8 Colon Cancer Questions That Could Save Your Life

By Everyday Health Guest Columnist

By Michelle Kang Kim, MD, MSc, AGAF, FASGE and Laura Manning, RD, Special to Everyday Health 

1. Are You at Risk for Colon Cancer?

The fact is, everyone is at risk for colorectal cancer.  As we get older, our risk increases, which is why it’s so important to understand your risks and get screened.
Each year approximately 140,000 Americans will be diagnosed with colorectal cancer and 50,000 will die from it.  Colon cancer is the third most common cancer in U.S. adults, and the second most common cause of cancer deaths.  We in the medical community strongly believe these numbers are too high. Here are our answers to some frequently asked questions we receive about colon cancer.
The majority of colon cancers develop in patients without a family history of the disease.  In a quarter of patients, hereditary factors may predispose us towards developing colorectal cancer. The most common is a family history of polyps or colorectal cancer.  Others may have cancer syndromes, such as familial adenomatous polyposis (FAP) or Lynch syndrome.  Patients with these conditions may be screened earlier and more frequently than the general population.
Other factors that may predispose you to develop colorectal cancer include smoking, obesity, and a low-fiber, high-fat diet.

2. Colon Cancer Has Symptoms, Right?

This is a myth.  Many patients with colorectal symptoms never have any symptoms.  Those who do have symptoms may experience rectal bleeding, anemia, abdominal discomfort, changes in bowel habits, or unexplained weight loss.

3. Why Screen for Colon Cancer? 

1. It is a common and serious disease.
2. We have excellent screening tools.
3. We can detect precancerous growths, or polyps, and remove them, preventing cancers from developing.  Even if polyps have already become cancers, they are more likely to be detected at an earlier stage, improving patients’ outcomes and long-term survival.

4. Is Colonoscopy the Only Screening Option Available?

In the United States, colonoscopy is the gold standard for colorectal cancer detection.  It is the only screening test that offers the benefit of detection and removal of precancerous growths (polyps). Despite this,  the best screening test is any test that gets done.  Fecal testing for blood, flexible sigmoidoscopy and “virtual” colonoscopy are other available options.

5. What Choices Do I Have When I Go for a Colonoscopy?

The vast majority of colonoscopies are performed by gastroenterologists.  Other practitioners such as internists and surgeons may also perform these procedures.  When choosing a provider, look for high-quality, well-trained providers who are equipped to handle routine and more complex matters.  Depending on your physician, your procedure may be performed in an office, ambulatory endoscopy center, or hospital.
You may also have choices when it comes to administration of your sedation, which is often given by the endoscopist.  In some areas, an anesthesiologist (physician specifically trained to sedate patients) may provide the sedation.
You may also have choices in the preparation you take to prepare for the colonoscopy.  The most important aspect is that it should be a split-dose prep.

6. What Questions Should I Ask My Gastroenterologist?

• How do you ensure a good quality exam?
• What is your adenoma (tumor) detection rate?
• What is your approximate volume of cases that you perform?

7. When Should I be Screened?

Unless you are in a higher risk category (family history, etc), start getting screened for colon cancer at age 50.

8. What Can I Do to Prevent Colon Cancer?

There are many things you can do to help lower your risk of colon cancer in addition to getting screened, including:
Stop smoking: Not only can smoking predispose a person to colon cancer, but it can cause many other cancers as well.
Keep your weight down: The best advice to give is to be at a healthy weight and maintain it, with your Body Mass Index (BMI) between 18-25.  If you have fat that tends to be around your belly, you may be at higher risk.
Keep your activity level up: Try to get 150 to 300 minutes of physical activity weekly, which you can do  in 20-30 minute increments.  At work, take the stairs or consider using a stand-up computer desk.  At home, do sit-ups during TV commercials.
Increase your fiber: Having more fruits, vegetables and whole grains in your daily diet increases your total fiber intake.  This helps prevent colon cancer by moving waste material more efficiently out of the body.
Lower your red meat intake: Eat less than 18 ounces (approximately 3 servings) per week of red meat, and avoid deli, cured, processed meats that contain nitrates.
Limit your alcohol intake:  Keep alcohol to 2 alcoholic per day beverages for men and 1 for women. Lower your alcohol intake by adding more water to drinks, or having a large glass of water between them.
Consume the recommended level of calcium and vitamin D:  The recommended amount of calcium for women is 1,000mg (age 19-50) to 1,200 mg  (50+) , and  about 600 IU daily of vitamin D.  It’s best to get your vitamins through food, so increase your intake of low fat dairy products (yogurt, low fat cheese and milk) and get a little sunshine, 15 minutes a day.
Have you had your colonoscopy yet?
Michelle Kang Kim, MD, MSc, AGAF, FASGE, is the Associate Director of Endoscopy and Director of Endoscopic Sound at Mount Sinai Hospital, and Assistant Professor of Medicine at Mount Sinai School of Medicine in New York City.
Laura Manning is a Registered Dietitian in the Department of Gastroenterology at Mount Sinai Medical Center.  She has spent the last 12 years at Mount Sinai, of which the last 10 have been in Gastroenterology.