Are You at Risk for Colon Cancer?

According to the American Cancer Society (ACS), colorectal cancer, which starts in the colon or rectum, is the third most common cancer among women and men in the United States. But there’s good news—the overall rate of people diagnosed with colorectal cancer has dropped since the mid-1980s because more people are getting screened.

The bad news is that this downward trend is only seen in older people. Since the mid-1990s, colorectal cancer rates for people under the age of 50 have steadily increased. From 2012 to 2016, ACS reports that the rate of diagnosis in this age group increased every year by 2 percent.

Doctors aren’t sure why this is happening. “We don’t really know why rates are increasing among younger people,” says Matthew Skancke, MD, a colorectal surgeon with Holy Cross Health Partners, “and that’s one of the scary things.” Dr. Skancke recommends paying close attention to your colorectal health and get regular colorectal cancer screenings.

Colorectal Cancer Risk Factors You Can and Can't Change

We don’t know what causes colorectal cancer, but several factors can increase your risk of developing it. These risk factors can be divided into two groups: lifestyle-related risk factors that can be changed, and non-lifestyle-related risk factors that can’t be changed.

Lifestyle-related risk factors you can change include:

• Being overweight
• Being physically inactive
• Eating an unhealthy diet
• Smoking
• Consuming alcohol

All of these lifestyle-related risk factors have been strongly linked to colorectal cancer. You can decrease your risk by losing weight, exercising regularly, eating a well-balanced diet, quitting smoking, and reducing your alcohol intake—or even better, not drinking at all.

Non-lifestyle-related risk factors you can’t change:

• Age: Colorectal cancer is more common in people over 50, though it is increasing among those under 50.
• Race and ethnic background: African Americans have the highest incidence and mortality rates of colorectal cancer. Jews of Eastern European descent (Ashkenazi Jews) are also a high-risk group.
• Personal or family history: If you or a family member have had colorectal polyps or colorectal cancer, your chance of getting colorectal cancer increases. As many as 1 in 3 people who develop colorectal cancer have other family members who have had it.
• Personal history of other diseases: Your risk for developing colorectal cancer increases if you have certain other diseases, including type 2 diabetes and inflammatory bowel disease.

Possible Causes of Colorectal Cancer

While those risk factors can increase your chance of developing colorectal cancer, it remains unclear how they might cause it. A few theories have emerged that may show a possible link to colorectal cancer.

Red and Processed Meats

An ACS study that followed people between the ages of 50 to 74 across a 10-year period determined that high consumption of red meats (such as beef, pork, lamb, and liver) and processed meats (such as hot dogs and deli meats) raises your risk for developing colorectal cancer. Current ACS guidelines recommend limiting your intake of these types of meats.

Cellphones

There’s no real evidence to support a link between cell phones and colorectal cancer. But some scientists remain concerned because:

1. Cellphone antennas emit radio waves, a form of low-energy radiation and parts of the body nearest to the antenna can absorb this energy.
2. The number of cellphone users has quickly increased—in 2017, there were more than 400 million cellphone subscribers in the United States.
3. Over time, the number of cellphone calls per day, the length of each call, and the amount of time people use their cellphones has increased. This increased exposure to cellphone radio waves could play a role in people developing certain cancers like colorectal cancer, but until an actual link has been proven, scientists are continuing to research this theory.

Gut Microbiome

Bacteria and other microorganisms found in your gut, mouth, lungs, skin, and other parts of the body are known as the microbiome. Changes to the gut microbiome could be a biomarker of colorectal cancer and could help in screening for the disease. A recent study found that people with colorectal cancer had the highest levels of certain bacteria that have been connected to the development of colorectal cancer, while those with benign growths—like polyps—had loss in "good" bacteria that support normal cells in the colon and inhibit the growth of tumor cells.

Dr. Skancke supports the microbiome theory. “If I had to put my money on it, I would say it's probably a microbiome issue,” he says. “Sometimes individuals will have stress in their life, have an exposure to a virus or bacteria from the outside, or they'll take antibiotics for a cough or an infection—that will change their microbiome. And as the microbiome changes, certain subpopulations of bacteria resist that environmental impact while others don't. When you change the group of bacteria in the body, that leads to downstream effects.”

Why You Should Get a Colonoscopy

“Since we don't know what causes colorectal cancer, it's hard for us to prevent it,” Dr. Skancke says. “So, the only solution we have is screening earlier in hopes of catching it.” Early detection is crucial because colorectal cancer symptoms don’t often appear until the disease is in an advanced stage.

Regular screening tests like colonoscopies are the most important way to find colorectal cancer in its early stages when treatment is most successful. Both ACS and the U.S. Preventive Services Task Force recommend that individuals with an average risk of developing colorectal cancer start regular screenings at age 45. You’re considered to have an average risk if you don’t have any of the non-lifestyle-related risk factors listed above. You can find more information on screening recommendations in our blog post, Colorectal Cancer Screenings Now Start at Age 45.

Learn More About Colorectal Cancer

Our renowned colorectal surgery experts – Dr. Bradley Bennett, medical director; Dr. Rami Makhoul; and Dr. Matthew Skancke – perform procedures at Holy Cross Hospital and Holy Cross Germantown Hospital. For more information about Holy Cross Health's cancer services, call 855-HCH-HOPE (424-4673).




Watch Dr. Bennett and Dr. Skancke discuss early screening, diagnosis, and treatment options for colorectal cancer.