A recent study found that fewer than half of patients who had an abnormal stool-based colon cancer screening test completed a follow-up colonoscopy within six months.

Colon Cancer Screening Tests Vary in Effectiveness and Accuracy

It’s always good to have options when making important decisions. When it comes to testing for colorectal cancer (CRC), you have many choices. There are several types of screenings, from stool tests to colonoscopy. However, some screenings are more thorough and comprehensive than others.

Stool-based screening tests (SBTs) are non-invasive and efficient, but a positive stool test requires a follow-up colonoscopy. A new study published in JAMA Network Open found that 52 percent of patients did not follow through with colon cancer screening recommendations when blood was found in their stool samples.

Study Finds Poor Follow-Through with Positive Stool Test Results

Elizabeth L. Ciemins, PhD, MPH, from the American Medical Group Association in Alexandria, Virginia, led a quality improvement study to analyze whether screening-eligible adults chose to get a follow-up colonoscopy after an abnormal stool test.

Dr. Ceimens and her research team looked at data from 38 healthcare organizations for 20,581 patients aged 50 to 75 years who received abnormal results from a colorectal cancer SBT. They looked at metrics including race, ethnicity, sex and insurance. The team found 47.9 percent had a follow-up colonoscopy within a median follow-up time of 53 days.

The study found follow-up colonoscopy screening rates were highest among White patients, at 49 percent. Rates were lower among Black patients (37.1 percent), Hispanic patients (38.4 percent) and patients with Medicare and Medicaid (49.2 and 39.2 percent, respectively).

“Use of SBTs may increase overall screening rates, but abnormal results must be followed up with a colonoscopy to diagnose CRC — ideally as soon as possible, but definitely within the six months after an abnormal test result,” the research authors wrote.

Advantages of Colonoscopy Over a Stool-Based Test

Stool-based tests offer many advantages in colon cancer screening because patients can perform them at home. SBTs do not require fasting, bowel prep, transportation or sedation, and patients do not need to take time off from work.

However, SBTs, like fecal immunochemical testing (FIT), guaiac-based fecal occult blood test (gFOBT) and multi-target stool DNA (mt-sDNA) tests, detect blood or abnormal chemicals in the stool. They do not identify the source. Patients should follow up with a colonoscopy within six months of a positive SBT. If the stool test is negative, it needs to be repeated in one to three years, depending on the test performed.

Another limitation of SBTs is that they can be inaccurate. One study found that 10 percent of fecal immunochemical tests could not be processed due to patient errors in collecting the specimen.

“We hope to learn more about where the blame lies,” Rasmi Nair, assistant professor in the Peter O’Donnell Jr. School of Public Health at UT Southwestern Medical Center in Dallas, told Healio. “Is it more patient-related? Did the patient not understand the instructions with regards to FIT or was it more system- or provider-related? Although our research is great at identifying the issue, we still are not able to pinpoint the exact problem.”

A visual exam like colonoscopy can detect and even prevent colon cancer because a doctor visually inspects the lining of the colon with a scope and can remove abnormal tissue called precancerous polyps during the exam. A negative colonoscopy often means the patient does not have to repeat the test for another 10 years. Colonoscopy is a smart option for many patients due to its accuracy and less frequent need for repetition compared to other methods.

Tips to Improve Your Colonoscopy Prep and Exam

Are you concerned about getting a colonoscopy? Or perhaps you have recently received an abnormal SBT and you’re wondering if you should schedule a colonoscopy or skip it.

A colonoscopy has never been easier. The new prep solutions are low volume, more palatable and easier to consume. You also only need to take one day off from work. Below are some tips to prepare for a successful colonoscopy.

The day before prep day:

1. Eat a big breakfast, a light lunch and a snack dinner.
2. Start a low-fiber diet three days before your colonoscopy.
3. Start hydrating several days before prep day.

On prep day:

1. Chill the prep beverage and drink it through a straw.
2. Chase the prep solution with cold water.
3. Enjoy all the clear liquids you like, including black coffee, tea, sodas, juices, popsicles, gelatin, hard candy, Italian ice and gummy bears. (Avoid anything with red or blue dye because it may make it more difficult to examine the colon).
4. Use baby wipes, Vaseline or diaper rash cream to give you relief.
5. Save your favorite TV show to binge-watch on prep day.

Begin Colon Cancer Screening at Age 45 If You Are at Average Risk

Colon cancer is a leading cause of cancer death in the United States, but one-third of Americans are overdue for a colon cancer screening.

The U.S. Preventive Services Task Force recommends that all adults who are at average risk for colon cancer begin screening at age 45. Individuals with a family history of colorectal cancer, colon polyps, inflammatory bowel disease, Lynch syndrome or Familial Adenomatous Polyposis (FAP) should consider starting screening at a younger age due to their increased risk of developing colon cancer.

Talk to your doctor about when you should begin colon cancer screening. If you experience symptoms like blood in the stool, abdominal pain or cramping, nausea or unexplained weight loss, don’t delay in calling your physician. Most colon cancer is treatable when diagnosed at an early stage, so call today to make an appointment if you are due for a screening.

Did you know that the second-leading cause of cancer death in the United States is one of the most preventable cancers? About 90 percent of colon cancer cases and deaths may be preventable, but millions of adults are not getting screened and are at risk for this life-threatening disease.

Study Suggests Millions of Americans Need Colon Cancer Screening

The lifetime risk of developing colon cancer is approximately five percent, or one in 20. New research published in JAMA Network Open found that there are approximately 57.1 to 59.6 million individuals aged 45 to 85 who are eligible for screening.

Despite the common belief that colon and rectal cancer only affect older individuals, it can impact people of all ages. Cases diagnosed before age 50 (called early-onset) have increased consistently in recent decades, but the reasons behind this trend remain unclear.

