Prevent Colon Cancer by Assessing Your Risk 8 Signs of Colon Cancer and When It’s Time to See a Doc

Afraid of getting a colonoscopy? The prep isn't as bad as you think – and the screening is more important than you know. Learn the risk factors to best prevent colon cancer in you or someone in your family... Just the word “colonoscopy” makes people cringe. The procedure, which involves having a video camera inserted into your colon to examine it for precancerous polyps or clumps of cells, sounds terrible. So does the preparation – a diet of Jell-O and laxatives – the day before. (It’s needed so the doctor can examine the bowel’s walls for polyps and other abnormalities.) But let’s face it: A day of discomfort is nothing compared with the chemotherapy and radiation used to treat cancers of the colon and rectum. Death rates from colorectal cancer have been dropping for more than 20 years, thanks to increased screening, but it’s still a leading killer: In 2009, more than 71,000 new cases of colorectal cancer were diagnosed among American women. A colonoscopy is the best way to catch colorectal cancer early. In fact, regular screenings can cut deaths by one third, the American Gastroenterological Association (AGA) estimates. As for the pain: You’re usually put under anesthesia so you won’t feel a thing. Plus, most people need the test only every 10 years after age 50, according to AGA’s recommendations. But fear of the prep and procedure are just two of the top reasons for avoiding colonoscopies, according to the Colon Cancer Coalition. Many women also assume they’re in the clear because they have no symptoms or family history of colon cancer. Not true. Here are 8 reasons to schedule your colonoscopy now: 1. Colon cancer runs in the family. The No. 1 risk factor? “A family history of colon cancer, particularly in first-degree relatives – mother, father, brothers, sisters,” says gastroenterologist Whitney Jones, M.D., a clinical professor of medicine at the University of Louisville in Kentucky. Even second-degree relatives – aunts, uncles, grandparents, half-siblings – can increase your risk, she says. For example, if your mom got colon cancer at 45, you should be screened for the first time at 35. “You should be tested 10 years before the age your relative got colon cancer, or at 40, whichever comes first,” says Richard Desi, M.D., a gastroenterologist at the Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. 2. You’ve reached your golden years. Unfortunately, “the older we are, the more likely we are to develop colon cancer,” says gastrointestinal oncologist Supriya Mohile, M.D., M.S., assistant professor of medicine at the University of Rochester Medical Center in New York. People 65 and older are most likely to get colorectal cancer, in part, because it takes almost a lifetime for cells to become cancerous. 3. You love red meat. Your triple cheeseburger will do more than just pack on pounds. If you eat lots of animal meats and not enough greens, you’re at risk for colon cancer. It may be meat’s higher fat content. “Colorectal cancer is less common in less developed countries,” Jones says. “People in Western countries with a higher fat diet have an increased risk.” A 2008 study of 600 people at the University of North Carolina found that those who ate the highest amount of trans fat – partially hydrogenated vegetable oil found in many baked goods – had an 86% increase in colorectal cancer risk compared with those who ate the least. To cut your risk and prevent colon cancer, eat lots of high-fiber fruits and vegetables, whole grains and lean proteins, such as fish and chicken. 4. You’re big and beautiful. Unfortunately, big may mean trouble. For women, the correlation could be even higher: A 2007 study of 1,200 women at Stony Brook University in New York found that a body mass index (BMI) of 30 or over doubles the risk of colorectal cancer. To check your BMI, use Lifescript’s calculator. 