Colorectal cancer prevention

Prevention and early detection of colorectal cancer (CRC) are often overlooked amid the emphasis placed on breast and reproductive health over a woman’s lifetime, but the facts are concerning. CRC is the third most common cancer and the third-leading cause of cancer death among women in the United States.

It also goes under the radar due to many women perceiving CRC as a male disease and feeling less susceptible, but data shows the numbers are close: Lifetime risk of colorectal cancer is approximately 1 in 25 for women (4.1%) and 1 in 23 for men (4.4%). The false assumptions surrounding CRC also mean women are being tested less; population-based studies examining the use of sigmoidoscopy and colonoscopy report rates among women up to 21% lower compared to men.

Early onset colorectal cancer is also becoming more common. In 2020, about 12% of colorectal cancers—about 18,000 cases—will be diagnosed in people under the age of 50 in the U.S. The reason for this rise in younger adults is not well known and is an active area of research.

What steps can you take?

The encouraging news is colorectal cancer is a potentially preventable cancer, with more than 50% of all cases and deaths attributable to modifiable risk factors, such as smoking, unhealthy diet, alcohol consumption, physical inactivity and excess body weight. That means there are steps you can start taking right away to improve your chances over a potential CRC diagnosis.

The biggest, of course, is monitoring your colorectal health. The United States Multi-Society Task Force (USMSTF) and the American Cancer Society recommend colorectal cancer screening to begin at age 45. There’s also a growing concern that patients, endoscopists and primary care providers are unaware of the familial risks associated with advanced colorectal polyps. In this situation, screening guidelines recommend screening beginning at age 40, or even earlier in some cases.

You’ll find additional lifestyle recommendations on the American Institute for Cancer Research website, which explores the relationship between diet, nutrition, physical activity and colorectal cancer.

Talk to your provider about your eligibility for colonoscopy

Northwell has developed a fast track colonoscopy program. Talk to your doctor to see if you’re eligible.

It is important to know your risk. Please talk to your first-degree relatives (parents, siblings, children) about their history of polyps or cancer.

Are you doing everything you can to protect yourself from developing cancer? These tools can help you calculate your risk. Please consult with your physician to learn more and interpret your findings.

You may lower your chance of developing future polyps and colorectal cancer by adopting healthy habits such as not smoking, avoiding alcohol intake, striving to maintain a healthy body weight, being physically active, limiting red and processed meat (such as beef, cold cuts, bacon and hot dogs) and eating a diet abundant in fruits and vegetables. 

Explore colorectal cancer screening guidelines from various expert institutions on cancer prevention and detection.

The following guidelines pertain to average risk adults, 45 years of age or older:

American Cancer Society: Average-risk adults should start screening at age 45

U.S. Preventive Services Task Force: Recommend screening for colorectal cancer in adults ages 45-59

American College of Gastroenterology: Screening average-risk individuals ages 45-49 to reduce incidence of advanced adenoma, CRC and mortality from CRC

National Comprehensive Cancer Network: Average-risk screening for age 45 years or older

The following guidelines pertain to high risk adults 40 years of age or older, and those with a family history of advanced colorectal polyps:

High risk indicators

Per the United States Multi-Society Task Force (USMSTF)

• Advanced adenoma in two first-degree relatives (any age) or advanced adenoma in one first-degree relative less than 60 years of age
  • Recommendation: Colonoscopy every five years beginning 10 years before the age at diagnosis or age 40, whichever is earlier.
• Advanced adenoma in one first-degree relative at age 60 or older
  • Recommendation: Begin screening at 40. Options for screening are the same as those for average-risk persons.

Per the National Comprehensive Cancer Network (NCCN)

• Advanced adenoma(s) in a first-degree relative regardless of age
  • Recommendation: Colonoscopy beginning at age 40 or at age of onset of adenoma in relative, whichever is first