Reducing the Risk of Colorectal Cancer

Posted on February 5th, 2009 by

By Allyson J. Ocean, MD
Medical Oncologist, the Jay Monahan Center for Gastrointestinal Health
Medical Oncologist, Solid Tumor Service, NewYork-Presbyterian Hospital
Assistant Professor of Clinical Medicine, Weill Medical College of Cornell University

Individuals can reduce their risk of developing colorectal cancer in two ways. The first is to change their lifestyle to support their colorectal and overall health.

Lifestyle measures to reduce the risk of developing colorectal cancer include avoiding or stopping smoking, using alcohol only in moderation, and eating a diet that is high in fruits, vegetables, and fiber and low in fats and red or processed meats. In addition, certain dietary factors have been associated with a reduced risk of colorectal cancer. Research has shown a potential protective effect with calcium, vitamin D, and folic acid (folate).[1],[2],[3] Finally, frequent exercise is important not only for maintaining a healthy body weight but also for keeping the body healthy and moving.

In addition to dietary and exercise factors, some studies indicate that the use of nonsteroidal anti-inflammatory drugs and certain statin agents (used to reduce cholesterol) may also reduce the risk of colorectal cancer.[4] Although these medicines may have the benefit of reducing colorectal cancer risk when taken for another purpose—such as the treatment of arthritis or the reduction of cholesterol levels—they are not recommended for the purpose of reducing colorectal cancer risk alone.

For women estrogen and progestin hormone therapy has been associated with a reduced risk of developing colorectal cancer, but it has also been linked with an increased risk of some other cancers. Women need to discuss their personal and family medical history, their personal preferences, and the potential risks and benefits of hormone replacement therapy with their physician.

The second step in reducing the risk of developing colorectal cancer and detecting any cancer early is to be vigilant about undergoing the recommended screening for this disease. Early colorectal cancer causes no symptoms, so screening is done when an individual feels well—before any signs of the disease develop.

Who Should Be Screened and When?

Colorectal cancer screening allows for both the prevention and the early detection of cancer. Early detection, in turn, allows for early treatment, when a cure is most likely. When this disease is detected in its early, localized stages, the five-year survival rate is 90%.[5] In addition, colorectal cancer is preventable when potentially precancerous colorectal polyps are detected and removed before they have the chance to develop into cancer.

For women and men at average risk of colorectal cancer, the American Cancer Society recommends one of the following screening options, beginning at age 50[6]:

  • Fecal occult blood test (FOBT) or fecal immunochemistry test (FIT) annually
  • Flexible sigmoidoscopy every five years
  • FOBT/FIT annually plus flexible sigmoidoscopy every five years (preferred over either test alone)
  • Double-contrast barium enema every five years
  • Colonoscopy every 10 years

Colonoscopy is the most comprehensive and effective screening option, but it is also the most invasive. Individuals should discuss their own health factors and personal preferences with their physician to determine which screening option is right for them.

For people who are at higher or increased risk for colorectal cancer, screening may need to begin at a younger age and be performed at more-frequent intervals.[7]


[1] Flood A, Peters U, Chatterjee N, Lacey JV Jr, Schairer C, Schatzkin A. Calcium from diet and supplements is associated with reduced risk of colorectal cancer in a prospective cohort of women. Cancer Epidemiology, Biomarkers, and Prevention. 2005;14(1):126-132.

[2] Slattery ML, Neuhausen SL, Hoffman M, et al. Dietary calcium, vitamin D, VDR genotypes and colorectal cancer. International Journal of Cancer. 2004;111(5):750-756.

[3] Martinez ME. Primary prevention of colorectal cancer: Lifestyle, nutrition, exercise. Recent Results in Cancer Research. 2005;166:177-211.

[4] Cancer Facts & Figures 2006. American Cancer Society Web site. Available at: http://www.cancer.org/downloads/STT/CAFF2006PWSecured.pdf. Accessed November 27, 2006.

[5] Cancer Facts & Figures 2006. American Cancer Society Web site. Available at: http://www.cancer.org/downloads/STT/CAFF2006PWSecured.pdf. Accessed November 27, 2006.

[6] Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2006. CA: A Cancer Journal for Clinicians. 2006;56(1):11-25.

[7] Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2006. CA: A Cancer Journal for Clinicians. 2006;56(1):11-25.

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Tags: Colon Cancer

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