Every year, healthcare providers and communities across the United States spend the month of March promoting awareness of colorectal cancer (CRC), stressing the importance of early screening and prevention. Since implementation of early screening in the 1970s, the incidence and mortality rates have decreased substantially in older adults. Unfortunately, in more recent years we have started to see the overall incidence plateau or slightly increase due to more younger adults being diagnosed. As a result, the US Preventive Services Task Force has adjusted recommendations to begin screening adults of average risk at 45 years of age (previously 50 years of age). The decision to screen those beyond 75 years of age should be made on an individual basis. It is imperative for adults, both young and old, to be familiar with risk factors, symptoms, and resources to prevent this disease and save lives.
Did you know?
According to the American Cancer Society, CRC is the third most common cancer diagnosed in men and women in the US with about a 4% lifetime risk.1 It is the second leading cause of cancer deaths worldwide,2 however early screening is saving lives. CRC is highly preventable with timely screening and removal of precancerous polyps, as survival rates near 90% with a diagnosis of localized disease.3 A great majority of CRCs develop from precancerous polyps that can take on average over 10 years to evolve to cancer,3 so the earlier they are detected and removed, the better.
A rise in mortality in adults under the age of 50 has prompted experts to recommend screening begin at age 45. The reason for the rise in mortality is not well understood, however increasing evidence is showing that unfavorable lifestyle factors may be contributing. Some risk factors are not modifiable such as family history/genetics, race, history of inflammatory bowel disease, age, or previous radiation to the abdomen or pelvis. However, about 55% of CRC diagnoses in the US are thought to be attributed to the following modifiable risk factors:3
Sedentary lifestyle. Maintaining an active lifestyle has a strong association with reduced risk for colon cancer (about 25% lower), however not for rectal cancer.3 The American Cancer Society recommends at least 150 to 300 minutes of moderate intensity activity or 75 to 150 minutes of vigorous intensity activity per week.
Diet. Consuming a diet high in red or processed meats, refined carbohydrates, or processed sugar has higher potential to increase inflammation and is associated with higher CRC risk.2,3 Following a healthy diet with a variety of fruits and vegetables, whole grains, lean protein, and dairy products is likely to reduce risk.
Overweight/Obesity. Increased risk is shown with excess body weight, up to 50% higher risk for men and 10% for women.3 Maintaining a healthy body weight can help lower the risk of CRC.
Smoking. The well-known cause of lung cancer is also linked to many other cancers, including CRC. Current or former smokers are at about 50% higher risk than nonsmokers.3 Quitting may seem daunting, but there are plenty of free resources available for help.
Alcohol. Light to moderate alcohol consumption increases risk for CRC, even more so for moderate to heavy drinking. Abstaining from alcohol consumption can decrease risk for many kinds of cancers, among other health benefits.
Compared to those with less favorable behaviors, several studies have shown that maintaining a healthy lifestyle has a 27% to 52% lower risk of CRC.3 Modifying risk factors and participating in early screening can prevent the development of CRC and save lives. Be an advocate for routine screening in your community to beat this disease and speak to your personal physician about your own risk and optimal time for screening.
Kim Meeuwsen, RDN, CSOWM is a registered dietitian and Certified Specialist in Obesity and Weight Management from West Michigan. Kim has over 10 years of experience providing nutrition care to both inpatients and outpatients in acute care and rehabilitation settings. Her experience is diverse, counseling families and patients with various disease states across the lifespan. Kim’s passion is promoting and teaching health optimization with food first.
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Colorectal cancer information: Understanding colorectal cancer. American Cancer Society. https://www.cancer.org/cancer/colon-rectal-cancer.html. Accessed February 22, 2022.
Wu CW-K, Lui RN. Early-onset colorectal cancer: Current insights and Future Directions. World Journal of Gastrointestinal Oncology. 2022;14(1):230-241. doi:10.4251/wjgo.v14.i1.230
Colorectal cancer facts & figures 2020-2022. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf. Accessed February 21, 2022.