Prevention

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The most important line of defense against colorectal cancer is screening for colorectal cancer. You should follow the established guidelines for screening procedures so that any precancerous polyps can be removed before they turn into cancer and, if cancer exists, it can be detected at the earliest possible stage. If you are at average risk of colorectal cancer, the American Cancer Society recommends that all women and men over the age of 50 undergo one of the following:

• An annual fecal occult blood test
• A flexible sigmoidoscopy every five years
• An annual fecal occult blood test (FOBT) or fecal immunochemical test (FIT) and a flexible sigmoidoscopy every five years
• (Of these first three options, the combination of FOBT or FIT every year plus flexible sigmoidoscopy every five years is preferable.)
• A Double contrast barium enema every five years
• A colonoscopy every 10 years unless you are African American, in which case your screening should begin at age 45.

Any positive screening test should be followed by an appropriate and complete diagnostic evaluation of the colon including a colonoscopy with biopsies, if necessary.

If you are at an increased risk of colorectal cancer or adenomas because of a family history of cancer or polyps, you should follow the above recommendations and also:

• Begin colorectal screening at age 40, or 10 years before the youngest case of the disease in the immediate family.

• Discuss genetic counseling and/or testing with your health care professional.

Modifying your diet and exercise may help decrease your risk of forming colon polyps and/or colon cancer. A diet rich in vegetables, fruit and fiber, and low in fat, may reduce the risk of developing colon cancer. Some suggest that getting an adequate supply of calcium (more than 1,250 mg a day) and folic acid (a B complex vitamin) decreases the risk of colon cancer. In addition to supplements, folic acid can be found in fruits, dark green leafy vegetables, dried beans and peas, folic acid-fortified enriched cereal grain products and breakfast cereals. Calcium can be found in dairy products, calcium-fortified products such as orange juice, soy and dark green vegetables

Regular exercise is important in preventing colon cancer. Experts say that vigorous exercise is not necessary. Instead, just incorporate more activity into your daily routine, such as taking the steps instead of the elevator or parking your car further from the building you're entering. Overall, the American Cancer Society recommends 30 minutes of physical activity at least five days per week and says that 45 minutes or more of moderate to vigorous activity five or more days a week may further reduce the risk of both breast and colon cancers.

It's also advisable to drink alcohol only in moderation (no more than one alcoholic beverage per day, for a total of less than seven drinks per week) and abstain from tobacco use.

Results from two randomized, controlled clinical trials published in 2003 demonstrated that taking daily aspirin for as little as three years reduced the development of adenomatous polyps by 19 percent to 35 percent in people at high risk for colorectal cancer. However, the risk of stomach ulcers and other side effects associated with aspirin and other NSAIDS may outweigh the benefits. Before you start taking aspirin for the prevention of colorectal cancer, discuss potential risks with your health care professional.