Five simple steps could help prevent colorectal cancer – expert

Colorectal surgeon David Liska, MD

The World Cancer Research Fund names colorectal cancer as the second most common cancer in women and the third most common cancer in men, and yet it is highly preventable, says an expert from global health system Cleveland Clinic marking Colorectal Cancer Awareness Month in March.

While lifestyle modifications can help to prevent many forms of cancer, the screening for colorectal cancer in itself represents an opportunity for intervention, says colorectal surgeon David Liska, MD,  who is director of the Center for Young-Onset Colorectal Cancer at Cleveland Clinic. During colonoscopies, precancerous polyps or lesions in the colon or rectum can be identified and removed before they cause any harm. “You can’t prevent breast, lung or brain cancer in the same way. You can’t take precancerous polyps off any of those organs like you can with the large intestine,” he points out.

Most colorectal cancers are found in people older than 50, but Dr. Liska notes there has been a recent increase in prevalence among younger patients. Researchers speculate this may at least partially be because of increasingly poor dietary habits and lack of exercise.

Dr. Liska stresses that if individuals experience any unusual symptoms such as rectal bleeding, change in bowel habits, or abdominal pain, it is important not to ignore these symptoms, regardless of their age or family history. “There is no such thing as ‘normal’ bleeding, so if this happens, people need to talk to their physician and be assessed. We see a number of young patients with colorectal cancer who may have initially ignored such symptoms or were told they were too young to have colorectal cancer,” he says.

Here, Dr. Liska shares details on his five steps to help prevent colorectal cancer.

Step 1: Undergo regular screening examinations

“Every colon and rectal cancer arises from a precancerous polyp or other precancerous lesion, and it takes around 10 years for a benign polyp to become cancerous,” says Dr. Liska. “A colonoscopy allows doctors to find and remove colon polyps before they’re a problem.”

Dr. Liska points out that colonoscopies are safe and relatively comfortable procedures, which typically last around 30 minutes if no polyps need to be removed. “Patients should look for an experienced colonoscopist who knows how to recognize polyps and remove them in the safest way possible. The whole experience is more comfortable than it used to be, with better formulas for the pre-procedure preparation as well as conscious sedation – or ‘twilight sleep’ – used in many cases,” he says.

Dr. Liska says everyone should undergo regular screening with either a colonoscopy or one of the other recommended screening tests starting at age 45, as this is when colorectal cancer risk starts increasing. However, individuals with a higher risk for the disease, for example if it runs in their family, should talk to their doctor about starting screening earlier.

“In general, colonoscopy math works like this: Take the age of the youngest affected relative when they were diagnosed with advanced precancerous polyps or cancer and subtract 10 years from that age. That’s when you should start having colonoscopies and continue them every five years if you have a family history of colorectal cancer,” says Dr. Liska.

Step 2: Follow a colon-friendly diet

Dr. Liska recommends eating more fruits, vegetables, whole-grain breads and cereals, nuts and beans as these are linked to a lower risk of some cancers and healthy bowel functioning. He also advises limiting red meat and high-fat or processed meats, which can increase colon cancer risk. In addition, alcohol is a general cancer risk factor, so should be limited or avoided.

A study published in the Journal of the American Medical Association found a Mediterranean-style diet, with its emphasis on fish and high-fiber foods such as fresh fruits and vegetables, lowered colorectal cancer risk by 43%, compared to a non-vegetarian diet.

Step 3: Maintain a healthy weight

Dr. Liska says the risk of colorectal cancer increases if an individual is overweight. He advises that people regularly monitor their body mass index (BMI), which is calculated by taking their weight in kilograms and dividing this by the square of their height in meters. He says A BMI of 25 or higher can raise a person’s risk for the disease.

Step 4: Exercise regularly

“If they can, I advise my patients to do at least 30 minutes of moderate-intensity exercise five days a week. Physical activity can help maintain a healthy weight and  reduce stress, which can decrease cancer risk,” says Dr. Liska. Examples of moderate-intensity exercise for a healthy adult include brisk walking, riding a bike, or doubles tennis.

Step 5: Avoid smoking and vaping

Dr. Liska says that, on top of many other health risks, smoking increases the risk of colon cancer, so it should be avoided completely.

In conclusion, Dr. Liska says, “Cancer is a leading cause of death worldwide, yet up to 85% of colorectal cancers could be prevented or successfully treated if everyone who is eligible for a colonoscopy got screened. In addition, Colorectal Cancer Awareness Month serves as an important reminder that simple lifestyle choices can help greatly reduce the risks of developing it.”