Colon cancer, also referred to as colorectal cancer, is a malignancy that originates in the colon or rectum, integral components of the digestive system. It ranks among the most prevalent cancers globally. While it is not possible to completely prevent colon cancer, certain lifestyle modifications may help lower the risk.
Orpheus (Mattisse) Hamilton, MSN, APRN, AGNP, is a Nurse Practitioner in the Department of Surgery, working in the areas of colorectal and general surgery. She regularly educates patients about the risk factors for colon cancer and when to get screened.
Modifiable Risk Factors for Colon Cancer
“Several lifestyle-related factors have been associated with an increased risk of colorectal cancer,” Hamilton says. These include:
- Weight management: Being overweight or obese is linked to a higher risk. Maintaining a healthy weight may help mitigate this risk.
- Physical activity: Engaging in regular moderate to vigorous exercise, ideally achieving 150 minutes per week, can contribute to risk reduction.
- Dietary choices: Diets high in red and processed meats are associated with an elevated risk of colorectal cancer. Cooking methods such as frying, broiling, and grilling may also increase this risk. A healthy diet should include ample fruits, vegetables, and whole grains.
- Smoking: Tobacco use is associated with multiple cancers, including lung cancer.
- Alcohol consumption: Moderate to heavy alcohol intake is linked to colorectal cancer.
Non-Modifiable Risk Factors for Colon Cancer:
Certain factors that cannot be changed are associated with an increased risk:
- Age: The risk of developing colorectal cancer increases with age.
- Personal medical history: Individuals with a history of colorectal polyps or colorectal cancer are at higher risk.
- Inflammatory bowel disease: Conditions such as ulcerative colitis or Crohn's disease elevate the risk.
- Family history: A family history of colorectal cancer or adenomatous polyps raises the risk. If a first-degree relative (parent, sibling, or child) has had the disease, your risk is increased.
- Inherited Syndromes: Conditions such as Lynch syndrome and Familial Adenomatous Polyposis (FAP) heighten the risk.
- Ethnicity: Certain populations, including American Indian and Alaska Native individuals, have the highest rates of colorectal cancer in the United States, followed by African American men and women. Eastern European Jews also show a significantly elevated risk.
- Type 2 Diabetes: This condition is associated with an increased risk of colorectal cancer and is often related to factors such as age, lifestyle, diet, and genetics.
Recent Updates in Colon Cancer Research and Treatment
“The landscape of colon cancer research and treatment is continuously evolving,” Hamilton says. Key recent updates include:
- Screening guidelines: Many organizations now recommend initiating regular screenings at age 45, a decrease from the previous recommendation of 50, to facilitate early detection.
- Genetic testing: Innovations in genetic testing are enabling the identification of individuals at higher risk for colon cancer, allowing for earlier intervention and personalized prevention strategies.
- Immunotherapy: Research into immunotherapy treatments for colon cancer is expanding, particularly for patients with specific genetic markers such as MSI-H (microsatellite instability-high) or MMR (mismatch repair) deficiency.
- Microbiome research: Studies are investigating the gut microbiome's influence on colon cancer development, with evidence suggesting that certain bacteria may affect cancer risk and treatment responses.
- Targeted therapies: Development of new targeted therapies is focusing on specific mutations like KRAS and BRAF, potentially improving outcomes for patients with advanced colon cancer.
- Adjuvant treatments: Ongoing clinical trials are examining the efficacy of combining various treatment modalities, such as chemotherapy and targeted therapy, to enhance patient outcomes following surgery.
The American Cancer Society estimates approximately 106,590 new cases of colon cancer and 46,220 new cases of rectal cancer this year. Although incidence rates have declined since the mid-1980s, new cases of colorectal cancer continue to emerge. Prevention and awareness are paramount.
“In my practice, I have observed numerous individuals with colorectal cancer who have survived and returned to a normal life thanks to early detection through colonoscopy. If you experience any unexplained bleeding, it is crucial to seek evaluation rather than assuming it is due to hemorrhoids or another benign cause,” Hamilton says.
She adds, those at risk and have not undergone a colonoscopy should consider scheduling one soon. While tests such as Cologuard can aid in the detection of colorectal cancer, they should not replace colonoscopy, which remains the gold standard for prevention.
References:
American Cancer Society. Cancer Facts & Figures 2023. Atlanta, Ga: American Cancer Society; 2023.
American Cancer Society. Colorectal Cancer Facts & Figures 2023-2025. Atlanta, GA.
National Cancer Institute. Genetics of Colorectal Cancer (PDQ®)–Health Professional Version. 2023. https://www.cancer.gov/types/colorectal/hp/colorectal-genetics-pdq#link/_2606. Accessed Jan 29, 2024.
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