March is colorectal cancer awareness month. That makes March a good time for readers new and old to get up to speed on the major issues regarding this deadly and often preventable disease.
But before we get into the details, this March also marks the 4th anniversary of Retroflexions! That’s right, this site has been going strong since March 1, 2015. You are currently reading our 112th article published on the site, and we are currently averaging about 3,000 page-views per day from 2,000 individual users per day. Not terrible for a site that I occasionally write stuff for in my spare time!
OK, now back to the topic of colorectal cancer. Let’s summarize some of the basic (and not so basic) things about the disease. Instead of writing a long boring article, here are the simple bullet points you should know to consider yourself “aware.” If you want more info, click on any of the links to read a full article about the topic. OK, ready? Here we go:
- Roughly 1 in 22 men and 1 in 24 women will develop colon cancer in their lifetime. If we consider both men and women with colon cancer, it becomes the second leading cause of cancer-related deaths in the US. Colorectal cancer is expected to cause about 51,000 deaths in 2019.
- Most people should start getting screened for colorectal cancer at age 50. This applies to men and women equally. This applies to people without any family history of colon cancer.
- The American Cancer Society thinks that 50 years old is too old to start screening, and that people should get screened starting at age 45 instead. I offer this to motivated patients, and often find polyps with these younger screenings. Sometimes you also just get lucky and find precancerous polyps in very young patients.
- Colonoscopy is the best screening test because it can both diagnose and prevent colon cancer. Removing precancerous polyps is the way colonoscopy prevents colon cancer.
- Not all doctors that perform colonoscopy will confer the same cancer prevention benefit to their patients: It’s important to find a doctor with a high “adenoma detection rate.”
- Colonoscopy is also somewhat costly on the healthcare system but getting the best of anything usually isn’t cheap.
- A negative (normal) colonoscopy, under the right circumstances, doesn’t really need to be repeated for ten years!
- If polyps are found on a colonoscopy, patients are usually brought back in 3-5 years to repeat a colonoscopy, instead of waiting 10 years.
- A stool test called Cologuard is a decent alternative to colonoscopy if all you’re interested in is seeing if you have cancer at the current time. Cologuard is easy and noninvasive, but suffers from many false-positives, and misses polyps routinely.
- Most people can stop screening for colorectal cancer sometime between the ages of 75 to 85. This only applies to people who have kept up-to-date with screening in the past, and don’t have a personal history of polyps or cancer, or a strong family history or colon cancer, or some other exception.
- There are several diet choices that people can make to increase or decrease their chances of getting colorectal cancer. Diets rich in red meats and processed meats seem to increase the risk. Diets rich in processed foods are also associated with cancer. Alcohol use, even 1-2 glasses per day, is strongly associated with developing colorectal cancer and is an even stronger risk factor than smoking! Fermented foods may decrease colorectal cancer risk. Fruits, vegetables, and plain old healthy eating may also decrease the risk.
- Aspirin and NSAIDs seem to decrease the risk of developing colon cancer and polyps.
- Obesity increases the risk of colorectal cancer. Exercise is a good way to reduce the risk of developing colon cancer, independent of any loss of weight that occurs from exercising!
- It’s OK to “cheat” on the colonoscopy prep like I did when I had my first colonoscopy!
- If you’re in the middle of a bowel preparation for a colonoscopy and something is not working, you can figure out what to do by reading this article.
I’ve written a lot about colorectal cancer here over the past four years, and there is always more to learn. Later this month there will be an article focusing on the interesting topic of colorectal cancer in the younger population. We know that more and more people are getting the disease earlier than 50 years old, and this population wouldn’t really be protected by routine screening colonoscopy since the test usually isn’t recommended until age 45 or 50. What is responsible for this trend? Is it our diet, environment, use of prescription drugs like antibiotics, sedentary lifestyle, or some other factor? I can’t definitively answer that question because the answer really isn’t known, however there have been some interesting studies recently that can help shed some light onto what we should be doing to help prevent colorectal cancer in younger people.
Also, watch out for my #StrongArmSelfie coming later this month. You can learn more about this easy and fun fundraiser at Fight Colorectal Cancer, but all you really have to do is flex your biceps for the camera, post it on social media with the tag #StrongArmSelfie, and get people to share it. Each share earns a dollar to help fund the fight against colorectal cancer! (Plus it gives you an excuse to flex your massive guns!)
About Frederick Gandolfo, MD
