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| Increased Risk of Colon Cancer |
Last updated: May 12, 2008 |
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Increased Risk of Colon Cancer |
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Contributing risk factors | It can lead to... | Recommendations
 Risk factors for Increased Risk of Colon Cancer: | |  | | | | Autoimmune |  Ulcerative Colitis | Inflammatory bowel disease increases the risk of colon cancer. |
Crohn's Disease| | Inflammatory bowel disease increases the risk of colon cancer. |
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Diet |
Low Fiber Intake| | Low fiber intakes have been strongly linked to an increased risk for developing colon cancer. |
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Family History |
Family history of colorectal cancer |
Hormones |
Elevated Insulin Levels| | Elevated insulin production, as reflected by elevated concentrations of plasma C-peptide, may predict the risk of developing colorectal cancer, independently of BMI, factors related to insulin resistance, or levels of IGF-I and IGFBP-3. [J Natl Cancer Inst. 2004 Apr 7;96(7): pp.546-53] |
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Metabolic |
 Problem Caused By Being Overweight |
Supplements and Medications |
Counter-indicators:
 Selenium supplementation |
Symptoms - Cancer |
 History of colon cancer |
Symptoms - Food - Intake |
Eating a high glycemic diet| | According to a study, women who consume a high dietary glycemic load may increase their risk of colorectal (colon) cancer. Glycemic load is a measure of how quickly a food's carbohydrates are turned into sugars by the body (glycemic index) in relation to the amount of carbohydrates per serving of that food. Researchers found that women who ate the most high-glycemic-load foods were nearly three times more likely to develop colon cancer. [Journal of the National Cancer Institute February 4, 2004;96(3): pp.229-233] |
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Symptoms - Gas-Int - Conditions |
(History of) colon polyps| | Usually cancer of the colon starts with a polyp or growth. Polyps can be removed long before they turn into cancer by using a colonoscope. If the polyp has turned cancerous, but is found early, survival rates are excellent.
The cumulative risk of cancer developing in an unremoved polyp is 2.5% at 5 years, 8% at 10 years, and 24% at 20 years after the diagnosis. The probability of any singular polyp becoming cancerous is dependent on its gross appearance, histologic features, and size.
The relative risk of developing colon cancer after polyps have been removed is 2.3 compared to a relative risk of 8.0 for those who do not have the polyps removed. Polyps greater than 1 centimeter have a greater cancer risk associated with them than polyps under 1 centimeter. Polyps with atypia or dysplasia are also more likely to progress on to colon cancer.
The risk of cancer is much higher in sessile villous adenomas than in pedunculated tubular adenomas. Cancer is found in 40% of villous adenomas, as compared to 15% in tubular adenomas. The good news is that 65% of adenomas are tubular, with villous adenomas accounting for only 10% of adenomatous polyps. It has been shown that the removal of polyps by colonoscopy reduces the risk of getting colon cancer significantly. |
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Increased Risk of Colon Cancer can lead to:
Recommendations for Increased Risk of Colon Cancer: | | | | | | Botanical |  Green / Oolong / BlackTea (Camellia sinensis)| | Regular and substantial consumption of green tea may provide protective effect against this type of cancer. |
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Diet |
 Increased Fish Consumption| | Study subjects who ate two or more servings of fish weekly had a much lower risk for esophageal, stomach, colon, rectum, and pancreatic cancers than those who avoided fish. In fact, the rates of these types of cancer were 30-50% lower among fish eaters. High fish consumption was also associated with lower risks for cancers of the larynx (30% lower risk), endometrial cancer (20% lower risk), and ovarian cancer (30% lower risk). |
Cabbage Family Vegetables| | Vegetables from the cabbage family (cruciferous vegetables) may reduce the risk of colon cancer. [The National Cancer Institute booklet, "Diet, Nutrition, & Cancer Prevention: A Guide to Food Choices"] |
Alcohol Avoidance| | You should drink under one alcoholic drink a day because drinking alcohol increases your risk of colorectal cancer. Since it can have both positive and negative effects on your health, you may wish to talk to a health care professional about how alcohol may affect you. |
Animal/Saturated Fats Avoidance| | Eat no more than 2-3 servings of red meat per week - the less red meat you eat, the better. Choose chicken, fish, or vegetarian alternatives such as beans instead. |
Increased Fruit/Vegetable Consumption| | The fiber of choice for prevention of colorectal cancer seems to be psyllium, pectin or guar gum. The amount of pectin in approximately two servings of fruit rich in pectin such as pears, apples, grapefruit, and oranges is 15gm. Psyllium or guar gum are obtained by supplement. The RDA of total fiber is 20-30gm. In Scotland, where the average fiber intake is 2-3gm per day, there is a very high incidence of colon cancer.
For years, dietary fiber has been promoted by nutrition researchers and practitioners for colon cancer prevention. However, in two recent studies high-fiber diets did not decrease risks of colon cancer. The two studies are significant contributions to the literature, but they can not and do not close the discussion. If anything, they underscore the real need for further research and analysis.
