Colon cancer also called colorectal cancer, is a malignancy that begins in the large intestine or rectum, the final part of the digestive tract. It usually starts with noncancerous clumps of cells called polyps that develop inside the colon. Eventually, some of these polyps can become cancerous.
How Common is Colon Cancer?
Colon cancer has unfortunately become highly prevalent today. According to the Centers for Disease Control and Prevention (CDC), colorectal cancer is the fourth most common cancer in the United States, excluding skin cancers. (1) It is also the third leading cause of cancer-related deaths in men and women. (2)
What Are My Odds of Developing Colorectal Cancer?
The American Cancer Society says, "The lifetime risk of developing colorectal cancer is: about 1 in 23 (4.3%) for men and 1 in 25 (4.0%) for women." (3)
However, your odds of developing colon cancer depend upon the various risk factors discussed below.
Signs and Symptoms of Colon Cancer
Many people do not have any symptoms until the latter stages of this disease, which is why it is essential to have regular colorectal cancer screenings.
Symptoms of colorectal cancer may include:
- Diarrhea
- Constipation
- Persistent change in bowel habits
- A change in the consistency of your stool
- Abdominal pain or cramping
- Anemia, caused by internal bleeding
- Blood in the stool, possibly making it look dark brown or black
- Rectal bleeding with bright red blood
- Bloating
- Fatigue
- Unexplained weight loss
- A feeling that your bowel never empties completely
- Weakness
The symptoms above don't necessarily signal colon cancer. These symptoms fit numerous gastrointestinal disorders like irritable bowel syndrome, inflammatory bowel disease, hemorrhoids, diverticulitis, infections, etc.
So, it's a good idea to see your doctor if you persistently experience any of these symptoms.
What Are the Causes of Colon Cancer?
The exact cause of colorectal cancer has not been established.
Like all cancers, colon cancer begins with changes in the cells' DNA, causing them to grow out of control, eventually forming a tumor in the colon or rectum as they accumulate. (4)
Colon Cancer Risk Factors
Though the cause of colon cancer is unknown, several factors may increase your risk of developing this disease.
Age. Though colon cancer can occur at any age, it is more common in those older than 50. This is why a regular colorectal cancer screening is recommended for everyone 50 and older. However, there is a disturbing trend of younger people developing this disease, so these age recommendations may need to be adjusted in the future.
Family history of colorectal cancer. Your risk of colon cancer nearly doubles if you have a family history. Like many diseases, you have an increased risk of colon cancer if a blood family member has had this disease. The risk is even greater if more than one blood relative has had colorectal cancer. (5)
Personal history of colon cancer or polyps. Having benign (noncancerous) polyps or colon cancer in the past increases your risk of developing it in the future.
Low-fiber diet. A lower fiber diet is associated with colon cancer development in numerous studies. The reason for this potential effect has not been established, but experts believe a low-fiber diet slows the elimination process, thus exposing your intestines to carcinogens for extended periods. On the other hand, a high fiber diet speeds the rate at which waste travels through your colon, leaving less time for carcinogens to affect your intestinal cells. (6)
Obesity. Statistics vary, but one epidemiological data suggests that obesity may increase the risk of colon cancer in men by 30% to 70%. (The association between obesity and colon cancer is not as consistent for women.) (7) In addition, there is an association between obesity and increased risk of more advanced-stage colorectal cancer on presentation, especially for men. (8) And finally, obesity increases the risk of dying from this disease.
Inactivity. Several studies show that regular physical activity reduces the risk of colon and rectal cancer, and a higher rate of physical activity leads to a more significant decline in colon cancer risk. (9)
Inflammatory bowel disease. Chronic inflammation of the colon, as occurs with IBS, has been found to increase the risk of colon cancer. The primary inflammatory bowel diseases are Crohn's disease and ulcerative colitis.
Diabetes. Insulin resistance and diabetes have been linked to a higher risk of colorectal cancer. In one study, veterans with type 2 diabetes were approximately one-third more likely to develop colon cancer than those without diabetes. (10)
Smoking cigarettes. The link between cigarette smoking and colon cancer is not definitive. However, multiple studies show a clear link between smoking and the formation of colon polyps, also called adenomas. Though most adenomas are benign (noncancerous), up to 10% of them can become cancerous. (11) In other words, adenomas are forerunners and risk factors for colorectal cancer.
Race. African Americans have a 20% higher risk of colon cancer than other races. They also face a 45% higher mortality rate from this disease. (12)
Alcohol usage. Alcohol usage is associated with a higher risk of colon and rectal cancer, especially in men.
How to Prevent Colon Cancer
Colon cancer screening
Regular screenings are the best way to prevent colorectal cancers, and early detection is the best way to survive this type of cancer.
After all, according to the National Cancer Institute, "Finding and removing polyps can prevent colorectal cancer." (13)
The only way to find and remove these polyps is to get regular checkups and colon cancer screening. There are several types of colon cancer screening tests available.
