1. Stay at a Healthy Weight
Men and women who are overweight or have obesity are more likely to develop colorectal cancer. A meta-analysis of 66 studies found that having obesity was associated with a 36 percent increased risk of colorectal cancer.
In one study of more than 135,000 participants, researchers asked the subjects to report their weight and height at three different times in their lives: at ages 20, 50, and after age 55. An analysis showed a 2 to 4 percent increased risk for colorectal cancer with every 1-unit rise in body mass index (BMI) score.
The danger seems to be especially high for men, and especially those who amass extra pounds around their midsection.
Rates of colorectal cancer among young people have also been increasing in recent years, and researchers suspect rising obesity rates in the United States may be a contributing factor.
2. Exercise More — the Harder, the Better
Regular, moderate exercise — exercise that slightly increases your heart rate, such as brisk walking — has been shown to help lower the risk of colon cancer and rectal cancer.
But vigorous exercise appears to offer the biggest benefit.
For instance, one study found that higher levels of physical activity, compared with lower levels, were associated with a 16 percent lower risk of colon cancer and a 13 percent lower risk of rectal cancer.
The American Cancer Society offers tools to help people who want to become more physically active, including a target heart rate calculator that helps you determine whether you are reaching workout goals.
3. Rethink Your Diet (Especially Produce Intake)
Numerous studies have confirmed that diet plays a role in many colorectal cancers.
Eating red meat (beef and lamb) and certain processed meats (such as sausage and hot dogs) has been linked to higher colorectal cancer risk. So, limiting these foods may help lower risk.
Plant-based diets that are high in whole grains, nuts, legumes, fruits, and vegetables seem to lower colon and rectal cancer risk compared with diets high in animal foods, refined grains, and added sugars. Fruits and vegetables are high in antioxidants, which may play a role in cancer prevention, and dietary fiber, which a number of large studies have suggested may reduce colorectal cancer risk. Fiber bulks up stool and helps it move more quickly through the digestive tract, thus flushing out potential carcinogens faster.
Dietary fiber may also help regulate the gut microbiota, whose composition has shown to be linked with onset of colorectal cancer in an increasing number of studies.
4. Avoid Drinking Alcohol to Excess
Moderate to heavy alcohol use has been associated with a higher risk of cancers of the colon and rectum.
Evidence for this is generally stronger for men than women, but studies have found a connection in both sexes.
The ACS suggests limiting alcohol to two drinks a day for men and one for women, although researchers are increasingly emphasizing that no alcohol is the best way to reduce risks for many types of cancer. According to the World Health Organization (WHO), no amount of alcohol is safe for health.
5. Don’t Pick Up a Cigarette
Many people know that cigarette smoking raises lung cancer risk but are less aware of its connection to other cancers, including colon and rectal cancers. In fact, people who have smoked for a long time are more likely to develop and die from colorectal cancer than people who don’t smoke.
6. Take Aspirin or Another Nonsteroidal Anti-Inflammatory — but Only With a Doctor’s Okay
Still, it’s necessary to balance the potential benefits with the possible side effects, some of which are quite serious, such as stomach ulcers.
Physicians generally do not recommend NSAIDs to patients who are at average risk. Talk to your doctor to see if you are a good candidate for these medicines.
7. Have Regular Colon Cancer Screening
They may be able to spot colorectal cancer at its early stages and can identify precancerous colorectal polyps (abnormal growths). There are two kinds of screening tests: stool-based tests and visual exams.
Stool-based screening tests analyze feces samples for occult (hidden) blood or abnormal sections of DNA. Samples are fairly easy to collect at home and return to a doctor’s office or medical lab. But testing must be done fairly frequently, even as often as every year.
There are a number of different colorectal visual exams, but the gold standard is a colonoscopy. During this procedure, while a patient is sedated, doctors examine the inside of the colon and rectum via a device inserted through the anus: a long, flexible tube with a tiny video camera at the end. Prior to this procedure, patients need to clean out the colon and rectum, a process that involves drinking a powerful laxative solution.
During a colonoscopy, doctors can remove and biopsy any polyps they find, leading to a determination of whether a growth is cancerous, precancerous, or benign.
Troublingly, almost 60 percent of Americans don’t realize that removing polyps during colonoscopy screenings can prevent cancer. But the good news is that removal of polyps detected through screening is one reason colorectal cancer death rates have been dropping over the past few decades.
Colorectal screening also offers the advantage of detecting and treating colorectal cancer while it is still localized, meaning it hasn’t spread beyond the large intestine. Cancer caught and treated in this early stage has a five-year survival rate of roughly 90 percent.
Still, research shows 3 in 10 Americans in a primary risk group for colorectal cancer (people ages 50 to 75) were not up to date on screenings as of 2020, although the rate of compliance has steadily improved over the last decade.
The U.S. Preventive Services Task Force, which sets policy for Medicare and private insurers under the Affordable Care Act, recommends that adults begin screening for colorectal cancer at the age of 45.
People who are considered at high risk, such as those with a family history of the disease, who have a prior history of cancer or polyps, or who carry certain genetic mutations known to increase cancer risk, may also want to start screening at an earlier age.
People at average risk generally need to be screened via colonoscopy only once every 10 years.
The Takeway
- Colorectal cancer is the third most common cancer in the United States (excluding skin cancers) and the second most common cause of cancer-related death.
- While some risk factors can’t be controlled, many others can be, including maintaining a healthy weight, exercising more, limiting red and processed meat and eating more fruits and vegetables, and abstaining from alcohol and smoking cigarettes.
- Regular screening with either stool-based tests or colonoscopy can help prevent and greatly reduce the risk of death from colorectal cancer.
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