This week was very sobering. I met a very young lady who was being evaluated for the recent onset of abdominal pain that was progressing in severity without explanation. An abdominal ultrasound discovered a large abdominal mass and subsequent testing confirmed that she had 
colon cancer, which had already spread to her liver. She did not have a family history or other obvious risk factors for colorectal cancer, a disease that can strike without warning.
March is Colorectal Cancer Awareness Month, which gives me an excellent opportunity to remind you about the importance of prevention, as well as of colonoscopy, a test that can literally save your life.
Colorectal cancer (also called colon cancer or large bowel cancer) is the growth of cancerous cells in the colon, rectum and the appendix. It is the most common cancer of the digestive organs, accounting for more than 50 percent of all cases of cancer in the digestive tract. Cancers of the digestive system account for almost 25 percent of annual cancer fatalities in the United States.
Who is at risk for colorectal cancer? The following factors play a role:
- Age. Colorectal cancer affects both men and women of all races and ethnicities. The risk of colorectal cancer begins at increase at age 40 but the disease is typically found in people age 50 or older. In fact, 90 percent of those who develop colorectal cancer are over the age of 50.
- Smoking
- Low physical activity
- Low fruit and vegetable intake
- High caloric intake from fat
- Obesity
- High alcohol intake
- High intake of red and processed meat
Prevention is Key
Fortunately, there's much you can do to prevent colorectal cancer. Good nutrition and physical activity play an important role in preventing colorectal cancer. Aim for at least 30 to 45 minutes of moderate-to-vigorous activity on most days of the week. The following nutritional factors have also been shown to help prevent colorectal cancer:
- Increase your fruit and vegetable intake. Favor cruciferous vegetables such as broccoli and cauliflower. Cruciferous vegetables are high in fiber and contain chemicals such as indole 3-carbinol and crambene that rev up our detoxification system while protecting our cells against the damaging effects of oxygen free radicals. Fruits and vegetables contain cancer-fighting phytochemicals and vitamins.
Early Detection Makes a Difference
The New York Times may have called it "the most unloved cancer screening test," but colonoscopy can save lives, as new research demonstrates: The study, published in the New England Journal of Medicine (NEJM), found that people who had adenomatous polyps identified and removed during a colonoscopy were 53 percent less likely to die from colorectal cancer than those who didn't have the test. That's strong evidence of what many doctors have long suspected: Colonoscopy is vitally important.
Today, colonoscopies are more mainstream -- and media-friendly -- than ever. News anchor Katie Couric underwent a colonoscopy screening on live TV; Ozzy and Sharon Osbourne (a colorectal cancer survivor) teamed up with CBS Cares Colonoscopy Sweepstakes to promote a three-day trip to N.Y. and a free colonoscopy; and Dr. Mehmet Oz brought attention to colonoscopy when he himself had a cancer scare. Such public discussion of a very private issue is raising awareness among millions of Americans in the hope of saving lives.
I want to add to that discussion here by emphasizing how important, effective, safe and valuable colonoscopy is as a screening tool. It's been estimated that more than 50,000 people die each year from colorectal cancer -- but no one should be dying from it, due to the easy access of a colonoscopy procedure, which is covered by most insurance companies. "Many people dislike having the procedure," write the researchers of the NEJM study. "However, a colonoscopy doesn't have to be completed each year." If no polyps are found, you need a colonoscopy just once every 10 years.
Screening for average risk individuals begins at age 50, though studies suggest that African-Americans should begin at age 45. The advice varies for those in higher risk groups:
- People with a sibling, parent or child with colorectal cancer or an adenomatous polyp diagnosed at younger than age 60 or with two first-degree relatives diagnosed with colorectal cancer at any age should have a colonoscopy starting at age 40, or 10 years younger than the earliest diagnosis in their family, whichever comes first.
Colorectal Cancer: Catch It Before It Catches You!
Please take control of your health and talk with your doctor about scheduling a colonoscopy procedure. For more information, see your healthcare professional.
To your good gut heath,
Dr. Gerry
For more by Gerard E. Mullin, M.D., click here.
For more on personal health, click here.
For more on cancer, click here.
References:
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[3] Adams KF; Lampe PD; Newton KM, et.al.; "Soy protein containing isoflavones does not decrease colorectal epithelial cell proliferation in a randomized controlled trial".American Journal of Clinical Nutrition, 2005 Sep; 82 (3): 620-6
[4] Flood A, Peters U, Chatterjee N, Lacey JV, Jr., Schairer C, Schatzkin A. "Calcium from diet and supplements is associated with reduced risk of colorectal cancer in a prospective cohort of women." Cancer Epidemiol Biomarkers Prev 2005;14(1):126-32.
[5] Baron JA, Beach M, Mandel JS, et al. "Calcium supplements for the prevention of colorectal adenomas." Calcium Polyp Prevention Study Group. The New England journal of medicine 1999;340(2):101-7.
[6] Wei EK, Giovannucci E, Selhub J, Fuchs CS, Hankinson SE, Ma J. "Plasma vitamin B6 and the risk of colorectal cancer and adenoma in women." Journal of the National Cancer Institute 2005;97(9):684-92.
[7] Kim YI. "Folate and colorectal cancer: an evidence-based critical review." Molecular nutrition & food research 2007;51(3):267-92.
[8] Jacobs ET, Jiang R, Alberts DS, et al. "Selenium and colorectal adenoma: results of a pooled analysis." Journal of the National Cancer Institute 2004;96(22):1669-75.