Are You at Risk for Colon Cancer?

April 2009

by Molly M. Ginty

When Jill Jensen put off her colon cancer screening, it nearly cost her life.

“As a nurse and health clinic administrator, I knew full well that I should get routine testing at age 50,” says Jensen, of Madison, Wisconsin. “But I got caught up in family and work commitments and waited until I was 54—only to discover I had colon cancer that had progressed to stage three of four possible stages.”

If Jensen had been screened and treated earlier, she would not have had to endure abdominal surgery, chemotherapy that thinned her hair, radiation treatment that made her skin erupt in rashes, and fatigue and nausea that kept her out of work two days a week during her six-month treatment.

Jensen’s case illustrates what can happen to the 50 percent of Americans who don’t get colon cancer screening when they should.

“Routine testing is crucial—especially because it doubles as a preventative measure,” says Dr. Durado Brooks of the American Cancer Society. “During colon cancer screening or colonoscopy, doctors can find and remove precancerous growths called polyps, preventing them from growing into cancer.”

Cancerous polyps can develop at any point along the four- to five-foot colon (which absorbs nutrients and stores waste matter) or the six-inch rectum below it. That’s why you must take measures to protect yourself from colon cancer, which appears in 154,000 new cases and claims 52,000 lives in the United States each year. During April or national Cancer Control Month, here’s how.

Keep Yourself Healthy

Diets high in fat, calories, and red and processed meats boost colon cancer risk, while diets rich in fruits, vegetables, and whole grains (and healthy levels of vitamin B-6, calcium, folic acid, and magnesium) lower it. Obesity and having a sedentary lifestyle are associated with colon cancer, so watch your weight and get the 30 minutes of daily exercise that health authorities recommend. Avoid smoking and having more than one alcoholic drink per day, which also boost your risk. And know that having type 2 diabetes (often associated with an unhealthy diet) makes you 30 percent more likely to develop colon cancer.

Watch for Warning Signs

Colon cancer is often accompanied by blood in the stool, which can be a symptom of less serious conditions such as hemorrhoids or anal fissures, but which you should nevertheless discuss with your doctor. Also make sure you talk about persistent diarrhea, constipation, abdominal discomfort, weakness, fatigue, or unexplained weight loss.

Get Screened

Ninety percent of colon cancers are diagnosed in people over age 50, which is why screening should start at that age and continue once every 10 years if results are normal. A strong laxative and 24-hour liquid diet are necessary before colonoscopy. And scopes are inserted in the rectum during the actual procedure. “Many people are intimidated or frightened by the idea of colonoscopy,” says Brooks. “But the exam is done under so much sedation that you likely won’t remember it clearly. Surveys show most people who have had a colonoscopy say it wasn’t nearly as bad as they expected, and they would have no problem going back and doing it again.”

Consider Other Tests

If you’re extremely squeamish about colonoscopy, know that a 2008 New England Journal of Medicine study found that “virtual” colonoscopy (CT colonography, which takes an X-ray of the abdomen instead of using a probe) is 90 percent as effective as regular colonoscopy at detecting cancerous polyps. Other screening tests include flexible sigmoidoscopy (which uses a smaller tube than colonoscopy); the barium enema (which uses pumped air, barium, and an X-ray) and stool tests (which look for signs of cancer in bowel movements). CT colonography, sigmoi¬doscopy, or a barium enema may be performed in lieu of colonoscopy once every five years. Stool tests may be performed annually, but aren’t a substitute for other screenings because they don’t check for polyps.

Know Your Family History

If you’re African American, your risk of getting colorectal cancer is 12 percent higher than that of the general population. People of Eastern European Jewish descent sometimes carry a genetic mutation that makes them more susceptible. And if you have an immediate relative with colon cancer, your risk is doubled. “In these cases, screening needs to start early, by age 45 at the latest,” says Carlea Bauman, president of the Colorectal Cancer Coalition.

Don’t Delay

As Jill Jensen’s case illustrates, putting off colon cancer screening can lead to serious trouble.

“My tumor was just centimeters away from necessitating colostomy, in which a part of the colon is removed and surgeons create an opening in the abdomen and insert a special waste-collection bag that hangs outside your body,” she says. “My cancer scare frightened me so much that I’m not only encouraging everyone I know to get colonoscopies, but driving them to their appointments and back.”

Colon cancer is one of the slowest-growing cancers. And only 1 percent of polyps become cancerous. But because so few people get screening when they need it, only 39 percent of cases are detected early—the reason this disease is the second-leading cause of cancer death in the nation, and the reason you can’t afford to wait.

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.

For more information

C3: The Colorectal Cancer Coalition

Colon Cancer Alliance

American Cancer Society