Healthy Habits And Early Awareness For Reduced Risk Of Colon Cancer

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Introduction

Cancer is a common disease that affects roughly 20% of people. The risk of dying of cancer is around 9.5%. Cancer is associated with genetic mutations. In some people, mutations can be created by long-term exposure to an unhealthy diet or cancer-causing agents (carcinogens) in cigarette smoke. This is why a healthy diet and lifestyle will reduce your chances of developing cancer. A predisposition to cancer can also be inherited and genetic screening may be suitable for some people who have a strong family history of cancer.1

In cancer, mutations cause cells to multiply excessively and uncontrollably, eventually growing into tumours. It is important to catch cancer as early as possible when it has a greater chance of being treated. If tumours grow large enough and spread to other organs it is more difficult to treat them and survival rates are lower.1 

What is colorectal cancer? 

Cancerous tumours can grow in the colon or rectum (colorectal cancer/bowel cancer). Colorectal cancer ranks as the fourth most prevalent form of cancer. It arises from a colon growth (polyp) through a series of genetic mutations. The average age of colorectal cancer diagnosis is 70 in men and 72 in women but genetic mutations and colon polyps often develop decades earlier. An earlier diagnosis is associated with a much greater survival chance as there are many more treatment options for an early diagnosis.2

How common is colorectal cancer? 

According to Bowel Cancer UK, almost 43,000 people are diagnosed with colorectal cancer every year in the UK and 268,000 people are living with colorectal cancer. The number of people dying from colorectal cancer has been falling over the past decades. This is due to the introduction of the bowel cancer screening program which has picked up more early diagnoses, as well as the development of more effective drugs and treatments. 

What causes colorectal cancer? 

Certain risk factors for colorectal cancer are outside of a person's control (non-modifiable). The most common risk factor for colorectal cancer is age, with 94% of diagnoses occurring in people over the age of 50. It is slightly more common in men than women. People who have close relatives who have had colorectal cancer or colon polyps are more likely to develop it themselves.

Certain cancer syndromes predispose people to getting cancer and there is an inherited condition called familial adenomatous polyposis (FAP) which is strongly associated with colorectal cancer development. People who have certain diseases like inflammatory bowel disease (IBD) are also at greater risk of getting colorectal cancer. It is important to keep symptoms of IBD under control as much as possible to reduce the long-term inflammation associated with colorectal cancer development. 

What can you do to reduce your risk of colorectal cancer? 

There are certain, more controllable factors that if managed can reduce your risk of developing colorectal cancer. Many of these healthy habits are good for reducing your risk of many different cancers and as well as promoting overall health and wellness.

People who are overweight have a higher incidence of colorectal cancer as well as many other conditions so it is good to reduce your weight to within a healthy range.3 Regular exercise helps maintain a healthy weight and promotes overall health and well-being.

As the colon is exposed to the food you eat it is important to consume things that are good for it and don’t cause cancer. A healthy diet is important to maintain overall health and vitality. It is important to eat a balanced, nutrient-rich diet full of fruit, vegetables and fibre. Individuals who incorporate higher quantities of fruits and vegetables into their diet demonstrate a reduced occurrence of colorectal cancer.3

Consuming more servings of red (beef and pork) or processed meat (sausages and bacon) per week has been associated with increased colorectal cancer.3,4 Limiting the consumption of unhealthy things like processed foods, products containing refined sugar or lots of saturated fat is also advisable for general health.

Moderating alcohol consumption is advised as greater consumption (more than 1 drink per day) increases the risk of colorectal cancer and many other diseases.4,5

Smoking is associated with an increased risk of many cancers including colorectal cancer. The risk of developing colorectal cancer increases with the number of packs of cigarettes you smoke a day and the number of years you have been smoking.3 It is therefore important to reduce or quit smoking if you want to reduce your risk of developing colorectal cancer. 

What is colorectal (bowel) cancer screening?

Many countries have implemented screening programs for the most common types of cancers to reduce the number of people dying from them. In England, bowel cancer screening is available to everyone aged 60 to 74 who is registered with an NHS GP. The program was extended to include everyone over 50 but this process is still in progress. If you are over 75 you can get a screening test every 2 years. The age range for bowel cancer screening varies between countries.

Why do I need to get screened for colorectal cancer? 

It is important to catch colorectal cancer as early as possible as an early diagnosis is associated with better outcomes. Colorectal tumours are grouped into stages depending on how big the tumour is and whether it has spread outside the colon to other organs. According to Table 1, individuals diagnosed with lower-stage colorectal cancers demonstrate a higher likelihood of surviving for five years after diagnosis. If it is caught in the earliest stage there is a greater than 90% chance of survival. 

