrogenated or partially hydrogenated oils. Excessive intake of the vegetable oils found in most junk foods can also turn up inflammation, even if the fats are not hydrogenated.

Cook Your Meat Properly

When you cook meat over high temperatures (think broiling, grilling, and frying), polycyclic aromatic hydrocarbons (PAHs) and heterocyclic amines (HCAs) are released into the food. These two compounds have known carcinogens and have been linked to an increased incidence of colon and rectal cancers. PAHs can also be found in cured or smoked foods, such as ham or bacon.

You don't have to toss your backyard grill, but it may be healthier to slow-cook foods at lower temperatures, stew, or slowly roast animal proteins.

If you do decide to grill your meat, be sure to use tongs to flip the meat rather than a fork. Piercing the meat causes fat and juices to drip onto the coals. This, in turn, causes the formation of carcinogens that coat the meat when smoke rises back up from the grill.

Add Fiber to Your Diet

Emerging research suggests that fiber, especially from whole grains, may help lower your risk of colon cancer. 

Start by adding fiber to your diet first thing in the morning. Try oatmeal with fresh or frozen berries, nuts, and a sprinkling of flax seeds. Or, try a high-fiber breakfast cereal with at least six or more grams of fiber per serving.

In the afternoon, snack on fresh or dried fruit or nibble on veggies with hummus instead of chips or cookies. And, finally, end the day by adding an extra serving of vegetables to dinner and ensuring that your bread is 100 percent whole grain.

Eat the Real Deal

You can find almost every micronutrient (think minerals, vitamins) available in a pill form nowadays. However, it's not just the micronutrients in healthy foods that matter. It’s the synergy of nutrients, phytochemicals, and antioxidants, basically, the food as a whole, that helps fight cancer cells.

The safest and most economical way to get all of your antioxidants, phytochemicals, and nutrients is to eat the whole, natural, plant-based food, largely unchanged from when it was harvested. Wash vegetables and fruits thoroughly, and enjoy the skins that are edible as well (this is where the fiber is stashed). 

Lifestyle

It will likely come as no surprise to see these strategies on the list. Use their connection to colon cancer risk as fuel for a lifestyle change, if needed.

Exercise Regularly

Regular physical activity can reduce inflammation, according to a 2017 study from the University of California San Diego School of Medicine. All it takes is 20 minutes of exercise four to five times per week, and any form of moderate to intense activity will do (for example, walking briskly, running, swimming, or biking).

That said, vigorous exercise may lower your risk of colon cancer even more than moderate exercise. So if you are already working out regularly, consider upping the intensity and/or frequency of your sessions (under the guidance of your personal physician). 

Quit Smoking, Reduce Alcohol

Research suggests that stopping smoking and limiting alcohol consumption can lower your risk of developing colon cancer. 

Smoking can deplete your body of vitamin C, which is a potent antioxidant. Antioxidants help reduce your colon cancer risk by sweeping out the free radicals (pollution, cellular waste) in your body. 

Likewise, heavy alcohol use can deplete the amount of folate (one of the B vitamins) that you absorb from healthy foods. Folate deficiency has been linked to an increased instance of colon cancer.

Natural Remedies

Few natural remedies or alternative therapies have been found to play a significant role in colon cancer prevention. However, preliminary research suggests that the following substances may help reduce colon cancer risk to some degree.

Vitamin D

High blood levels of vitamin D may be linked to a lower risk of colon cancer, according to a 2010 study. Analyzing data on 1,248 people with colorectal cancer and the same number of healthy individuals, researchers determined that those with the highest levels of vitamin D had a 40 percent reduced risk of colon cancer compared to those with the lowest levels.

Folate

Making sure you consume enough folate (a B vitamin found in foods like spinach, asparagus, and fortified cereals) may lower your risk of colon cancer. The recommended daily intake of folate is 400 mcg for most adults. Pregnant women should consume 600 mcg daily while breastfeeding women should consume 500 mcg daily.

Quercetin

In lab tests on cell cultures, scientists have demonstrated that quercetin may help stall the growth of colon cancer. What's more, a 2010 population-based study of 672 people found that dietary intake of quercetin may be linked with reduced risk of colon cancer.

An antioxidant available in supplement form, quercetin is naturally found in foods like apples, onions, and berries.

Tea

White tea may help inhibit the growth of aberrant crypts (a precursor to colon cancer). Green tea has also been found to fight colon cancer in animal-based research and test-tube studies. However, the available scientific data are insufficient to conclude that any type of tea may prevent colon cancer in humans.

Preventive Medications

Many people wonder if taking certain medications may reduce their risk of developing colon cancer. For instance, a number of studies suggest that people who regularly use aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) have a lower risk of colon cancer. The truth is, the jury is still out.

Since NSAIDs can cause serious side effects (including bleeding from stomach irritation), it's important to consult your physician before taking these drugs on a regular basis. In fact, the American Cancer Society notes that "experts do not recommend NSAIDs as a cancer prevention strategy for people at average risk of developing colorectal cancer."

While some studies have suggested that statins—drugs commonly used to treat high LDL cholesterol levels, such as Lipitor (atorvastatin) and Crestor (rosuvastatin)—may reduce the risk for developing colon cancer, others have not supported this idea. 

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