Approximately 20 percent of colon cancer diagnoses are linked to heredity, like Lynch syndrome and familial adenomatous polyposis (FAP). The other 80 percent may result from environmental factors such as alcohol and tobacco use and a low-fiber and high-fat diet.

Due to the rise in early-onset colon cancer cases, the American Cancer Society advises individuals with an average risk of developing the disease to start undergoing regular screenings at age 45.

Deficits in Colon Cancer Screenings

Many Americans are not up to date on colorectal cancer screening, leading to millions not receiving necessary medical care.

Derek W. Ebner, MD, of the division of gastroenterology and hepatology at the Mayo Clinic, conducted a study of people between 45 and 85 who were at average risk for colon cancer. In that sample, 59.3 percent to 61.8 percent were current on screening.

“We hope our estimates can support policy makers and health care stakeholders to advance initiatives surrounding colorectal cancer screening to prevent this disease or identify it earlier when more can be done to treat it,” Dr. Ebner said.

What Are the Screening Options for Colon Cancer?

Two main categories of colon cancer screening methods are tests that analyze stool samples and visual examinations. All tests have different risks and benefits.

• Stool-based tests — These tests are non-invasive and check for signs of cancer in a stool sample. You must repeat these tests more often. Examples of stool-based tests include the following:
  • Fecal immunochemical test (FIT) — You must repeat this test every year.
  • FIT/Stool DNA test — You must repeat this test every three years.
  • Guaiac-based fecal occult blood test (gFOBT) — You must repeat this test every year.
• Visual exams — These cancer screening tests look for abnormalities in the structure of the rectum and colon. Examples of visual exams include the following:
  • Colonoscopy — This is the gold standard for colon cancer screening because a doctor can remove pre-cancerous polyps during the procedure and reduce the risk of cancer. If you do not have polyps, you may not need to repeat the test for 10 years.
  • CT colonography — This screening must be repeated every five years.
  • Sigmoidoscopy — This must be repeated every five years.

Which Colorectal Cancer Screening Method Is Best?

Many tests can screen for colon cancer, but a colonoscopy can detect, diagnose and remove polyps in the same procedure, making it the gold standard of screening methods.

Often, the best colon cancer screening is the one that gets done. Because screening rates are lower than they should be, any colon cancer screening is better than no colon cancer screening.

Stool-based tests have the benefit of being non-invasive and convenient. Many average-risk patients prefer a stool test because it does not require preparation, diet changes or sedation. If you receive an abnormal result from a stool-based test, it is important to follow up with a colonoscopy (American Cancer Society). Follow-up is recommended within six months after an abnormal test result.

Lifestyle Factors That Affect Colon Cancer Risk

Since most colon cancers are not hereditary, you can make choices that affect your personal risk. Actionable steps you can take to prevent colon cancer include the following:

1. Eat a diet high in fruits, vegetables, whole grains and fiber.
2. Decrease your intake of red meat like beef, pork and lamb and processed meat such as hot dogs and deli meats.
3. Get daily exercise. Obesity is linked to colon cancer risk, so a healthy BMI will reduce your risk.
4. Manage your weight. A healthy BMI will make you less prone to obesity, which can make you more likely to develop colon cancer.
5. Do not smoke or use tobacco.
6. Avoid alcohol. Alcohol use increases your risk of colon and rectal cancer, so it is best to not drink.
7. Get screened for colorectal cancer starting at age 45 if you are at average risk.

Is It Time for Your Colon Cancer Screening?

Many insurance plans cover screening colonoscopies for patients starting at age 45. Contact your insurance provider to confirm coverage. Colonoscopy prep has never been easier, thanks to the low-dose prep solution.

If you have risk factors or a family history of the disease, talk to your doctor about screening earlier. If you have digestive symptoms, see your healthcare provider for evaluation.

Ask your gastroenterologist for more information about colon cancer screening, inflammatory bowel disease or other digestive system conditions. Call today to make an appointment.

As the weather warms up and the days get longer, it’s time for grill masters and rookies alike to fire up the Green Egg, flat top grill and smoker to sizzle up barbecued meats.

Although everyone loves burgers, bratwurst and ribeye steaks, these meats can raise cholesterol levels and increase your risk of developing cancer. A new study supported by the National Institutes of Health suggests that genotype can affect colon cancer risk based on red or processed meat consumption.

New Study Underscores Health Risks of Red and Processed Meat

The study found that people who ate red or processed meat were more likely to develop colorectal cancer (CRC). The study was led by the USC Norris Comprehensive Cancer Center, part of the Keck School of Medicine of USC. The results were published in Cancer Epidemiology, Biomarkers & Prevention.

The researchers studied data on more than 29,000 people with colon cancer and more than 39,000 without colon cancer. During the study, they isolated two genes, HAS2 and SMAD7, that affected colon cancer risk based on red or processed meat consumption.

They also included data from 27 studies of colorectal cancer risk in participants of European ancestry. The team analyzed consumption of red meat like beef, pork and lamb as well as processed meat, including hot dogs, deli meat, bacon and sausage. Participants with the highest levels of red meat intake increased their risk for colorectal cancer by 30 percent, and those with the highest levels of processed meat intake increased their risk by 40 percent.

The study found that people who had a variant of the HAS2 gene present in 66 percent of the population faced a 38 percent higher risk of colorectal cancer if they consumed the highest amount of meat.

“These findings suggest that different genetic variants may confer a differing risk of colorectal cancer in individuals who consume red meat and highlight possible explanations for how the disease develops,” said a study co-author Joel Sanchez Mendez, a doctoral student in the Keck School of Medicine’s department of population and public health sciences.