Stage5-year survival (%)
191.7
284.1
364.9
410.3

Table 1: People with higher-stage colorectal cancers are less likely to survive for 5 years after diagnosis (ONS data)

What does colorectal cancer screening involve?

A home test kit will be sent every 2 years to you in the post. This is known as a faecal immunochemical test (FIT). You will be provided with instructions to follow. You will be asked to provide a poo sample in a labelled container and send it to the address provided.

The purpose of the test is to look for small quantities of blood in your poo that could indicate the presence of colorectal cancer. Most people will not test positive. If your test is positive you will be offered a colonoscopy to look for the presence of colorectal cancer or other conditions such as colon polyps.

Concerns or difficulties with the bowel cancer screening program 

  • No screening test is 100% accurate and it is possible that colorectal cancer could be missed or you may have to undergo further tests even though you don’t have colorectal cancer
  • Several private companies offer bowel cancer tests for people outside of the standard risk age range, these can vary in quality and accuracy so care must be taken when choosing one
  • Screening is not provided for younger people but if you have symptoms then it is important to speak to your healthcare provider because young people can also develop colorectal cancer
  • Sometimes there will be difficulties for people who don’t read English to understand the test instructions. The instructions for bowel cancer screening in 10 other languages can also be accessed
  • Many people have a fear of a cancer diagnosis and so put off doing the screening test or going to their GP if they have symptoms. It is important to complete the screening tests when they are sent to you to catch it early if you have it

More information about bowel cancer screening can be found here:

https://www.nhs.uk/conditions/bowel-cancer-screening/
https://www.bowelcanceruk.org.uk/about-bowel-cancer/screening/

Do I have colorectal cancer (symptoms)?

As discussed earlier, it is important to catch colorectal cancer early. One way to do this is to familiarise yourself with the most common symptoms of colorectal cancer so that you can spot them if and when they arise.

The most common symptoms of colorectal cancer are:

  • Blood in your poo (red or black)
  • Bleeding from your bottom
  • Tummy pain
  • Constipation or diarrhoea
  • Feeling that you still need to poo even after you have just been
  • Bloating
  • Losing weight without trying
  • Feeling very tired for no reason

It is important to see your healthcare provider as soon as possible if you are concerned about your symptoms. Your healthcare provider will ask you for more information about your symptoms, they may perform an examination and you may be asked to provide a poo sample. 

Summary 

Colorectal cancer, affecting approximately 20% of people, ranks as the fourth most common cancer type, typically detected in older individuals but can emerge earlier due to mutations. Genetic predispositions and conditions like inflammatory bowel disease increase susceptibility. Various risk factors include obesity, sedentary lifestyle, and certain dietary and lifestyle habits, while consuming fruits, vegetables, and fiber alongside regular exercise can mitigate risks.

Early detection significantly enhances survival rates, facilitated by programs like England's bowel cancer screening initiative targeting individuals aged 60-74. Symptoms like abdominal pain, rectal bleeding, and changes in bowel habits necessitate prompt medical attention.

References

  1. Mattiuzzi C, Lippi G. Current cancer epidemiology. J Epidemiol Glob Health [Internet]. 2019 Dec [cited 2024 Apr 4];9(4):217–22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310786/
  2. Glover M, Mansoor E, Panhwar M, Parasa S, Cooper GS. Epidemiology of colorectal cancer in average risk adults 20-39 years of age: a population based national study. Dig Dis Sci [Internet]. 2019 Dec [cited 2024 Apr 4];64(12):3602–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858534/
  3. Johnson CM, Wei C, Ensor JE, Smolenski DJ, Amos CI, Levin B, et al. Meta-analyses of colorectal cancer risk factors. Cancer Causes Control [Internet]. 2013 Jun [cited 2024 Apr 4];24(6):1207–22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161278/
  4. Bradbury KE, Murphy N, Key TJ. Diet and colorectal cancer in UK Biobank: a prospective study. Int J Epidemiol [Internet]. 2020 Feb [cited 2024 Apr 4];49(1):246–58. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7124508/
  5. Fedirko V, Tramacere I, Bagnardi V, Rota M, Scotti L, Islami F, et al. Alcohol drinking and colorectal cancer risk: an overall and dose–response meta-analysis of published studies. Annals of Oncology [Internet]. 2011 Sep [cited 2024 Apr 4];22(9):1958–72. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0923753419383425

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Harvey Fowler-Williams

Doctor of Philosophy - PhD, Oncology and Cancer Biology, University of Liverpool

Harvey obtained a Master of Research degree in Translational Medicine from the University of Liverpool. Subsequently, he earned a Doctorate of Philosophy for his study on the efficacy of chemotherapy drugs on 3D colon cancer models. This academic background provided Harvey with a deep understanding of the complexities of cancer research, particularly concerning the development of new treatment approaches.

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