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Prevention
By Mayo Clinic staff
Get screened for colon cancer
People with an average risk of colon cancer can consider screening beginning at age 50. But people with an increased risk, such as those with a family history of colon cancer, should consider screening sooner. African-Americans and American Indians may begin colon cancer screening at age 45.
Several screening options exist — each with its own benefits and drawbacks. Talk about your options with your doctor, and together you can decide which tests are appropriate for you. Options may include:
- Annual fecal occult blood testing
- Flexible sigmoidoscopy every five years
- Colonoscopy every 10 years
- Virtual colonoscopy (CT colonography) every five years
- Stool DNA testing — though this is a new screening approach and it's not clear how often it should be repeated
More frequent or earlier screening may be recommended if you're at increased risk of colon cancer. Discuss the benefits and risks of each screening option with your doctor. You may decide one or more tests are appropriate for you.
Make lifestyle changes to reduce your risk
You can take steps to reduce your risk of colon cancer by making changes in your everyday life. Take steps to:
- Eat a variety of fruits, vegetables and whole grains. Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention. Choose a variety of fruits and vegetables so that you get an array of vitamins and nutrients.
- Drink alcohol in moderation, if at all. If you choose to drink alcohol, limit the amount of alcohol you drink to no more than one drink a day for women and two for men.
- Stop smoking. Talk to your doctor about ways to quit that may work for you.
- Exercise most days of the week. Try to get at least 30 minutes of exercise on most days. If you've been inactive, start slowly and build up gradually to 30 minutes. Also, talk to your doctor before starting any exercise program.
- Maintain a healthy weight. If you have a healthy weight, work to maintain your weight by combining a healthy diet with daily exercise. If you need to lose weight, ask your doctor about healthy ways to achieve your goal. Aim to lose weight slowly by increasing the amount of exercise you get and reducing the number of calories you eat.
Colon cancer prevention for people with a high risk
Some treatments, including medications and surgery, have been found to reduce the risk of precancerous polyps or colon cancer. However, not enough evidence exists to recommend these medications to people who have an average risk of colon cancer. If you have an increased risk of colon cancer, discuss the benefits and risks of these preventive treatments with your doctor:
- Aspirin. Some evidence links a reduced risk of polyps and colon cancer to regular aspirin use. However, studies of low-dose aspirin or short-term use of aspirin haven't found this to be true. It's likely that you may be able to reduce your risk of colon cancer by taking large doses of aspirin over a long period of time. But using aspirin in this way carries a risk of side effects, such as gastrointestinal bleeding and ulcers.
- Other pain relievers. Other pain relievers, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others), have also been studied as a way to prevent colon cancer. Some studies have found these other pain relievers may reduce the risk of precancerous polyps and colon cancer. But side effects include ulcers and gastrointestinal bleeding. Some of these other pain relievers have been linked to an increased risk of heart problems.
- Celecoxib (Celebrex). Celecoxib and other drugs known as COX-2 inhibitors provide pain relief. Some evidence suggests COX-2 drugs can reduce the risk of precancerous polyps in people who've been diagnosed with these polyps in the past. But COX-2 drugs carry a risk of heart problems, including heart attack. Two COX-2 inhibitor drugs were removed from the market because of these risks.
- Surgery to prevent cancer. In cases of rare, inherited syndromes such as familial adenomatous polyposis, or inflammatory bowel disease such as ulcerative colitis, your doctor may recommend removal of your entire colon and rectum in order to prevent cancer from occurring.
- Compton C, et al. Colon cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008:1477.
- What you need to know about cancer of the colon and rectum. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/colon-and-rectal/allpages/print. Accessed June 15, 2011.
- Colon cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 15, 2011.
- Rectal cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 15, 2011.
- Colon and rectum. In: Edge SB, et al. AJCC Cancer Staging Manual. 7th ed. New York, N.Y.: Springer; 2010:143.
- Distress management. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 15, 2011.
- Colorectal cancer screening. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/guidelines_and_more/gl_os_prot/preventive_health_maintenance/colorectal_cancer_screening/colorectal_cancer_screening_6.html. Accessed June 16, 2011.
- Chan A. NSAIDs (including aspirin): Role in prevention of colorectal cancer. http://www.uptodate.com/home/index.html. Accessed June 16, 2011.
- Young MC. Colon cancer. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed June 15, 2011.
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