Colon Cancer Risk and Screening for Women
By Dr. Sherry Ross
Colon cancer is common and deadly. It’s the 2nd most common cancer women, first being lung, 3rd being breast. Men are more likely to get colon cancer, ranking as the 3rd most common cancer. In the US, the incidence of colon cancer is on the decline about 2-3% due to better awareness in screening and better lifestyle choices over the past 15 years. A women’s lifetime risk of colon cancer is about 5%. 90% of colon cancer occurs in women over the age of 50. 70% of all colon cancers are due to environmental and dietary factors. The remaining 30% are due to inherited and “familial” causes.
Of the 70 % of the cases where environmental and diet is the cause, who is at risk?
- Unhealthy diet including processed, fatty foods and red meat
- Over 50 years of age
- Sedentary lifestyle
- Cigarette Smoking
- Excessive alcohol intake-2 or more drinks/day
- Adenomatous polyps before age 60 years.
- African American
- Lower socioeconomic classes
- Those that do not get proper screening
Inherited and “familial” causes would include a family history of colon cancer. If you have a first-degree relative such as a parent, child or sibling who has colon cancer your risk of colon cancer increases 1.7-fold over the general population. The most common types of familial colon cancer would include Familial adenomatous polyposis (FAP) and Lynch Syndrome (hereditary nonpolyposis colorectal cancer (HNPCC)). Fortunately these conditions make up 5% of the causes of colon cancer. Colon cancer screening would begin much sooner, as early as age 40year, for those that have a family history of polyps in relative under the age of 60 years old.
Other risk factors of colon cancer include those with inflammatory bowel disease such as Ulcerative colitis and Crohn’s disease. Low Vitamin D has also been associated with an increase risk.
Protective factors that may decrease your risk of colon cancer include regular physical activity, a diet rich in fruits and vegetables and a high fiber diet. Omega 3 fish oil has also been associated with a decrease risk of colon cancer. Dietary Folic acid, Vitamin B6 , Calcium and garlic may also provide some protection. Aspirin and NSAID’s may also protect against polyps of the colon as well as colon cancer.
Colon cancer screening saves lives. Consistent and regular screening will reduce your risk of developing colon cancer up to 90%. If colon cancer is detected early, the chance of a successful treatment and long term survival is substantial.
In the early stages of colon cancer, you may not experience any symptoms. However if you experience any of these symptoms you should alert your health care provider.
Symptoms NOT to ignore:
- Rectal bleeding or blood in your stool
- Change in bowel habits such as constipation or diarrhea or in consistency and shape
- Persistent bloating, cramping, gas or pain
- Fatigue or weakness
- Unexplained weight loss
The Dreaded Prep
In order for the gastroenterologist to see your entire colon the colon must be completely clean, no stool can be present. For best results a 24 hour liquid diet and prep allows the whole colon to be accurately visualized. Diarrhea and intestinal cramping is common. If the prep is not done correctly it can be challenging to an adequate colonoscopy and reassure you that there are no polyps or tumors present. The colonoscopy is typically done in an outpatient setting with mild sedation. A thin tube is passed through your colon as the doctor looks onto a television screen evaluating its entirety. The procedure takes less than an hour. Complications, such as bleeding or trauma to the colon, are rare occurring in 1 in 1,000 patients.
Screening guidelines for colonoscopy:
- Beginning at age 50, all adults should undergo a colonoscopy. Every 10 years is the typical screening cycle if you have normal results.
- African Americans should consider screening at 45years.
- Virtual Colonoscopy or Computed Tomographic Colonoscopy begins at 50year. Every 5 years is the typical screening cycle is you have normal results.
- Fecal occult blood test should begin yearly for women 50y and older.
- Family history of colon cancer should begin sooner depending on the circumstance.
- Women over 75y with consistently negative colonoscopy’s do not need additional testing.
Consult with your health care provider for further information relating to your own medical history and colon cancer risks.