Increased Risk of Colon Cancer

Colorectal cancer is one of the most preventable cancers. No matter what your age, there is a lot you can do to lower your risk of developing it: there are many lifestyle changes that will successfully lower your risk.

The best way to detect colorectal cancer is to have screening tests performed on a regular basis after the age of 50 or sooner if there is a family history of this cancer or if you have had a predisposing condition. These tests may find non-cancerous tumors, called polyps, that sometimes develop into cancer. By finding them early and having them removed, you can prevent cancer from starting. Colorectal cancer screening tests include checking a stool sample for hidden blood, sigmoidoscopy, colonoscopy and barium enema. Talk to a health care professional about which ones may be right for you.

 


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.



Diet  

Low Fiber Intake

Low fiber intakes have been strongly linked to an increased risk for developing colon cancer.



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]



Metabolic  


Supplements and Medications  

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]



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.




Increased Risk of Colon Cancer can lead to

Risks  



Recommendations for Increased Risk of Colon Cancer

Botanical  

Mistletoe (Viscum album)

The news (Dec 11, 2012) of a potential new cure could all the same come as a relief to many at-risk American patients of both genders, as according to the Centers for Disease Control and Prevention in Atlanta, colon cancer is the second leading type of cancer that affects men and women in the United States.

Mistletoe’s potential alternate use was reportedly discovered by student Zahra Lotfollahi, who completed a research project comparing three different types of mistletoe extract to chemotherapy on colon cancer cells. She additionally compared the impact of mistletoe extract and chemotherapy on healthy cells, the news website learned.

Lotfollahi found that one type of mistletoe extract known as Fraxini was not only highly effective in combating colon cancer cells, but was also gentler on healthy cells than chemotherapy.

“Of the three extracts tested, and compared with chemotherapy, Fraxini was the only one that showed a reduced impact on healthy intestinal cells,” she was quoted as saying. “This is an important result because we know that chemotherapy is effective as killing healthy cells as well as cancer cells.”

She noted that the mistletoe chemical could come with its own set of negative side effects, including ulcers in the mouth and hair loss.

According to her supervisor, Professor Gordon Howarth:

“Although mistletoe grown on the ash tree was the most effective of the three extracts tested, there is a possibility that mistletoe grown on other, as yet untested, trees or plants could be even more effective.

“This is just the first important step in what we hope will lead to further research, and eventually clinical trials, of mistletoe extract in Australia,”

Howarth claims the extract has been available in Europe and other countries overseas, but not in the the United States or Australia, hence the need for research. I’m sure much has to do with big pharma, since there’s not any money to be made with natural alternatives, but hopefully something will come of this.



 

Green / Oolong / BlackTea (Camellia sinensis)

Regular and substantial consumption of green tea may provide protective effect against this type of cancer.



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]



Drug  


 

NSAIDs

Aspirin and other NSAIDs have been previously reported to protect against the development of colorectal cancer. [ Gastroenterology, March 1998]



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.



Hormone  


Lab Tests/Rule-Outs  

Digestive Enzymes / (Trial)

See the link between Colon Cancer and Digestive Enzymes



 


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.



 


Nutrient  


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]



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

Glossary

Colorectal Cancer

A cancerous tumor of the large intestine. It is marked by dark, sticky stools containing blood and a change in bowel habits.

Cancer

Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Polyp

A usually nonmalignant growth or tumor protruding from the mucous lining of an organ such as the nose, bladder or intestine, often causing obstruction.

Colon

The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.

Insulin

A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

Carbohydrates

The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.

Dysplasia

Abnormal development of tissue.

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