Understanding the risk of colorectal cancer

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One out of every 50 people, or 2 percent of the population, will get colorectal cancer. Women are at a higher risk for colon cancer, while men are more likely to develop rectal cancer.

The majority of people who develop colorectal cancer have no known risk factors. Although the exact cause of colorectal cancer is not known, there are some factors that increase a person's risk of developing the disease. These include: age, gender, polyps, personal history, family history, diet and lifestyle factors.

The risk of developing colorectal cancer increases as we age. The disease is more common in people over 50, and the chance of getting colorectal cancer increases with each decade. However, colorectal cancer has also been known to develop in younger people.

Polyps are non-cancerous growths on the inner wall of the colon or rectum. While they are fairly common in people over 50, one type of polyp, referred to as an adenoma, increases the risk of developing colorectal cancer. Adenomas are non-cancerous polyps that are considered precursors, or the first step toward colon and rectal cancer.

Research shows that women who have a history of ovarian, uterine or breast cancer have a somewhat increased risk of developing colorectal cancer. Also, a person who already has had colorectal cancer may develop the disease a second time. In addition, people who have chronic inflammatory conditions of the colon, such as ulcerative colitis or Crohn's disease, are at higher risk of developing colorectal cancer.

Parents, siblings and children of a person who has had colorectal cancer are somewhat more likely to develop colorectal cancer themselves. If many family members have had colorectal cancer, the risk increases. A family history of familial polyposis, adenomous polyps or hereditary polyp syndrome also increases the risk.

A diet high in fat and calories and low in fiber may be linked to greater risk of developing colorectal cancer. Drinking alcohol, smoking, a lack of exercise and being overweight can contribute to your risk as well.

If you have one or more of these risk factors you should talk with your doctor. He or she may be able to suggest ways to reduce your chances of developing colorectal cancer. Getting regular check-ups may be the best prevention method. Early detection of any abnormal cells allows for prompt treatment and better chance for a cure.

The American Cancer Society recommends the following:

  • Digital rectal exam performed every year after age 50.
  • Fecal occult blood test performed once a year, every year after age 50.
  • Flexible sigmoidoscopy performed every 3 to 5 years beginning at age 50.
  • Colonoscopy performed once every 10 years starting at age 50.
  • Air contrast barium enema performed once every 5 to 10 years starting at age 50.

Sigmoidoscopy, colonoscopy and barium enema are interchangeable. Your doctor will recommend which screening test is best for you. However, colonoscopy is the most accurate and offers the possibility of treating polyps at the time they are found.

People with known risk factors for developing colorectal cancer should be screened more frequently and at a younger age. Some screenings may be recommended as early as puberty.

"The biggest challenge to successful preventive colorectal cancer screening is avoidance and denial," said Dr. Dan Smilkstein, family practice physician and director of Community Health and Wellness at Yampa Valley Medical Center. "As with most things, the stigma and fear of the exams are far worse than the reality.

"The digital rectal exam should be part of every annual physical exam past age 50. Stool testing for hidden blood is painless, cheap and can be done in the privacy of your own home," he said.

"The more invasive tests such as barium enema or colonoscopy are not as bad as people may think. For the majority of people, if you follow recommendations and survive to age 90, you may be fortunate enough to undergo these procedures four times during your life. If you are one of the minority who have an abnormal test, then the scope may be the instrument that allows you to survive until 90 years old," Smilkstein said.

Betsy Kalmeyer, MPH, PA-C, is a Wellness Counselor at Yampa Valley Medical Center.

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