In the future, the research team wants to continue experimental studies that could “provide stronger evidence for the role of dysregulated iron metabolism in the development of colorectal cancer” (Medical Xpress).

What Are Some Alternatives to Red or Processed Meat?

No one can resist the aroma of grilling food over an open flame. But foods like hamburgers, kielbasa, pork butt and lamb chops can put you at risk for colon cancer. In fact, all muscle meats that get charred can be harmful to your gut.

Heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) are chemicals formed when beef, pork, fish, or poultry cooks at high temperatures. Laboratory studies show HCAs and PAHs change the DNA in meat and can increase the risk of cancer.

You can still enjoy all the flavor of an outdoor barbecue by grilling colorful vegetables like peppers, squash, onions, eggplant and zucchini. You can even grill fruit like pineapple, apples, peaches, plums, nectarines, apricots, pears and mangos.

Are You Younger Than 50? Colon Cancer Incidence Is Increasing.

According to the American Cancer Society, 2024 is the first year that an estimated two million Americans will receive a cancer diagnosis. Because of higher screening rates, colon cancer incidence is declining among older Americans, but it is steadily increasing in younger adults.

Of all the cancer deaths in people younger than 50, colorectal cancer is the leading cause of death in men and the second-leading cause of death in women. Increasing obesity rates may account for some cases of young-onset colon cancer, but there are unknown reasons as well.

Routine Screenings Can Detect and Prevent Colon Cancer

Routine screening is the most effective way to detect and prevent colorectal cancer, even more so than diet or exercise. Colon cancer can affect all age groups, but the U.S. Preventive Services Task Force recommends that adults at average risk for colon cancer should begin screening at age 45 and continue to age 75. Individuals with a family history of colon cancer or polyps, inflammatory bowel disease or hereditary colon cancer should consider getting screened for CRC at an earlier age.

Several screening options are available, but the gold standard is colonoscopy. The goal of colonoscopy is to find and remove polyps, which are growths on the colon wall. Most polyps are non-cancerous, but if left untreated, some may develop into cancer. If the exam does not detect polyps and you are not at higher risk for colon cancer, the next screening may be in 10 years.

If you choose to take an alternate screening test and your result is positive, you will need a follow-up colonoscopy to determine the cause of the positive result.

Call Your Gastroenterologist Today

How long has it been since your last colon cancer screening? Call your gastroenterologist if you are not sure. If you are experiencing GI problems like abdominal pain, nausea, diarrhea or constipation, you should make an appointment to see a specialist. Ignoring issues may only make the problem worse, so call today and schedule an evaluation.

Researchers found distinct differences in tumor-related bacteria linked to young-onset colon cancer.

Colorectal Cancer Increasing Among Young People

Adults older than 50 have a higher risk of colorectal cancer (CRC), but the disease is rapidly increasing among young people. By 2030, young-onset colon cancer is expected to comprise 11 percent of colon cancers and 23 percent of rectal cancers.

Hereditary cancer syndromes only cause about 20 percent of young-onset CRC cases, which means most young people are not predisposed to colon cancer. However, young people are more likely to have advanced disease at the time of diagnosis, possibly due to low screening rates.

While it is still unclear why so many young people are developing CRC, some possible reasons may include the following:

• Antibiotic use
• Lack of exercise
• Obesity

Study Shows Tissue Differences

A new study published in eBioMedicine suggests young-onset colon cancer patients may have specific tumor-related bacteria compared to average-age colon cancer patients. The purpose of the study was to explore factors that could contribute to the rise in young-onset colon cancer.

“This research is the first step in exploring factors that could play a role in the rise of young onset colorectal cancer,” Shimoli V. Barot, MD, medical oncologist at Cleveland Clinic Cancer Institute, told Healio. “Having identified the tumor bacteria, we can now explore utilizing this information to devise strategies to address this challenge.”

The research analyzed colon tissue samples from 136 people diagnosed with colon cancer before age 50, comparing them to samples from 140 older patients with colorectal cancer above age 60. The research team found young colon cancer patients had more bacterial diversity, and the bacteria interacted with the tumor in different ways. Young patients were also more likely to have left-sided, rectal and advanced stage tumors (such as stage IV cancer).

What Impact Could This Have on Colon Cancer Research?

Dr. Barot said she hopes the study results can help produce preventive treatments in the future. Perhaps probiotic or antibiotics could promote healthy gut bacteria and eliminate the tumor-causing bacteria.

“We will need to compare the bacteria to that of individuals who don’t have colorectal cancer,” she said. “Then we will try to figure out the role bacteria play in the pathogenesis of early-onset colorectal cancer. We want to determine what these bacteria are secreting, how they are interacting with the immune system around the tumor area and how the immune system could be primed to fight these bacteria.”

Naseer Sangwan, PhD, of the Cleveland Clinic Lerner Research Institute, added that “further research is needed into how lifestyle factors such as diet, medications and obesity may impact gut bacteria and contribute to young-onset colon cancers” (Medical Xpress).

Young-onset Colon Cancer Is Increasing

About 19,550 Americans younger than 50 develop colorectal cancer every year, and about 3,750 die from the disease. Colon cancer is the fourth-leading cause of death in this age group, following car accidents, homicide and suicide.

Since 2011, colorectal cancer incidence has been increasing by two percent a year in adults younger than 50, as well as adults between 50 and 54.

Get Your First Colon Cancer Screening at 45 or Before

Adults at average risk for colon cancer should begin screening at age 45. But if you have a family history of colon cancer or colon polyps, it is recommended to start screening earlier. People with hereditary cancer syndromes like familial adenomatous polyposis or Lynch syndrome — also known as hereditary non-polyposis colorectal cancer (HNPCC) — have a higher risk of colon cancer, and tumors usually develop at an earlier age.

