Colorectal cancer is now the leading cause of cancer deaths in people younger than 50, and cases are increasingly appearing in women and younger individuals overall. During Colorectal Cancer Awareness Month in March, gastroenterologists are urging people to understand their personal risk factors and know when screening should begin. The good news: early detection through screening can lead to remission, and lifestyle changes can significantly reduce your risk of developing the disease in the first place. Who Is at Highest Risk for Colon Cancer? Not everyone needs to start screening at the same age. Your risk level depends on several factors, including family history, personal medical conditions, and lifestyle habits. Understanding where you fall on the risk spectrum helps you and your doctor decide when screening should begin. Dr. Veronica Jarido, a gastroenterologist who specializes in serving rural and impoverished communities, identifies several high-risk groups. "Individuals who have a family history can be at risk of colon cancer. It can be genetic," Dr. Jarido explained. People with a personal history of polyps are also at higher risk because they "may make more polyps." Additionally, those with inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis lasting eight years or longer, face increased risk because prolonged inflammation can prime the colon for cancer development. Understanding your family history is the first step toward prevention. Dr. Jarido recommends: "To reduce the risk of colon cancer, first know your family history, especially of your parents and siblings." If you have first-degree relatives (parents or siblings) with colon cancer, or multiple second-degree relatives with the disease, your screening timeline changes significantly. When Should You Get Screened? Screening age recommendations vary based on risk level. For people with average risk and no family history, the current guideline recommends starting colonoscopy screening at age 45. However, those with family history need earlier screening. People with a family history of colon cancer should begin screening at age 40 or 10 years before the age at which their family member was diagnosed, whichever comes first. For example, if your parent was diagnosed at age 52, you should start screening at age 42. Those with inflammatory bowel disease should begin colon cancer screening after having the condition for eight years. What Warning Signs Should You Never Ignore? Certain symptoms warrant an immediate conversation with your doctor. While some signs like blood in the stool can have benign causes such as hemorrhoids, it's critical to get them evaluated rather than assume. Dr. Jarido emphasizes: "Blood in the stools is abnormal and should be addressed immediately. Hemorrhoids can cause blood in stools, but it is better to know this and not guess." Other warning signs include changes in bowel habits, new constipation, thin stools, unexplained iron deficiency, and unexplained weight loss. How to Reduce Your Colorectal Cancer Risk Diet and lifestyle choices play a major role in colorectal health. Recent research published in JAMA (Journal of the American Medical Association) has identified specific foods and habits that either increase or decrease your risk. Making these changes now can have a meaningful impact on your long-term health. - Avoid Ultra-Processed Foods: Diets high in ultra-processed foods, sugary items, processed meats, and red meats significantly increase colon cancer risk. Dr. Jarido notes that "JAMA has recently published that overly processed and ultra-processed foods, sugary foods, processed meats, and red meats are big contributors to the contribution of colon cancer." - Eat a High-Fiber, Low-Fat Diet: Focus on natural, balanced foods with plenty of fiber and minimal fat. This dietary pattern helps protect colon health and supports overall wellness. - Stay Hydrated: Drink plenty of water throughout the day. Adequate hydration supports digestive health and helps your body function optimally. - Exercise Regularly: Physical activity is a cornerstone of cancer prevention. Regular exercise reduces inflammation and supports healthy bowel function. - Limit Alcohol and Quit Smoking: Reducing excessive alcohol use and stopping cigarette smoking completely are essential steps to lower your colorectal cancer risk. What Happens During a Colonoscopy Screening? The colonoscopy is the gold-standard test for colorectal cancer screening. Many people feel anxious about the procedure, but understanding what to expect can ease concerns. The process involves preparation, the procedure itself, and recovery, all of which typically occur within a single day. The day before your colonoscopy, you'll drink a colon-cleansing solution to clear your bowels. Dr. Jarido acknowledges the reality: "It involves drinking a colon solution that will clean out the bowels. I will be honest here; it isn't pleasant, but it is necessary. Stool can hide polyps that can go on to become cancer, so I would always encourage patients that this is only for 24 hours." On the day of the procedure, you'll follow a clear liquid diet and receive sedation so you won't be awake during the screening. "On the day of the actual procedure, patients will not be awake or remember once the procedure starts. When they wake up, patients will often feel the same way they did when they went to sleep," Dr. Jarido explained. Some patients experience mild gas discomfort after the procedure because air is used to open the colon and visualize polyps. This discomfort resolves quickly. The entire process is completed on an outpatient basis, meaning you go home the same day. For those who prefer a less invasive option, Cologuard is an at-home colon cancer screening test that may be appropriate for certain patients, though colonoscopy remains the gold standard. Can Colon Cancer Be Cured? The earlier colorectal cancer is detected, the better the prognosis. "The earlier the stage the cancer is found, the more likely there will be remission," Dr. Jarido stated. This is why screening is so powerful; it catches cancer at earlier, more treatable stages before symptoms develop. People who have had colon cancer remain at increased risk for recurrence and must undergo more frequent surveillance colonoscopies than the average person. However, early detection through screening dramatically improves outcomes and survival rates, making the screening process a worthwhile investment in your long-term health.
