Colorectal cancer often has no symptoms. When symptoms do occur they may include blood in or on the stool, change in bowel habits, stools that are narrower than usual, general stomach discomfort (bloating, fullness, and/or cramps), vomiting, diarrhea, constipation, or feeling that the bowel does not empty completely, frequent gas pains, weight loss for no apparent reason, rectal bleeding and constant tiredness.
- Increasing age (it is most common in people over age 50)
- High-fat, high-calorie and low-fiber diets
- Having certain types of polyps (benign growths) develop in the colon or rectum
- Ulcerative colitis (a condition that causes inflammation of the lining of the colon)
- Genetics – inherited genes that increase your risk
- Women with a history of ovarian, uterine or breast cancer
- First-degree relatives (parents, siblings, children) who have had colorectal cancer
- Large alcohol consumption
- Lack of physical activity
Get Regular Screenings
The following screenings can help reduce your risk:
- Annual fecal occult screenings to detect the presence of hidden blood in the stool beginning at age 40
- A flexible sigmoidoscopy test is recommended every five years. This test checks the rectum and lower colon only.
- A colonoscopy, which checks the whole colon and rectum, is recommended for those age 50 and older every ten years
Everyone should have regular colorectal cancer screening beginning at age 40 with a yearly fecal occult blood test. This test includes a digital rectal exam and collection of a small amount of stool to be checked for signs of blood. Blood in the stool may be due to hemorrhoids or other anal problems, but it is also a sign of a bleeding polyp or colorectal cancer. You should not assume that blood in the stool is due to an anal problem until the possibility of a cancer has been evaluated. Unfortunately, only about 50 percent of colorectal cancers are found this way because not all cancers bleed early on.
Starting at age 50, you should have a full evaluation of the colon with either a colonoscopy or a sigmoidoscopy and radiologic test such as barium enema or colonography (virtual colonoscopy). Although the x-ray studies are useful, they are not as accurate as colonoscopy which allows a physician to view the entire colon. Also, polyps (precancerous growths) often can be removed during the colonoscopy procedure. Most can be performed on an outpatient basis with little discomfort. This should be repeated every 5 to 10 years and more often if you develop symptoms or have a personal or family history of colorectal cancer or colorectal polyps.
If you have risk factors for colorectal cancer, such as a personal history or family history of colorectal or other cancers or inflammatory bowel disease, you should talk to your doctor about earlier and/or more frequent screening.
Medicare Part B covers colorectal cancer screenings for men and women over age 50. Medicare covers a sigmoidoscopy once every 48 months. If you are ‘at risk' for colon cancer Medicare covers a colonoscopy once every 24 months with a prescription from your doctor. If you have a managed care plan (HMO) check as to whether or not it covers colorectal screenings.
- Healthy diet – Eating between 25 to 30 grams of fiber each day is a good way to keep your digestive system healthy. Dietary fiber comes from eating fruits, vegetables, whole grain breads and cereals, nuts and beans. Low-fat foods and those rich with folate, such as leafy green vegetables are especially important. Maintaining a healthy weight is important too. Carrying extra pounds around the midsection can put you at a higher risk.
- Exercise – Exercising for at least 20 minutes three to four days each week or moderate exercise such as walking, gardening or climbing steps may help reduce your risk.
- Reduce alcohol and eliminate tobacco use – If you use alcohol, do so only in moderation. Smoking puts you at high risk for lung, vascular and heart problems and for many types of cancer including lung and colorectal. The best preventative approach is to stop smoking and get recommended screening.