Know the Warning Signs of Colon Cancer

Colon cancer may not cause symptoms right away. It is also possible for a separate condition, like hemorrhoids, irritable bowel syndrome or inflammatory bowel disease, to cause similar symptoms.

Common symptoms of colon cancer may include the following:

• A change in bowel habits, such as diarrhea, constipation or narrowing of the stool, that lasts for more than a few days
• A feeling that you need to have a bowel movement that is not relieved by having one
• Blood in the stool, which might make it look red, dark brown or black
• Cramping or abdominal (belly) pain
• Weakness and fatigue
• Unintentional weight loss

If you experience any of these symptoms, regardless of your age, make an appointment to see your doctor.

Colonoscopy Screening for Colon Cancer

There are two basic types of screenings:

1. Stool-based tests — These tests are less invasive because they test the stool for signs of cancer.
2. Colonoscopy — These tests examine the structure of the colon and rectum and look for abnormalities called polyps. They are done with a scope placed into the rectum.

Many people prefer stool-based tests because they are faster and less expensive, but abnormal test results require a colonoscopy.

Colonoscopy is the most effective because it allows your gastroenterologist to examine the entire colon and remove polyps before they become cancerous. A screening colonoscopy typically lasts less than an hour, and it is typically repeated every 10 years if no abnormalities are detected by your doctor and you are not at higher risk for colon cancer.

Call your gastroenterologist today to make an appointment.

A wife, mother and career woman, Karen Fisher lives a busy life in Inverness, Florida.

Fisher’s life turned upside down when she was diagnosed in 2020 with Stage 2A colon cancer. She was 54.

“Colon cancer wasn’t really even on the radar,” she said. “So, it was kind of a shock.”

The American Cancer Society (ACS) estimates about 106,590 people will be diagnosed with colon cancer and about 46,220 with rectal cancer in 2024.

Now the 57-year-old colon cancer survivor helps newly diagnosed colorectal cancer (CRC) patients find support resources and encourages adults to get timely screenings.

“I have been able to help friends, coworkers and neighbors get screened for colon cancer,” Fisher said. “It makes me feel good to be able to help other people prevent going through what I went through.”

March is National Colorectal Cancer Awareness Month. This monthlong campaign promotes the research, prevention, diagnosis, treatment and, ultimately, cure for this disease. CRC is an umbrella term for cancer in the colon or rectum.

Don’t Make Excuses About CRC Screening

In 2016, experts recommended colorectal cancer screenings begin at 50 for people at average risk for the disease. Fisher turned 50 that year but made excuses to postpone her screening.

“I was busy with work and teenagers and after-school activities, and you know, moms take care of everybody else but themselves,” she said. “I had even driven my husband to his colonoscopy when he turned 50. He’s five months younger than me.”

In 2021, the U.S. Preventive Services Task Force lowered the screening age to 45 because of an increase in cancer in younger people. Now, CRC is the number one cause of cancer death in men and the second in women younger than 50.

Fisher had no family history of CRC and did not think she had any symptoms.

“I had blood in the stool, but at the time I was perimenopausal, and I thought I was spotting between periods,” she said. “Looking back, I can recognize that yes, I had a symptom.”

Fisher’s health insurance required her to get a colonoscopy at the hospital where she works as a pharmacist. She did not feel comfortable getting screened there.

“That was one thing that prevented me from getting screened in a timely manner. I didn’t want to get naked in front of my coworkers,” she said. “I knew everyone in the endoscopy department. I didn’t want them to see me, so I put it off.”

Colonoscopy Reveals Cancer Diagnosis

Four years later, in May 2020, Fisher tried to donate blood but was turned away because her hemoglobin level was low.

“I thought that was kind of weird because I was otherwise healthy. I’d been running for two years just for exercise and didn’t really notice anything,” she said.

Blood tests revealed Fisher had iron deficiency anemia. To determine the cause, her family doctor ordered a colonoscopy, a procedure that allows a gastroenterologist to examine the entire length of the colon for polyps or other abnormalities.

Because of the COVID-19 pandemic, a backlog of cases at the hospital and the urgent nature of her anemia, she got a medical exception to have the procedure at an ambulatory surgery center nearby.

Gastroenterologist Trupti Shinde, MD, performed the colonoscopy and found a 5 cm mass in Fisher’s colon. Dr. Shinde referred Fisher to Parth Patel, MD, general surgeon, to remove the tumor and scheduled surgery in July 2020. Pathology revealed Stage 2A colon cancer.

“It was just such a whirlwind of activity with me. You know, me still trying to work full time, too, and trying to process all of this in my head,” Fisher said. “I did a lot of research online and found a lot of good resources. I wanted to share them with other colon cancer patients.”

A Foundation to Help CRC Patients

About six months post-surgery, Fisher scheduled a follow-up appointment with Dr. Shinde. They discussed the need for a support group and resources for colon cancer patients.

“I always felt there is no support system for them,” Dr. Shinde said of CRC patients. “We are doing a good professional job, but I felt there was a lack of connection if they needed emotional support. I was always unhappy about that situation.”

The duo began offering support groups at the local library without much success. Undeterred, they compiled a list of patient resources and produced a pamphlet designed by Fisher’s son. Then they shared the pamphlets with local surgery centers and healthcare facilities for distribution to CRC patients.

From this outreach, Fisher worked with Dr. Shinde and Dr. Patel to create the nonprofit Citrus Colorectal Cancer Foundation in June 2021, Fisher’s one-year “cancerversary.”

The foundation offers direction for educational, financial and emotional support for CRC patients, caregivers and the community. The foundation is planning ColonFest ‘24 on March 23 and the second annual Charity Casino Night in April.

