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March is Colorectal Cancer Awareness Month, a time when the healthcare community works to raise awareness of this disease and promote early screening and prevention.
Colorectal cancer often begins as small growths called polyps in the colon or rectum. These polyps may not cause symptoms, but when symptoms do occur, they can include changes in bowel habits (such as diarrhea or constipation), rectal bleeding or blood in the stool and unexplained weight loss.
Colorectal cancer has been on the minds of many, as actress Catherine O’Hara died earlier this year at age 71 from a blood clot in her lungs, and her death certificate listed rectal cancer as the long-term cause of death. Actor James Van Der Beek then died at age 48 following a journey with stage III colorectal cancer.
Colorectal cancer is the second overall leading cause of cancer-related deaths in the United States. It is now the leading cause of cancer death in men under 50 and the second leading cause in women under 50. Fortunately, it is one of the few cancers that are highly preventable through screening. Colonoscopy, an outpatient procedure, can remove precancerous polyps and reduce your risk of future colon cancer by more than 70%.
Dr. Carl Crawford, an assistant professor of clinical medicine at Weill Cornell Medicine and a gastroenterologist at NewYork-Presbyterian/Weill Cornell Medical Center, notes that more younger individuals are being diagnosed with colorectal cancer. “Over the last 20 years, there's been an increase of about 1 to 2% more colorectal cancers per year being diagnosed in individuals between the ages of 20 and 50.” He adds, “Over the last 15 to 20 years, as we've started to recognize this increasing trend, we've changed the screening ages for colorectal cancer from the age of 50 to 45, and we actually started to recognize this first in African Americans, where they are often diagnosed with aggressive colon cancers late.”
Dr. Crawford says we don’t know exactly why we’re seeing this increasing trend in early onset colorectal cancers, but “there are a lot of different things in our environment and our lifestyles that are uniquely different from this cohort that's being diagnosed with colorectal cancers,” he says. “We can hypothesize right now until more research is done about what is different. We can look at the kinds of foods we eat. The typical western diet, for instance, is lower in fiber and it’s higher in ultra-processed foods. In addition, our lifestyles are slightly different, we’re more sedentary as we’re working at a desktop, and we’re not getting as much exercise as we should.” Healthy diets and exercise have gradually been replaced by convenience—unhealthy, addictive foods that undermine good nutrition and technology that promotes a sedentary lifestyle, both of which increase disease risk.
Dr. Crawford offers insight into what foods to avoid and what foods to eat to help reduce your risk of getting colorectal cancer. He said it’s best to avoid ultra-processed and artificial foods and focus on eating whole foods, such as “fresh fruits and fresh vegetables, with vegetables being the biggest source of nutrients that you can get. And this includes not just things like a carrot here and there. It means eating the whole spectrum of colors in the plant kingdom. So, when I eat a salad, for instance, it contains a lot of green leafy vegetables like spinach and kale. I'm also including a lot of other vegetables that have bright colors. All these bright colors are unique because they have strong antioxidant as well as antitumorigenic properties that are useful in helping reduce inflammation and in reducing the risk for colorectal cancer, as well as other cancers.”
While diet and lifestyle play an important role, Dr. Crawford emphasizes that the gold standard for prevention is screening with colonoscopy. You may be eligible for screening if you are 45 or older (most adults should start screening at age 45), have inflammatory bowel disease (Crohn’s or Ulcerative Colitis), have a personal or family history of colorectal cancer or colorectal polyp or have a genetic syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome. If you have any symptoms of abdominal pain, blood in the stool, changes in bowel habits or unintentional weight loss, you should be evaluated by a doctor to determine if you need a colonoscopy regardless of age.
If you meet any of these criteria, don’t delay—schedule your colonoscopy online today. In many cases, you can book your screening without needing a prior physician visit.
