Colorectal Cancer – Risk Reduction, Prevention, & Early Detection

March 26, 2021

It’s estimated that more than 140,000 new cases of colorectal cancer have impacted Americans in the last year alone, according to the American Cancer Society. Even though this number is significantly smaller than it was decades ago, it doesn’t mean we’re in the clear.

The good news: colorectal cancer is one of the most preventable cancers, thanks to highly safe and effective screening methods, says Jefferson Health Gastroenterologist Dr. C. Andrew Kistler. Colonoscopies – recommended for all adults starting between 45 and 50 years old or younger depending on risk level – can remove pre-cancerous growths (or polyps), thus preventing cancer, as well as catch cancer in its early stages.

However, many people still delay screening. Why?

Dr. Kistler suggests it’s typically 1 of 3 reasons:

  • Concerns regarding the prep.
  • Concerns regarding the procedure risks. 
  • Concerns regarding the results and potentially being diagnosed with polyps or cancer.

The prep isn’t fun, but what many people don’t realize is that it has an integral purpose, explains Dr. Kistler. “Cleaning out your colon and rectum as much as possible actually helps shorten the procedure; it allows us to find things easier – things that could go missed if the prep wasn’t done correctly”

Complications are a natural concern, adds Dr. Kistler, but, over the years, we’ve learned that there’s less than a one percent chance for the average person to experience any. “And could you be diagnosed with cancer? It’s certainly always possible, BUT the earlier you are screened, the less likely it is.”

While colonoscopies are the gold standard, there are other options available for both people who are at low to average risk of colorectal cancer and those who are at high risk for going under anesthesia (i.e., those with certain lung and heart conditions).

A sigmoidoscopy uses a shorter scope and is a shorter procedure; it can view things well and remove polyps. The only downfall is, it only reaches the left, lower side of the colon, so you could potentially miss things that are further up, notes Dr. Kistler.

A stool test/FIT test (fecal immunochemical test) – where a small stool sample is tested at a lab for occult, or hidden, blood – may also be appropriate. If it comes back negative, there’s no need to undergo an unnecessary procedure at that time; however, this would typically need to be repeated at least yearly, adds Dr. Kistler.

Your physician will recommend the best screening option for your individual needs.

In addition to being screened, there are a few things we can do on a daily basis to help lower our risk for developing colorectal cancer, such as:

  • Avoid smoking,
  • Limit consumption of alcoholic beverages,
  • Limit consumption of red and processed meats,
  • Stay physically active – it’s recommended that all adults get at least 150 minutes of moderate aerobic activity each week.

Other risk factors, unfortunately, are out of our control, continues Dr. Kistler, such as:

  • Family history,
  • African American heritage,
  • Inflammatory bowel diseases, including Crohn’s and ulcerative colitis,
  • Genetic syndromes, such as Lynch Syndrome.

If you fall into certain high-risk categories, your physician will likely recommend screening at an age younger than 45 to 50 years old. For example, if you’ve had a first-degree family member who has had colorectal cancer, many physicians would recommend that screening should start at age 40 or 10 years younger than the age they were diagnosed.

“One of the most worrisome trends in colorectal cancer, currently, is that people with none of the risk factors above are developing cancer at younger ages,” added Dr. Kistler. “It might be due to a number of reasons related to unhealthy lifestyles, but we aren’t entirely sure at this time.”

Because of this, Dr. Kistler urges everyone, at any age, to tell their primary care provider (or GI, if they have one) of any suspicious symptoms that could point to cancer, including persistent and painful bloating; abdominal pain; rectal bleeding; dark or black stools; and unintentional weight loss.

If you have cancer, it’s best to catch it early, as survival rates are higher and there’s typically less extensive treatment required. These symptoms could also align with a number of other common GI conditions, but it’s better to be safe than sorry.

For more information on Gastroenterology and other Primary & Specialty Care services offered at Jefferson Health - New Jersey, click HERE.