In the future, Dr. Shinde wants to expand the foundation’s mission.

“My dreams are very big,” she said. “I want to have a foundation presence globally because (colorectal cancer) is not only a problem for the United States.”

From Pain to Purpose

As a colon cancer survivor, Fisher’s pain has emerged into purpose.

“I feel like maybe this was God’s plan for me that I went through this,” Fisher said. “And now He’s guiding me to help others go through it and prevent what I went through.”

To raise awareness, Fisher often shares her story at luncheons, healthcare fairs and community events. To describe CRC and the importance of screening, she often uses a gardening metaphor.

“I talk about weeding your intestinal garden,” she said. “Think of polyps as weeds that could take over your body and kill you — just like weeds can rob your garden of nutrients and kill your plants.”

Colorectal cancer begins as a polyp, a small cluster of cells in the lining of the colon (large intestine) or rectum.

“There are many types of colon cancer screenings available these days, but I always recommend a colonoscopy,” Fisher said.

Colonoscopy is the only screening method that can detect and prevent colorectal cancer. During this procedure, a doctor can find and remove any polyps — often before they become cancerous.

If you choose to take a stool test and you receive a positive result, you will need a follow-up colonoscopy to determine the cause.

Schedule Your Colonoscopy at Age 45

Colorectal cancer diagnosis in adults 40-49 has increased by nearly 15 percent in the past decade. Experts recommend that colorectal cancer screening begin at age 45 for adults who are at average risk.

“There are a lot of messages that I like to spread for the younger people,” Fisher said. “Number one is it might not be hemorrhoids or gluten intolerance or IBS (Irritable Bowel Syndrome). The only way to know for sure is to get scoped. You’ve got to find out for sure.”

Early detection is key in CRC because it is more treatable in the early stages.

“Prevention is a cure, and we have to prevent bad things,” Dr. Shinde said. “I tell my patients, if you’re healthy and you want to do all these things in your life, then you are the perfect candidate to get the colonoscopy because it’s the best preventive tool.”

Coverage of colonoscopy differs with health insurance policies. In most cases, there should be no out-of-pocket costs (such as copays or deductibles) for CRC screening tests. You should contact your health insurance provider to verify any charges and to approve a colonoscopy before age 45.

Getting screened if you are 45 or older is critical to detecting and even preventing colorectal cancer. Call today to make an appointment.

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This article is designed for educational purposes only. The information provided should not be used for diagnosing or treating a health concern or disease. It is not a substitute for professional care. If you have or suspect you may have a health concern, you should consult your healthcare provider.

Experts advise eating a well-balanced diet with fiber, fruits and vegetables and doing 150 minutes of aerobic exercise weekly for good health.

You still may be at risk for colorectal cancer even if you eat healthy foods, exercise regularly and don’t smoke or drink alcohol.

The American Cancer Society (ACS) released new data in mid-January listing colorectal cancer as the leading cause of cancer death in men and the second-leading cause of cancer death in women younger than 50.

CRC diagnosis in adults 40-49 has increased by nearly 15 percent in the past decade. Annually, about 18,000 CRC cases are diagnosed in people younger than 50. That’s about 49 new cases per day.

“The continuous sharp increase in colorectal cancer in younger Americans is alarming,” said Ahmedin Jemal, DVM, PhD, ACS senior vice president of surveillance and health equity science, regarding the new data.

Researchers have not determined why more young adults are being diagnosed with this disease. Scientists speculate the cause could be changes in lifestyle habits that originated with individuals born around 1950.

If you’re 45 or older, include a colorectal cancer screening for your well-being.

What is Colorectal Cancer?

The ACS estimates about 106,590 people will be diagnosed with colon cancer and about 46,220 with rectal cancer in 2024.

Colorectal cancer almost always begins as a polyp. A polyp is a small cluster of cells in the lining of the colon (large intestine) or rectum.

Many CRC cases have no symptoms or warning signs until the cancer has advanced.

In Healio, Seth A. Gross, MD, advises people of any age to consult a healthcare provider immediately if they “notice rectal bleeding, abdominal pain or change in bowel habits” and any of the following symptoms:

• Blood in stool
• Unexplained weight loss
• Unexplained anemia
• Vomiting

Timely Screening May Help Prevent Colorectal Cancer

Colorectal cancer is preventable. As CRC cases rise in young adults, more than any diet or exercise regimen, a timely screening offers the best prevention.

“We need to halt and reverse this trend by increasing uptake of screening, including awareness of non-invasive stool tests with follow-up care, in people 45-49 years,” Dr. Jemal said in the ACS news release.

The U.S. Preventive Services Task Force recommends that adults who are at average risk start screening for CRC at 45.

Experts recommend getting screened earlier if you have a family history of the disease or a history of precancerous polyps.

“Up to one-third of people diagnosed before 50 have a family history or genetic predisposition and should begin screening before age 45 years,” Dr. Jemal said.

Regardless of your age, if you have digestive system issues, visit your doctor.

Several screening options are available, but colonoscopy is the only screening method that can detect and prevent colorectal cancer. During a colonoscopy, a gastroenterologist looks for polyps that are cancerous or may develop into cancer. Your doctor can remove polyps in the same procedure.

If you choose to take a stool test and you receive a positive result, you need a follow-up colonoscopy to determine the cause.

For patients 45 and older, most insurance plans cover a colonoscopy. In most cases, there should be no out-of-pocket costs (such as copays or deductibles) for CRC screening tests. Call your health insurance company to confirm you are eligible for a screening colonoscopy.

If you are 45 or older, getting screened is critical to detecting and even preventing colorectal cancer. Talk with your doctor about scheduling your screening.

