The third most common cancer worldwide can be deadly, but it’s curable if discovered early. Even if you’re in good health, you should get this screening.
Tall, lean Steffi Wessa of Landau, Germany, had never had a serious illness. So when in late 2013 after she turned 55, her physician suggested they add a routine colorectal cancer screening by colonoscopy to her regular medical check-up, Steffi had no reason for concern. Colorectal cancer (CRC), often called colon cancer, is a malignancy in the large intestine, that twisty tube through which waste products exit the anus. The last six or so inches of the colon is called the rectum.
During the colonoscopy—examination of the entire colon with an endoscope—the doctor found two polyps, benign growths in the intestinal wall that have the potential to turn cancerous if left untreated. The doctor removed these during the procedure. But there was something more: a five-centimeter growth in the rectal area. It appeared to be a carcinoma.
A biopsy confirmed the physician’s suspicions: Steffi had colorectal cancer. On hearing the news, Steffi was distraught. ‘My world collapsed. To me, cancer meant death.’
What puts us at risk of getting colon cancer in the first place? The risk increases with age—those older than 50 make up the vast majority of cases—but it can strike much younger people as well.
‘There can be genetic factors, environmental factors, or an interplay between the two,’ says Dr. Jordan Karlitz, MD, FACG, associate professor of gastroenterology at Tulane University School of Medicine in New Orleans, Louisiana. He notes that ulcerative colitis and Crohn’s disease can lead to the development of CRC if the illness afflicts a significant portion of the colon. A sedentary lifestyle adds to the risk.
The modern diet and lifestyle are believed to be among the most significant risk factors. A diet heavy on meat, especially processed meats, and light on fruits, vegetables, and fiber, can predispose someone to CRC, as can smoking tobacco and drinking alcohol, says Dr. Luc Colemont, a Belgian gastroenterologist and managing director of the foundation Stop Colon Cancer. People who are obese or who have type two diabetes have a heightened risk as well.
Possibly the most common/readily accessible in Europe is the fecal test. It’s both simple and inexpensive. You get a kit from the doctor, follow the at-home directions for collecting a stool sample, and ship everything back. These tests look for blood in the sample that isn’t apparent to the naked eye. A positive result may be evidence of either pre-cancerous polyps or of cancer.
But colonoscopy is an invasive procedure and it can be difficult to persuade people to get screened this way. When physicians in the Netherlands were seeking to increase screening participation, they sent out invitations to members of the population 50 and older, offering a variety of screening options. When the invitations yielded more than twice the number of participants for fecal tests than colonoscopies, that’s where the Netherlands focused its efforts. Today, the country has the highest rate of CRC screening in Europe. In Britain, too, a fecal test kit is sent every two years to everyone over 60 who is registered with a GP. In France, fecal tests kits are sent to everyone age 50 and older. Since colonoscopies can be a little rough, here’s what doctors say you should do to prepare.
Once you notice symptoms of CRC, putting off screening can be a bad decision. In early 2013, Belgian Filip Luypaert, 44, was focused on his career as a high-powered executive for an international medical device company. In great physical condition, he had no known risks for cancer. But he’d recently noticed blood in his stool. When he mentioned this to his GP, the doctor recommended a sigmoidoscopy, just as a precaution.
Vitamin D might also play a role in prevention, although the link isn’t proven. ‘We have population studies showing that of patients who have lower vitamin D levels, they have a higher rate of colon cancers,’ says Dr. Grothey.
According to the U.S. National Institutes of Health, two randomized controlled trials suggest that 1,200 to 2,000 milligrams of calcium per day may reduce the risk of polyps recurring. The American College of Gastroenterology recommends supplements to colorectal cancer survivors.
But the best way to lower your risk is to stay vigilant. If you are over age 50 and have never had CRC and have no symptoms, talk to your doctor about screening. Those who have had CRC or are at risk for getting it should be screened more often than the general population. And if you experience any of the symptoms associated with the disease, even if they seem mild and inconsequential, tell your doctor. Your life could depend on it. Learn some more ways you can reduce your risk, and check out the best foods to eat to prevent several kinds of cancer.