UCLA offers 10 tips to lower colorectal cancer risk

March is Colorectal Cancer Awareness Month. In view of this, UCLA experts are offering 10 tips to reduce your risk. They note that colorectal cancer the second leading cause of cancer death. “Colorectal cancer surpasses breast and prostate cancers as a leading cause of cancer death in men and women,” said Dr. James Yoo, assistant professor of surgery and chief of the colon & rectal surgery program at the David Geffen School of Medicine at UCLA. He added, “It is largely preventable with early screening and detection.”

10 Tips to Lower Your Risk of Colorectal Cancer:

  1. Receive regular colorectal cancer screenings beginning at age 50 if you are at normal risk.
  2. If you are at higher risk, due to a personal or family history of colorectal cancer, other cancers or inflammatory bowel disease, talk to your doctor about screenings before age 50.
  3. Eat between 25 and 30 grams of fiber each day: from fruits, vegetables, whole grain breads and cereals, nuts, and beans.
  4. Eat a low-fat diet. Colorectal cancer has been associated with diets high in saturated fat.
  5. Eat foods with folate, such as leafy green vegetables.
  6. Drink alcohol in moderation and quit smoking. Alcohol and tobacco in combination are linked to colorectal cancer and other gastrointestinal cancers.
  7. Exercise for at least 20 minutes three to four days a week. Moderate exercise such as walking, gardening or climbing stairs may help reduce your risk.
  8. Report to your doctor any persistent symptoms such as blood in the stool, a change in bowel habits, weight loss, narrower-than-usual stools, abdominal pains or other gastrointestinal complaints.
  9. Maintain a healthy weight. Obesity may increase the risk of colorectal cancer.
  10. For more information, please visit the Web site of the American Cancer Society at this link.

Colon, or colorectal, cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Almost all colon cancer starts in glands in the lining of the colon and rectum. When most people and when doctors talk about colorectal cancer, this is generally what they are referring to. There is no single cause for colon cancer. Nearly all colon cancers begin as noncancerous (benign) polyps, which slowly develop into cancer.

You have a higher risk for colon cancer if you:

  • Are older than 60
  • Are African American and eastern European descent
  • Eat a diet high in red or processed meat
  • Have cancer elsewhere in the body
  • Have colorectal polyps
  • Have inflammatory bowel disease (Crohn's disease or ulcerative colitis)
  • Have a family history of colon cancer
  • Have a personal history of breast cancer
  • Certain genetic syndromes also increase the risk of developing colon cancer. Two of the most common are hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, and familial adenomatous polyposis (FAP).

What you eat may play a role in your risk of colon cancer. Colon cancer may be associated with a high-fat, low-fiber diet and red meat. However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear. Smoking cigarettes and drinking alcohol are other risk factors for colorectal cancer.

Symptoms:

  • Many cases of colon cancer have no symptoms. The following symptoms, however, may indicate colon cancer:
  • Abdominal pain and tenderness in the lower abdomen
  • Blood in the stool
  • Diarrhea, constipation, or other change in bowel habits
  • Intestinal obstruction
  • Narrow stools
  • Unexplained anemia
  • Weight loss with no known reason

Signs and tests:

  • With proper screening, colon cancer can be detected before symptoms develop, when it is most curable.
  • Your doctor will perform a physical exam and press on your belly area. The physical exam rarely shows any problems, although the doctor may feel a mass in the abdomen. A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.
  • A fecal occult blood test (FOBT) may detect small amounts of blood in the stool, which could suggest colon cancer. However, this test is often negative in patients with colon cancer. For this reason, a FOBT must be done along with colonoscopy or sigmoidoscopy. It is also important to note that a positive FOBT doesn't necessarily mean you have cancer.

Imaging tests to diagnose colorectal cancer include:

  • Colonoscopy
  • Sigmoidoscopy (Note: Only colonoscopy can see the entire colon)

Blood tests that may be done include:

  • Complete blood count (CBC) to check for anemia
  • Liver function tests
  • If your doctor learns that you do have colorectal cancer, more tests will be done to see if the cancer has spread. This is called staging. CT or MRI scans of the abdomen, pelvic area, chest, or brain may be used to stage the cancer. Sometimes, PET scans are also used.

Stages of colon cancer are:
Stage 0: Very early cancer on the innermost layer of the intestine
Stage I: Cancer is in the inner layers of the colon
Stage II: Cancer has spread through the muscle wall of the colon
Stage III: Cancer has spread to the lymph nodes
Stage IV: Cancer has spread to other organs

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, LA Health Examiner

Robin Wulffson is a California native and a graduate of the UCLA School of Medicine. He is a Diplomate of the American Board of Obstetrics and Gynecology and a Lifetime Fellow of the American Board of Obstetrics and Gynecology. He served as a battalion surgeon with the 2/77th Artillery, 25th...

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