Colon Cancer Prevention

Colorectal cancer is the third most common cause of cancer worldwide. In the state of Maryland colon cancer is the second leading cause of cancer-related deaths, accounting for approximately 9% of deaths annually.

Several modifiable factors have been shown to increase the risk of colon cancer. These factors include the consumption of processed meats, limited fruit and vegetable intake, obesity, physical inactivity, excessive alcohol consumption (more than one per day for females and more than two per day for males) and smoking.

Risk factors outside of a person’s control include being male, advancing age, African American race, inflammatory bowel disease and a family history of colon cancer or colon polyps.

Along with a healthy lifestyle and diet, the most effective way to prevent terminal illness from colon cancer is early detection and treatment of precancerous and cancerous lesions. The U.S. Preventative Services Task Force recommends colorectal cancer screening from ages 45 to 75 years old for those at average risk (no underlying bowel disease, family history of colon polyps or cancer, etc.). The American Society of Clinical Oncology categorizes screening methods as those that detect polyps and cancer (colonoscopy, flexible sigmoidoscopy, barium enemas, virtual colonography) and those that primarily detect cancer (stool samples looking for blood or polyp DNA).

The goal of a colonoscopy is to detect and remove polyps (growths of tissue) before they can grow and turn cancerous. Colonoscopies have been shown to result in removal of polyps in up to 35% of cases on average, with a predominance in men to women of 41% and 31%, respectively.

A large, randomized trial in April 2023 found that colonoscopy was the most effective method studied, with a mortality reduction of 73%. The reduction in mortality was best seen in those patients who had their screening at the earliest recommended age and were adherent with the recommended time intervals between screening.

The development and impact of colon cancer can be greatly reduced with colorectal cancer screening. For optimal health, it is essential that you meet with your gastroenterologist or primary provider to discuss when you should start screening, and which method is right for you.

David Jencks, M.D., is a gastroenterologist at Anne Arundel Gastroenterology Associates. He completed his internal medicine residency at Stanford University and gastroenterology fellowship at George Washington University. Learn more at www.aagastro.com.