As 2024 begins, you may make New Year’s resolutions in an effort to improve your life going forward.

Two popular resolutions — to lose weight and to exercise more — may have greater health significance than you realize.

Being overweight is linked to a higher chance of developing at least 13 types of cancer, according to a recent Clinical Practice Statement by the Obesity Medicine Association (OMA).

Risk factors for colon and rectal cancer include being overweight or living with obesity, eating a high-fat diet and living a sedentary lifestyle.

Losing weight and increasing physical activity may help lower your risk of developing colorectal cancer (CRC).

Obesity Is Linked to Colon Cancer

“Obesity is second only to cigarette smoking as the most common preventable cause of cancer,” the OMA reports. “For nonsmokers, obesity is considered the single most common preventable cause of cancer, especially when accompanied by unhealthful nutrition and physical inactivity.”

The OMA reports an increase in body weight may be contributing to a rise in cancer among young adults. One in 260 people will get colon cancer before they turn 50, according to the Colorectal Cancer Alliance. This is called early-onset or young-onset CRC.

By 2030, about 10.9 percent of all colon cancers and 22.9 percent of all rectal cancers are expected to affect patients younger than 50.

Maintain or Achieve a Healthy Weight

Healthcare providers use Body Mass Index (BMI) and waist circumference as screening tools to assess a person’s weight status and its potential impact on disease risk.

“Maintaining a healthy weight has a preventive role. Intentional weight loss of more than 5 percent of body weight has been associated with a lower risk for obesity-related cancers,” writes Monu Khanna, MD, in Healio.

Dr. Khanna emphasized it is important for people to know about obesity as a cancer risk factor.

“Although cancer has many risk factors, managing one’s weight effectively is an essential step in keeping that risk minimal,” Dr. Khanna wrote in Healio.

By making healthy lifestyle choices, like eating healthy foods and exercising, you can achieve a healthy weight.

“Eating a diet centered around “real foods,” including protein and lots of fiber from non-starchy vegetables, eliminating ultra processed foods, avoiding sugary drinks and managing stress and sleep, are all important,” Dr. Khanna wrote in Healio.

The Centers for Disease Control and Prevention (CDC) recommends a minimum of 150 minutes of moderate-intensity aerobic exercise each week to maintain your weight. To lose weight, you may need to exercise more and eat fewer calories. Consult your doctor before starting any weight loss or exercise programs. The CDC recommends the following:

Moderate exercises

• Walking briskly (a 15-minute mile)
• Light yard work (raking/bagging leaves or using a lawn mower)
• Light snow shoveling
• Actively playing with children
• Biking at a casual pace

Vigorous exercises

• Jogging/running
• Swimming laps
• Rollerblading/inline skating at a brisk pace
• Cross-country skiing
• Most competitive sports (football, basketball or soccer)
• Jumping rope

“Being physically active can improve your brain health, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities,” according to the CDC.

45? Get Screened for Colon Cancer

More than any diet or exercise regimen, screening for colorectal cancer offers the best prevention against the disease. Screenings save thousands of lives every year.

For people at average risk for colon cancer, healthcare agencies recommend starting screenings at 45, even if you don’t have symptoms. If you have a family history of CRC, you may need to be screened earlier. And if you have digestive symptoms, you should see your doctor regardless of your age.

Delaying or avoiding cancer screenings may be detrimental to your health.

Colonoscopy Is a Key Preventive Measure for CRC

Colorectal cancer almost always begins with a polyp, a small cluster of cells on the lining of the large intestine (colon) or rectum.

Although there are several screening options, colonoscopy is the most thorough. The procedure helps doctors see the whole colon to check for cancerous polyps or ones that could turn into cancer.

Your doctor can often remove small precancerous polyps during your colonoscopy so they will not develop into cancer.

Anyone with digestive system issues like inflammatory bowel disease should be considered for colonoscopy screening regardless of age.

Most insurance plans provide coverage for a screening colonoscopy for patients 45 and older. Call your health insurance company to confirm your coverage.

Colorectal cancer is the second-leading cause of cancer death in the United States. According to the American Cancer Society, beginning screenings at 45 may potentially prevent 60 percent of deaths caused by colon cancer.

If you are 45 or older, regardless of your weight, you should make a resolution to get healthy and discuss scheduling a colon cancer screening with your doctor.

Homemade pies, cakes and other sweet treats abound during the Yuletide season. For your health and waistline, you may want to consider limiting servings or even skipping dessert.

Many foods and beverages contain sweeteners, so it’s important to know about the ingredients. The USDA recommends consuming only 200 calories from added sugars (about 12 teaspoons) in a 2,000-calorie diet.

The Centers for Disease Control and Prevention lists added sugars as sucrose, dextrose, table sugar, syrups, honey, and sugars from concentrated fruit or vegetable juices.

A new study by the University of Pittsburgh scientists shows eating too much sugar also may aggravate inflammatory bowel disease (IBD) symptoms and affect the colon.

“Too much sugar isn’t good for a variety of reasons, and our study adds to that evidence by showing how sugar may be harmful to the gut,” said senior author Timothy Hand, Ph.D., in Medical Xpress. “For patients with IBD, high-density sugar–found in things like soda and candy–might be something to stay away from.”

Hand is an associate professor of pediatrics and immunology at Pitt’s School of Medicine and UPMC Children’s Hospital of Pittsburgh.

What Is Inflammatory Bowel Disease?

The CDC states that IBD is a term for two conditions: Crohn’s disease and ulcerative colitis. Both conditions are “characterized by chronic inflammation of the gastrointestinal (GI) tract. Prolonged inflammation results in damage to the GI tract.”