Both studies, for example, involved only short-term (four-year) adjustments to the diet. One of them involved the use of wheat bran. Colon cancer is a disease that can take decades to develop. Convincing epidemiological evidence suggests that a healthy diet has its greatest preventive effect as a lifelong commitment, not a stopgap measure. While wheat bran does not appear to provide any protective benefit, a high fruit and vegetable diet may still provide benefit in preventing colorectal cancer.
Dr. Tim Byers, M.D., M.P.H. from the University of Colorado School of Medicine stated in the same issue of NEJM that "...observational studies around the world continue to find that the risk of colorectal cancer is lower among populations with high intakes of fruits and vegetables and that the risk changes on adoption of a different diet, but we still do not understand why." [NEJM, January 22, 1999, NEJM 342: pp.1149-55, pp.1156-62, 2000.] |
Vegetarian/Vegan Diet| | Diets high in fiber-rich foods may reduce the risk of cancers of the colon and rectum. [The National Cancer Institute booklet "Diet, Nutrition, & Cancer Prevention: A Guide to Food Choices"] |
Milk / Dairy Products| | A long-term high consumption of milk, but not calcium, vitamin D or fermented milk, was associated with a reduced risk of colon cancer in a study of 9,959 men and women aged 15 years or older without history of cancer at baseline who were
followed for 24 years. [Eur J Clin Nutr 2001,55(11): pp.1000-1007] |
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Drug |
LDN - Low Dose Naltrexone
NSAIDs| | Aspirin and other NSAIDs have been previously reported to protect against the development of colorectal cancer. [ Gastroenterology, March 1998] |
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Habits |
Aerobic Exercise| | Try to get at least 30 minutes of physical activity every day.
Regular, moderate-to-vigorous aerobic exercise significantly reduces a risk factor associated with the formation of colon polyps and colon cancer in men, according to a study led by researchers at Fred Hutchinson Cancer Research Center. The findings, from the first randomized clinical trial to test the effect of exercise on colon-cancer biomarkers in colon tissue, appear in the September 2006 issue of Cancer Epidemiology, Biomarkers and Prevention. |
Tobacco Avoidance| | Smoking increases your risk of colorectal cancer in both men and women. |
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Hormone |
DHEA |
Lab Tests/Rule-Outs |
Digestive Enzymes / (Trial)| | See the link between Colon Cancer and Digestive Enzymes |
Test AMAS (AntiMalignin Antibody Screen) |
Mineral |
Calcium| | A higher dietary calcium intake (914mg/d compared to 486mg/d) was associated with a reduced risk of colorectal cancer in a study of 61,463 women followed for an average of 11 years. [Nutr Cancer 2002;43(1): pp.39-46]
Previous studies have shown that people with noncancerous colorectal tumors called adenomas who take calcium supplements for 4 years can reduce their risk of an adenoma recurrence. A new study shows that the protective effect of those supplements lasts for up to 5 years after stopping supplementation. They note that current guidelines recommend that people simply consume recommended levels of calcium (1000 mg/day for adults up to age 50 years and 1200 mg/day for those older than 50 years) [Calcium Polyp Prevention Study, Jan. 17, 2007 JNCI] |
Selenium| | Blood levels of selenium have been reported to be low in patients with a variety of cancers including colon cancer. People with the lowest blood levels of selenium have an increased risk of dying from cancer compared with those who had the highest selenium levels. |
Calcium-D-Glucarate |
Nutrient |
Butyrate |
Vitamins |
 Vitamin D| | The colorectal cancer study, published online February 6, 2006 in the American Journal of Preventive Medicine, is a meta-analysis of five studies that explored the association of blood levels of 25(OH)D with risk of colon cancer. All of the studies involved blood collected and tested for 25 (OH)D levels from healthy volunteer donors who were then followed for up to 25 years for development of colorectal cancer.
"Through this meta-analysis we found that raising the serum level of 25-hydroxyvitamin D to 34 ng/ml would reduce the incidence rates of colorectal cancer by half," said co-author Edward D. Gorham, Ph.D. "We project a two-thirds reduction in incidence with serum levels of 46ng/ml, which corresponds to a daily intake of 2,000 IU of vitamin D3. This would be best achieved with a combination of diet, supplements and 10 to 15 minutes per day in the sun." |
Vitamin Folic Acid| | Long-term use of a multivitamin containing 400mcg of folic acid, found mostly in leafy green vegetables, beans and nuts, may reduce the risk of colon cancer in women by as much as 75%. The investigators in one study found that folic acid obtained from dietary supplements had a stronger protective effect against colon cancer than folic acid consumed in the diet. In other words, although foods naturally high in folate may provide other beneficial micronutrients, consumption of these foods is probably less effective than use of supplements and fortified foods in enhancing folate status. [Annals of Internal Medicine October 1, 1998;129: pp.517-524] [Int J Canc 2002;Vol. 97; pp.864-867]
In studies, a higher folic acid intake needed to occur for many years (15) in order to produce this anticancer effect. Perhaps supplementation with higher doses would produce protective benefits in a shorter period of time. |
Vitamin E| | Although useful in helping colon cancer cases about to be treated, supplementation with vitamin E was found not to be associated with the risk of colon cancer in a study of 87,998 women and 47,344 men. [Cancer Epidemiol Biomarkers Prev 2002;11(11): pp.1298-1304] |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link | | | Very strongly or absolutely counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
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