Are you at risk for colorectal cancer?

Colorectal cancer rates in people under 50 have been on the rise the past few decades. It’s also the second-leading cause of cancer-related deaths in the U.S. when numbers for men and women are combined.

“Colorectal cancer is a largely preventable disease, yet it remains one of the most common cancers worldwide,” says MultiCare colorectal surgeon Gabriela Vargas, MD. “Understanding and addressing your risk factors can significantly reduce the likelihood of developing this disease.”

When colorectal cancer develops, it can occur in any part of the colon or rectum, which together are about 5 1/2 feet in length. These structures make up the large intestine — the last step of the digestive process responsible for turning digested food into stool and moving it out of your body.

Because what you consume ultimately travels through this part of your body, could your eating and drinking habits contribute to a potentially higher risk of colorectal cancer?

Factors that increase your risk, but can be changed

There is no definitive cause of colorectal cancer, but there are risk factors that increase the likelihood of the disease.

If your diet is high in fat and low in fiber, you may be putting your colon at risk.

Regular consumption of red and processed meats is also associated with an increased risk of colorectal cancer. Processed meats have been preserved by curing, salting, smoking or adding chemical preservatives — like deli meat, bacon, ham, pepperoni, salami, sausage (including hot dogs) and beef jerky.

Are you a smoker? Do you drink alcohol regularly? Smoking tobacco and moderate to heavy alcohol use have both been linked to colorectal cancer.

Leading a sedentary lifestyle is also higher risk, says Laila Rashidi, MD, a colorectal cancer surgeon at MultiCare.

Risk factors out of your control

While maintaining a healthy diet, quitting smoking, limiting alcohol and staying active are within your control, there are risk factors you can’t change. These include:

• Being male: Men are more likely to die from colorectal cancer than women
• A family history of colorectal cancer
• Genetic syndromes, including Lynch syndrome and familial adenomatous polyposis
• Being American Indian, Alaska Native, African American or having Ashkenazi Jewish descent
• Chronic inflammatory bowel conditions, such as Crohn’s disease and ulcerative colitis

What are my options for colorectal cancer screening?

Like going to the dentist or having an annual physical, getting screened for colorectal cancer can feel like a chore you’d rather put off. But colorectal cancer screenings are vital in detecting cancer early — and can save your life.

The type of screening test you get comes down to your level of risk, medical history, access, preference and insurance coverage. It’s important to discuss with your doctor or other health care provider which screening is right for you.

“Regular screening is one of the most powerful tools we have, as it allows us to detect and remove precancerous polyps before they turn into cancer,” Dr. Vargas says.

Colonoscopy is the most well-known screening test for colorectal cancer due to its accuracy and thoroughness. Colonoscopies are recommended every 10 years, starting at age 45 for someone with average risk. The procedure is most often covered by insurance.

“Colonoscopy is the gold standard for a reason,” Dr. Rashidi adds. “It fully evaluates the colon, and if polyps are found, they can be removed on the spot.”

You may opt for virtual colonoscopy, which uses a CT scan to take pictures of your colon and rectum rather than using a scope like a traditional colonoscopy — so it’s less invasive and doesn’t require you to be under anesthesia. However, you’ll still need to do the bowel prep, and the test is needed every five years. In addition, if polyps are found, you’ll need to undergo a regular colonoscopy to get those removed.

Flexible sigmoidoscopy is another procedure that doesn’t require sedation, but you’ll need to do it every five years. The main drawback is that it is less thorough than a colonoscopy, as it does not examine the entire colon — only the lower third.

At-home tests

At-home tests are convenient and private, and they don’t require sedation or bowel prep. However, they are not as thorough as a colonoscopy, and you’ll need to test more regularly — every three years for stool DNA tests and every year for fecal immunochemical tests (FIT) and fecal occult blood tests (FOBT). And if you test positive, you’ll still need to get a colonoscopy.

As the name suggests, an at-home test requires you to collect a stool sample at home and send it to a lab for testing.

The stool DNA test looks for DNA markers for colorectal cancer and for blood in your stool. FIT and FOBT only check for blood in the stool.

“These tests are sensitive, but not specific,” says Dr. Rashidi. “If someone doesn’t have access to colonoscopy, it is a good option. It’s better than not getting screened at all.”

Pay attention to any unusual symptoms

As a reminder, screenings are only for those who aren’t experiencing symptoms. Please see your provider if you have symptoms like abdominal pain, rectal bleeding or changes in your bowel habits.

“Look out for symptoms and pay attention to your body,” Dr. Rashidi advises. “If you notice any change to your bowel habits or if you see blood mixed with stool, don’t assume that it’s hemorrhoids. If you feel something wrong is going on, ask your primary care provider for a workup.”

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