Although the exact cause of IBD is unknown, it is the result of a weakened immune system, according to the CDC.

Too Much Sugar Harms the Colon

Cellular and Molecular Gastroenterology and Hepatology published the University of Pittsburgh’s 14-day study.

The research, led by Ansen Burr, Ph.D., studied the effects of sugar on inflammatory bowel disease. Burr is a student in Pitt’s Medical Scientist Training Program.

In the study, researchers fed mice either a standard or high-sugar diet. Then, they treated the mice with DSS, a chemical that damages the colon and produces IBD symptoms.

Nine days later, all the mice on the high-sugar diet died. By comparison, all the animals on the standard diet survived until the end of the experiment.

Findings showed a high-sugar diet impairs cell renewal in the colon and exacerbates gut damage in IBD.

“Our research suggests that consuming high levels of sugar could have negative outcomes for repairing the colon in patients with inflammatory bowel disease,” Hand said.

IBD and Colon Cancer Similarities

IBD and colon cancer can share similar symptoms, so it is important to establish an accurate diagnosis. Consult your healthcare provider if you experience any of these symptoms:

• A change in bowel habits
• Abdominal pain
• Rectal bleeding
• Weight loss
• Fatigue

To accurately determine your condition, a colon cancer screening may be recommended. Colonoscopy is the gold standard for CRC screenings. This screening allows a doctor to view the entire large intestine, as well as find and remove polyps that could be cancerous.

People with IBD have a higher risk of colorectal cancer than the general population, according to the Crohn’s and Colitis Foundation. Patients with Crohn’s disease and ulcerative colitis should schedule a colonoscopy at doctor-recommended intervals.

Get Screened at 45+

Colorectal cancer is the second-leading cause of cancer death in the United States for both men and women. Everyone is at risk for this disease, regardless of age.

For people at average risk for colorectal cancer, healthcare agencies recommend starting screenings at age 45. Individuals should be screened even if they don’t have symptoms.

You may need to get screened before age 45 or more frequently if you have IBD, a family history of colorectal cancer or polyps (growths inside the colon and rectum) that may become cancerous.

Get a Colon Cancer Screening

Your quality of life may improve if you restrict consuming sugary foods and drinks and get screened for colorectal cancer.

The 12^th annual Crohn’s and Colitis Awareness Week is Dec. 1-7. Improving your nutrition by reducing sugar may lessen IBD symptoms and help prevent other harmful medical conditions, like obesity.

When detected early, before the disease has spread to other organs, colorectal cancer is highly treatable. In 2020, the CDC said about 68 percent of colorectal cancer deaths could be avoided if everyone eligible got screened.

Coverage of colonoscopy differs with health insurance policies. In most cases, there should be no out-of-pocket costs (such as copays or deductibles) for CRC screening tests.

You should contact your health insurance provider to verify any charges and to approve a colonoscopy before age 45.

If you are 45+, don’t delay your diagnosis. Discuss with your healthcare provider about scheduling your colonoscopy.

One of the risk factors for colorectal cancer is having a family history of the disease.

According to the American Cancer Society (ACS), around 33 percent of individuals with colorectal cancer (CRC) have relatives who have also been diagnosed with the disease.

A “family history” means a first-degree relative (mother, father, sister or brother) had colon cancer or precancerous polyps.

If you don’t know much about your family’s medical background, consider talking with your relatives about their colorectal health during Thanksgiving. Nov. 23 is National Family Health History Day.

“Nobody has to share their personal health information if they don’t want to, but I encourage patients to ask different family members and explain how this information can be helpful in being more informed about their health and making health decisions,” said Saundra Nguyen, MD, in Medical XPress. “Talking to first-degree relatives like parents and siblings can be a good starting point.”

Second-degree relatives may also have an increased risk for CRC. You should also consider talking to them about their medical history. Aunts, uncles, grandparents, grandchildren, nieces and nephews are considered second-degree relatives.

Collecting Your Family Medical History

The Centers for Disease Control and Prevention (CDC) recommends compiling a list of questions to collect your family’s medical history. When you talk with your relatives, write their answers down on this Family Health Tree.

Here are a few questions to ask relatives about their colorectal health:

Have you been diagnosed with colorectal cancer or have polyps been discovered during a colonoscopy?

Colorectal cancer is cancer of the colon or rectum. Most cases of CRC begin as small clumps of cells called colon polyps. Polyps start out as benign but can become cancerous if not identified and removed during a colonoscopy.

How old were you or a family member (exact or approximate age) when you were diagnosed or when polyps were found?

Everyone is at risk for this disease, regardless of age. In the United States, around 10 percent of people diagnosed with colorectal cancer annually are younger than 50.

If your relative was diagnosed before turning 50, you have a higher risk for CRC. This is called early-age-onset or young-onset cancer. Young adults tend to have more aggressive tumors that may be challenging to treat.

What is the origin of your family?

Your racial and ethnic background can be a factor in your risk for a colorectal cancer diagnosis.

According to the ACS, American Indian and Alaska Native individuals have the highest colorectal cancer rates in the United States, followed by African American males and females.

The ACS reports individuals of Ashkenazi Jewish background face a significantly elevated risk of colorectal cancer compared to other ethnic groups worldwide.

Once you collect your family medical history, share that information with your healthcare provider. Request that this data be included in your medical records. The documents need the names and ages of relatives who have had colon cancer and/or polyps.

Schedule Your Colonoscopy Screening

Colorectal cancer is the second-leading cause of cancer death in the United States. An estimated 153,020 new cases of colon cancer will be diagnosed this year, and 52,550 Americans are expected to die from the disease.

The good news is colorectal cancer is preventable and highly treatable when detected early through timely screenings.