5. The couch is your best friend. See a pattern here? Poor diet, obesity, lack of exercise – basically not taking care of yourself – significantly boosts your risk. A 2009 Washington University School of Medicine review of 52 studies since 1984 found that men and women who exercise the most are 24% less likely to get colon cancer than those who exercise the least. The most active women exercised 5-6 hours a week, the least active a half hour a week. A woman in good shape should get about 30 minutes of cardiovascular exercise, such as swimming, running or walking, at least three times a week. But “anything that gets the cardiovascular system up and running seems to help,” Desi says. “Just get out and do some physical activity every day.” 6. You go to town on the hard stuff. “When you drink, you’re more likely to develop carcinogens [the substances that cause or exacerbate cancer],” Mohile says. “Smoking’s related for the same reason.” But what you drink may matter as much as quantity. A 2005 Stony Brook University study found that heavy drinkers – those who consumed more than 8 drinks of hard liquor or beer a week – had 2.5 times the risk of developing colon cancer than those who rarely drank. Wine’s a different story: Moderate and heavy wine drinkers were about 46% less likely to get colon cancer than abstainers. Antioxidants like resveratrol may protect against the disease, researchers speculate. 7. You’re avoiding screenings. Colon cancer doesn’t show symptoms – bleeding in the stool, anemia, abdominal pain, bowel changes like constipation or a change in stool size – until it’s often too late. Early screening is essential, says Jones. “It takes 10-15 years to grow from a polyp to cancer,” Desi says. Plus, small polyps found during the exam can be removed so they don’t develop into colorectal cancer. (If you’ve had colon cancer or polyps in the past, your doctor probably will recommend more frequent screenings because you’re more likely get them again.) “But if you undergo screening regularly, exercise and eat healthily, you can lower your risk by 90%,” Mohile says. Colonoscopies are the gold standard for colorectal screenings, but there are other options: Virtual colonoscopy This new procedure involves a CAT (computerized axial tomography) scan that produces images of the colon and polyps. The good: Unlike a colonoscopy, you don’t have to be sedated, so it's an option for people who can’t tolerate anesthesia. The bad: It exposes you to radiation and you still have to cleanse your bowels the day before. Plus, if a polyp is found, you’ll need a full colonoscopy to remove it anyway, says Desi. Because small polyps aren’t seen in a virtual colonoscopy, it can still leave you at risk for colorectal cancer and you’d have to repeat it in five years, she says, versus every 10 years for colonoscopies. Flexible sigmoidoscopy A doctor examines the last third of the colon, called “descending,” and rectum with a video camera on a scope. The good: It’s an office procedure that doesn’t require sedation. The bad: It doesn’t examine the entire colon, so problems in other parts will be missed. You’ll have to cleanse your bowels, though this test requires less prep time – usually 2 hours prior – and, if a polyp is found, you’ll still need a colonoscopy. Fecal occult blood test (FOBT) You’ll need to provide a stool sample that’s sent to a lab to check for blood. Bloody stools can mean polyps and cancerous tumors. The good: It’s not a colonoscopy replacement, but is offered by some doctors as an extra precaution starting at age 50. "It’s been shown to be helpful and it’s cheap,” says Desi, costing under $50 per test. The bad: It can check for – but doesn’t diagnose – colorectal cancer because “it’s not a sensitive and specific test,” Desi says. Plus, you have to give up non-steroidal anti-inflammatory drugs (NSAID) like ibuprofen (Advil) seven days before testing and vitamin C or red meat three days prior. A newer version, the fecal immunochemical test (FIT), doesn’t have dietary and drug restrictions and is less likely to react to blood from other parts of the digestive tract. If you have a choice, pick this. Barium enemas are another option, but they’re usually used to diagnose bowel disorders such as Crohn’s disease, not colon cancer. A technician fills the bowels with barium, a contrast dye, which on an X-ray creates an image of the colon and rectum. Talk to your doctor about which is the right option for you to help prevent getting colon cancer. 8. You have other digestive diseases. Inflammatory Bowel Disease (IBD), an umbrella term for both Crohn’s disease and colitis, significantly raises the risk of colon cancer, says Jones. “And the risk tends to increase, depending on how long you’ve had the disease,” he says. Why? Inflammatory conditions may change the cells’ DNA, he says. Most doctors begin looking for precancerous changes 7-10 years after someone develops IBD.