Colonoscopy
A colonoscopy is an imaging test in which a long, flexible tube with a tiny video camera is inserted into the rectum to allow the doctor to view the entire colon and rectum for inflammation, polyps, cancer, and other irregularities. Polyps and tissue samples (biopsies) can be removed through the scope during the procedure.
The procedure takes 30 to 60 minutes and should be performed every 10 years starting at age 50. The American Cancer Society recommends that those at average risk of colorectal cancer start regular screening at age 45. (14)
Colonoscopy is the most sensitive colorectal cancer screening test in the United States.
Stool DNA Test
A stool DNA test uses a stool sample to look for DNA cell changes and blood that may signal colorectal cancer or precancerous polyps.
For this test, you simply collect a sample at home and then mail it to a laboratory to be tested. A stool DNA test is usually repeated every 3 years.
A stool DNA test is easy and convenient, but it is not as sensitive as a colonoscopy in detecting cancer and precancerous polyps.
A fecal occult blood test or fecal immunochemical test
These tests are used to check stool samples for hidden blood. You collect the sample at home and ship it to a lab for testing.
A fecal occult blood test or fecal immunochemical test is usually required annually.
Like a stool DNA test, a fecal occult blood test or fecal immunochemical test is not as sensitive as a colonoscopy.
Virtual colonoscopy (CT colonography)
According to the Mayo Clinic:
"During a virtual colonoscopy, a CT scan produces cross-sectional images of the abdominal organs, allowing the doctor to detect changes or abnormalities in the colon and rectum. To help create clear images, a small tube (catheter) is placed inside your rectum to fill your colon with air or carbon dioxide." (15)
This procedure takes around 10 minutes and should be performed every five years.
Colon Cancer Treatment
There are 4 main colon cancer treatments.
- Surgery to remove the tumor.
- Radiation therapy to kill cancer cells
- Chemotherapy to kill cancer cells
- Targeted therapy, such as monoclonal antibody therapy, to target specific molecules in cancer cells
The type of colorectal cancer treatment option chosen depends upon the cancer stage.
Natural Ways to Reduce Colon Cancer Risk
Improve Diet Quality
Enjoying a high-quality diet is one of the best ways to reduce colorectal cancer risk.
Eat a Colorful Diet
Eat a variety of different colored fruits and vegetables each day.
Why is color important? Plants contain phytonutrients (pigments) that give them their color. These phytonutrients provide various health benefits. So, eating a variety of different colored fruits and veggies ensures you're getting high levels of these nutrients, which among other things, help strengthen the immune system.
Excellent options include:
- Artichoke
- Asparagus
- Broccoli
- Carrots
- Cauliflower
- Green beans
- Orange
- Peach
- Kale
- Blueberries
- Spinach
- Strawberries
Increase Fiber Intake
Getting enough dietary fiber promotes bowel regularity, removes toxins from the gastrointestinal system, and may decrease the risk of colon and rectum cancer. It can also help you maintain a healthy weight, another factor that can reduce your risk of colorectal cancers.
Remember to gradually increase your fiber intake to avoid digestive system discomfort, such as bloating and gas.
Reduce or Eliminate Ultra-Processed Foods
Ultra-processed foods are made in a lab and filled with artificial colorings/flavorings, preservatives, chemicals, added sugars, trans fats, etc. They also contain little to no fiber.
Common ultra-processed foods include:
- Potato chips
- Cookies
- Candy
- Pastries
- Instant noodles
- Soda and carbonated drinks
- Microwave-ready meals
- Hot dogs
- Fast food
Get Regular Exercise
Try to get at least 30 minutes of exercise nearly every day of the week. Remember to start slowly, gradually building up to 30 minutes of exercise at a time. Increase the time before increasing intensity.
For example, start with 5-10 minutes of a slow-paced exercise, then gradually increase the time until you reach at least 30 minutes. Once you can exercise pretty easily for 30 minutes, gradually increase the intensity until you gain moderate- to high-intensity.
Always check with your healthcare provider before starting an exercise program.
Lose Weight or Maintain a Healthy Weight
If you're overweight, dropping a few pounds can help reduce the risk of colon cancer. You can lose or maintain a healthy weight by combining a high-quality diet with regular physical activity.
Don't worry about slashing calories. Studies show that calorie quality is much more important than the number for health and weight. So you may be surprised that when you enjoy a high-quality diet, you'll automatically eat few calories than you did previously because high-quality calories satisfy your hunger and reduce food cravings.
Speak to your doctor or a nutritionist for additional dietary strategies to help you drop some pounds.
Stop Smoking
Quitting smoking can be difficult, but it is one of the best things you can do to ensure the health of your colon and rectum and reduce cancer risk.
Drink Alcohol in Moderation
Limit the amount of alcohol you drink. The Mayo Clinic recommends that women have no more than one alcoholic beverage per day, two for men. (16)
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References
1- https://www.cdc.gov/cancer/colorectal/statistics/index.htm
4- https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669
8- https://pubmed.ncbi.nlm.nih.gov/24918610/
13- https://www.cancer.gov/types/colorectal
16- https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669