The United States Preventive Services Task Force recommends that people at average risk start screening for colorectal cancer at age 45. If you have digestive system complaints, talk to your doctor, regardless of your age.

Not everyone has symptoms, but common warning signs of CRC may include the following:

• Abdominal pain
• Blood in the stool
• Change in bowel habits

“Someone with a strong family history of colon cancer may be recommended for a colonoscopy earlier than the general population …,” said Dr. Nguyen in Medical XPress. “We can also identify early warning signs of disease and work on preventive lifestyle measures.”

Individuals who have a genetic disposition for colorectal cancer, a family history of precancerous polyps, or certain hereditary cancer conditions may be advised to undergo …

• a colonoscopy starting at age 40, or 10 years before the age that the immediate family member was diagnosed with cancer;
• more frequent screening;
• colonoscopy only instead of other tests; and
• in some cases, genetic counseling.

During a colonoscopy, a gastroenterologist examines the entire length of your colon for polyps or abnormalities. Doctors can detect and remove precancerous polyps in the same procedure.

Coverage of colonoscopy differs with health insurance policies. In most cases, there should be no out-of-pocket costs (such as copays or deductibles) for CRC screening tests. You should contact your health insurance provider to verify any charges and to approve a colonoscopy before 45.

Learning about your family’s colorectal health is important for your health. On National Family Health History Day, or anytime, talk to your relatives about their medical history and write it down. Then, discuss with your healthcare provider about scheduling your colonoscopy.

Since hemorrhoids and colon cancer may have similar symptoms, it’s important to know the facts about each condition and to get an accurate diagnosis from a physician.

What Are Hemorrhoids?

Hemorrhoids, or piles, are swollen blood vessels around the anus or lower rectum. When the surrounding tissues become inflamed, they can enlarge, protrude and bleed. Hemorrhoids are common ­— about half of all adults older than 50 are affected.

Common symptoms of hemorrhoids may include the following:

• Blood in the stool, on the toilet paper or in the toilet bowl
• Inflammation or a hard lump around the anus
• Pain, itching or burning around the anus

Hemorrhoids can be internal or external, and both types can bleed. Untreated hemorrhoids can cause infection, anal spasm, ulceration and anemia.

“Hemorrhoids are common, and it’s easy to assume they could be the cause of rectal bleeding. But don’t take a chance — see your doctor and be sure,” said AMSURG Medical Staff Lead Jay Popp, MD.

Many people can treat mild cases of hemorrhoids efficiently and inexpensively at home. Sitz baths, over-the-counter creams and pain relievers can help reduce symptoms and provide comfort. If you cannot get relief from over-the-counter medication, you should visit a doctor.

If you are prone to hemorrhoids, there are several things you can do to prevent future flare-ups:

• Drink plenty of water
• Eat high-fiber foods, like fresh fruits and vegetables
• Take a stool softener or fiber supplement
• Avoid straining when having a bowel movement
• Avoid lifting heavy objects

What is Colon Cancer?

Colon cancer is cancer of the large intestine that forms in the colon’s lining. Most cases of colon cancer begin as an abnormal growth of cells called a polyp. All polyps start as benign; however, if not discovered and removed, polyps can become cancerous.

Symptoms of colon cancer include the following:

• Abdominal pain and cramping
• Rectal bleeding
• Fatigue
• Thin, pencil-like stools
• Changes in bowel habits like constipation, diarrhea or both
• Nausea and vomiting
• A feeling of incomplete evacuation
• Anal urgency, or feeling a constant need to pass stool
• Weight loss

Differences Between Colon Cancer and Hemorrhoids

Only a physician can accurately diagnose hemorrhoids or colon cancer, so it is essential to avoid self-diagnosis. Certain activities and conditions often can cause hemorrhoids. Some of these include the following:

• Pregnancy
• Constipation
• Straining to have a bowel movement
• Lifting too much weight frequently
• Sedentary lifestyle

With colon cancer, diagnosis can be complicated. Some people do not experience any symptoms. Also, many colon cancer symptoms are commonly experienced with non-cancerous conditions other than hemorrhoids, such as infection, irritable bowel syndrome or inflammatory bowel disease.

Most importantly, colon cancer has more severe health implications, as it is the second-leading cause of cancer death in the United States. An estimated 153,020 new cases of colon cancer will be diagnosed this year, and 52,550 Americans are expected to die from the disease.

You’re Never Too Young for Colon Cancer

Colon cancer incidence is steadily decreasing among adults over 65, but rates are increasing in adults younger than 50 as well. The number of new cases of colon cancer in adults younger than 55 has doubled from 11 percent in 1995 to 20 percent in 2019. According to the Colorectal Cancer Alliance, “The incidence rate of colorectal cancer is rising by about 2 percent annually in young people. By 2030, researchers predict that colorectal cancer will be the leading cause of cancer death in people ages 20-49.”

Because colon cancer is rising in younger adults, it is essential to know the warning signs of the disease and get screened at recommended intervals.

Make an Appointment for a Colonoscopy

If you are experiencing colon cancer symptoms, you should make an appointment with your doctor. Colon cancer is highly treatable when diagnosed early, and colonoscopy is the most effective test. A colonoscopy allows your doctor to view the entire colon and remove polyps before they become cancerous.

The American Cancer Society recommends that all adults at average risk for colon cancer begin screening at age 45. You may need to get screened earlier if you have a family history of colon cancer or a personal history of polyps. If you have digestive complaints, talk to your doctor regardless of your age. It is important you have troublesome symptoms evaluated.

Genetic syndromes like familial adenomatous polyposis (FAAP) and hereditary nonpolyposis colon cancer can also contribute to colon cancer risk, so talk to your doctor about when and how often you should get screened.