Colon Cancer Prevention

  • Medical Author:
    Dennis Lee, MD

    Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Quick GuideColon Cancer: Symptoms, Signs, Screening, Stages

Colon Cancer: Symptoms, Signs, Screening, Stages

What are the risk factors for colorectal cancer?

Family history: People who have a family history or other risk factors for colon polyps, cancer, or IBD (inflammatory bowel diseases like ulcerative colitis and Crohn's disease) should discuss screening ages and options with their doctor.

A genetic syndrome: familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).

Those with a positive family history, or diagnosed with a genetic syndrome should begin testing to look for possible early colon cancer at a younger age. This should be discussed with their doctor.

Lifestyle factors: Several lifestyle factors increase the risk of colorectal cancer including:

  • Obesity
  • Alcohol use
  • Cigarette smoking
  • Sedentary lifestyle (lack of regular physical activity)
  • A diet low in fiber and high in fat and red meat

What measures to prevent colorectal cancer have proven effectiveness and long term safety?

Colonoscopy and flexible sigmoidoscopy (along with digital rectal examination and stool occult blood testing) are the primary and most important tools for both preventing colorectal cancers and detecting early colorectal cancers.

Most colorectal cancers arise from colorectal polyps (small growths on the inner lining of the colon and the rectum). Even though colorectal polyps are initially benign, they can grow and change into colorectal cancers over a period of time ranging from five to twenty years. A large study that was conducted in several research centers in the United States showed that patients who had their polyps removed (usually via colonoscopy) had a 90% decrease in colorectal cancer.

Early detection and subsequent treatment of abnormal cells or structures (polyps and/or adenomas) can be precancerous or early signs of colon cancer. If these cells and structures are detected and removed by colonoscopic procedures, many colon cancers can effectively be prevented or stopped. The FDA approved Cologuard on August 11, 2014, as the first stool-based (non-invasive) colorectal test that can be used at home to test for blood and abnormal cells in the stool. The test detects hemoglobin (a blood component) and mutations of DNA seen in colorectal cancers. Positive results suggest the patient should undergo a colonoscopy. The safety and effectiveness of this new test was based on a clinical trial involving over 10,000 patients. Cologuard detected 92% of colorectal cancers and 42% of advanced adenomas. The FDA approval was done in conjunction with the approval of Medicare; the test will be covered by Medicare once every three years for patients aged 50 to 85 who are asymptomatic and are at average risk for developing colorectal cancer. The CDC estimates that regular screening tests for colorectal cancer may reduce deaths from this cancer by at least 60%.

Medically Reviewed by a Doctor on 2/23/2016

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