March is Colorectal Cancer Awareness Month! But the goal is not only to spread awareness about the symptoms and diagnosis of colorectal cancer (CRC)- but also how to prevent it! You may not have thought about your risk factors yet, but with colorectal cancer being the 2nd leading cause of cancer-related deaths and the 3rd most common cancer in men and in women- it’s time to think about it!
1. First understand your risk of colon cancer and get screened!
Check out NIH’s Colorectal Cancer Risk Assessment Tool at https://ccrisktool.cancer.gov. The Colorectal Cancer Risk Assessment Tool is designed for doctors and other health care providers to use with their patients. The tool estimates the risk of colorectal cancer over the next 5 years and the lifetime risk.
Currently the guidelines recommend screening for African Americans at 45 and the rest of the population at 50. The American Cancer Society has even recommended for everyone to start screening at 45.
What factors increase your risk of colorectal cancer?
Hereditary colon cancer syndromes (ask about your family history!)
Personal or family history of sporadic colorectal cancer or polyps
Inflammatory bowel disease- Crohn’s disease or ulcerative colitis
Signs and symptoms of colon cancer include:
A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than 1 month
Rectal bleeding or blood in your stool
Persistent abdominal discomfort, such as cramps, gas or pain
A feeling that your bowel doesn't empty completely
Weakness or fatigue
Unexplained weight loss
2. Now that you’ve gotten screened- what can you do to prevent colon polyps or colon cancer in the future???
FACTORS THAT INCREASE RISK OF COLORECTAL CANCER
OBESITY: A systematic review and meta-analysis of 13 studies reported that a weight gain between early adulthood and midlife was associated with a significant increase in the risk of CRC.
DIABETES & INSULIN RESISTANCE: A meta-analysis of 14 studies estimated that the risk of colon cancer among diabetics was 38% higher than nondiabetics and 20% higher for rectal cancer.
RED & PROCESSED MEAT: Studies show that long-term consumption of red meat or processed meats appears to be associated with an increased risk of CRC, particularly for left-sided tumors. High temperature cooking (eg, barbecuing, pan-frying) contributes to risk, perhaps by the production of polyaromatic hydrocarbons and other carcinogens produced from proteins in the charring process. The World Health Organization (WHO) has actually classified processed meats (ex. sausages, bacon, ham) as group 1 carcinogens, placing these foods in the same risk category for cancer as asbestos, cigarettes, and alcohol.
TOBACCO— A meta-analysis of 106 studies estimated that the risk of developing or dying from CRC was increased among cigarette smokers. Cigarette smoking is also a risk factor for colon polyps.
ALCOHOL — A meta-analysis of 61 studies concluded that, compared with never drinkers, there was a significant increase in risk of CRC for moderate (2-3 drinks/day) and heavy drinkers (≥4 drinks/day) but not light drinkers (<1 drink/day).
FACTORS THAT DECREASE RISK OF COLORECTAL CANCER
FIBER- A meta-analysisfunded by the World Cancer Research Fund found that for every 10 g/day increase in dietary fiber consumption (especially GRAINS), there was a significant reduction in the risk of CRC by 10 percent
RESISTANT STARCH — Undigestible starches escape digestion in the small bowel and in the colon are fermented and product short-chain fatty acids. Butyrate, one of these fatty acids, has antineoplastic properties in the colon. Foods that contain resistant starch include:
Plantains and green bananas (as a banana ripens the starch changes to a regular starch)
Beans, peas, and lentils (white beans and lentils are the highest in resistant starch)
Whole grains including oats and barley
Cooked and cooled rice
VITAMIN B6 (pyridoxine) — A meta-analysisshowed that the risk of colorectal cancer decreased by 49% for every 100-pmol/mL increase in blood PLP levels (the active form of vitamin B(6). Foods high in B6 include:
Chickpeas- 55% DV
Beef liver- 45% DV
Yellowfin tune- 45% DV
Sockeye salmon- 30% DV
Chicken breast- 25% DV
Boiled potato- 20% DV
CALCIUM- A meta-analysisconcluded that the risk of recurrence of colorectal adenoma (colon polyps_ was significantly lower in patients randomized to calcium.
VITAMIN D- Keep your vitamin D levels between 30-40 ng/mL. An analysis of 17 cohorts found that compared with vitamin D levels of 20 to <25 ng/mL, a 25(OH)D level of <12 ng/mL (30 nmol/L) was associated with a higher risk of CRC, whereas 25(OH)D levels ≥30 ng/mL (75 nmol/L) were associated with a lower risk.
GARLIC: Eating garlic has been associated with a reduced risk of colonic adenomas in studiesof patients with CRC and in laboratory studies. Garlic has been included as a probable protective factor by the World Cancer Research Fund/American Institute of Cancer Research.
FISH — Consumption of omega 3 fatty acids (mainly as fish oil) has been associated with a reduced incidence of colorectal neoplasia. A meta-analysisof 41 studies found an overall lower incidence of CRC among individuals with the highest compared with the lowest fish consumption. 2g daily of eicosapentaenoic acid (EPA) has been shown in a randomized controlled trial to reduce the numbers of adenomas by 22.4%.