Colorectal Cancer: Prevalence, Risk Factors and Prevention

Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum (Siegel et al., 2023).

Many colon cancer cases are sporadic, with approximately 5 percent attributed to inherited genetic mutations and familial adenomatous polyposis (Menon & Cagir, 2024). The progression from normal colon epithelium to invasive cancer occurs gradually, typically following a sequence marked by the accumulation of genetic mutations, formation of adenomas, and eventual carcinogenesis (Gajendran et al., 2019; Sokic-Milutinovic et al., 2019; Xiao et al., 2019.)

Risk factors for the development of colon cancer include age, family history, inherited colon-cancer related mutations, adenomas on colonoscopy screening, history of inflammatory bowel disease, and environmental factors such as alcohol consumption, cigarette smoking, obesity, diets high in processed food, insulin resistance, immunosuppression, and a history of radiation (Menon & Cagir, 2024).

Initially, the evaluation process may include a barium enema or a CT colonography, however, a colonoscopy will be required for a tissue diagnosis (Dawson et al., 2019; Grimm et al., 2019). If completed by an experienced endoscopist with good bowel preparation, a colonoscopy is approximately 94.7% sensitive (Menon & Cagir, 2024).

The standard of care for colon cancer is surgical resection – the resection type, lymphadenectomy extent, and specific techniques are dependent upon the location and stage of the tumor (Menon & Cagir, 2024). Chemotherapy and systemic therapy may be used in cases of advanced colon cancer or metastatic disease, and radiation is rarely used (Menon & Cagir, 2024).

Preventative action and tools against colon cancer include diets rich in fruit, vegetables, fiber, resistant starch, fish, coffee, and garlic, as well as physical activity, supplementation of magnesium, vitamin D, calcium, pyridoxine, folate and folic acid, and nonsteroidal anti-inflammatory drugs, among other medication (Hou et al., 2013; Menon & Cagir, 2024).

Learn more about colon cancer by reviewing the references cited in this blog post.