Let’s Talk About Your Colorectal Health

Tricia Borchers, PA-C, Cucamonga Valley Medical Group

By Tricia Borchers, PA-C

People typically don’t like to openly discuss colorectal health. The topic can be uncomfortable, but it is an important conversation regarding our health.

As your providers, we at CVMG want to know about your concerns related to this issue. We want you to feel comfortable talking to us about it.

Some common colorectal signs and symptoms that you should bring to your providers’ attention include rectal bleeding, blood in your stool, abdominal pain, persistent constipation or diarrhea. Not everything is dangerous and some issues can just be related to sedentary lifestyle, diet or lack of water intake.

Colon cancer is the biggest concern to most people. According to the American Cancer Society (ACS), your risk of being diagnosed with colorectal cancer in your lifetime is approximately 4.4% for men (1 in 23) and 4.1% of women (1 in 25).

As of 2021, the United States Preventive Services Task Force now recommends colon rectal screening for ages 45-to-75 years old. That means the screening test for colon cancer now starts 5 years earlier.

Let’s break this down, for there are some things that you have control over, and others you do not when evaluating your risk for colon cancer.

Your age, family history of colon cancer, race and ethnicity are among factors that impact risk.

The Centers for Disease Control and Prevention (CDC) states most colorectal cancers occur in people over age 50. The highest rates of colon cancer are among non-Hispanic African Americans, American Indians, Alaska Natives and Jewish Ashkenazi descent.

Personal history of colorectal polyps puts you at a higher risk of colon cancer.

Other health conditions, such as inflammatory bowel disease (this can be Ulcerative Colitis or Crohn’s disease), Type 2 Diabetes and some genetic concerns such as Lynch syndrome all increase your risk of colon cancer.

The American Cancer Society states that 55% of colorectal cancers in the U.S. are attributed to controllable lifestyle factors. What are the lifestyle factors that can reduce our colon cancer risk?

• Diet – a low fat diet with reduction of processed meat helps reduce your colon cancer risk. Choose a diet of fruits and vegetables and whole grains. A diet high in fiber moves the waste though your colon faster.

• Alcohol – Limit alcohol intake. It has been noted that drinking more than one drink a day for women and two for men increase your colon cancer risk.

• Weight – Your risk is increased if you are overweight or obese. Fat can increase growth of cells in the colon leading to colon cancer.

• Activity level – Daily exercise is helpful to reduce your risk. It also moves the food though your colon faster as well. People who are sedentary have a 25-50% higher risk of developing colon cancer.

• Smoking – The ACS notes that there is sufficient evidence that tobacco smoking causes colorectal cancer. Approximately 12% can be attributed to smoking. If you can’t stop smoking, at least cut back and talk to your health care provider on ways to help.

Colon cancer typically has a slow growth course from precancerous polyp to invasive colon cancer. This provides a great opportunity for prevention of colorectal cancer with early detection techniques when treatment is more successful.

Let’s talk about the most commonly used colorectal screenings that are available to you. They are separated into stool-based test and visual test.

The Stool based test looks at the stool (feces) for possible signs of colorectal cancer. The advantage is these tests may be done at home. They include Fecal immunochemical test (FIT), and Stool DNA test (Cologuard). The FIT test needs to be done yearly. Cologuard is done every 3 years if they are negative.

The disadvantage is both tests can miss polyps and some cancers. They also can have false positives. If a positive test result is found then a colonoscopy will be needed.

The Visual test uses a scope to look directly in the colon for signs of colorectal cancer or other diseases. The disadvantage is these tests require preparation.

Since it is a procedure, you will need to see the gastroenterologist and you will usually need full bowel preparation and sedation.

The colonoscopy is mostly used. The advantage with this test is that if needed, a biopsy can be done or the removal of any suspicious, possibly precancerous areas or polyps. A colonoscopy can also help diagnosis other diseases. If normal results, the colonoscopy is done every 10 years. Therefore, you may only do two in your life if normal.

So, don’t delay your screening test and start any necessary changes to your lifestyle today. Talk to your CVMG health care provider at your next visit to decide on the screening option best for you.