Colorectal cancerMarch is National Colorectal Cancer Awareness Month. According to the Colorectal Cancer Alliance, as the COVID-19 pandemic gripped the country throughout this past year, colorectal cancer screenings plummeted. This March, the Alliance wants to not only raise awareness of this type of cancer, but also encourage screening so that more individuals may know if they have it or are at risk of developing it.

Since weight gain and obesity are risk factors for colorectal cancer, we wanted to break down the key information you should know.

What is Colorectal Cancer?

Colorectal cancer (CRC) is the 3rd most common cancer in both males and females, and the 3rd leading cause of cancer-related deaths. The colon is the large intestine and rectum. CRC occurs when benign cells accumulate and form a colonic polyp with the potential to transform into cancer. It’s one of the few cancers that is entirely preventable by early and regular screening through a variety of available tests.

When and How Do I Get Screened for CRC?

According to the American Cancer Society, screening begins at the age of 45 years old, or earlier if you experience symptoms or if you belong to a high-risk group such as having a family history of colorectal cancer. There are various tests available and organized by how frequently they need to be repeated. Screening tests can be chosen based on personal preference or comfort level.

Annual or Yearly:

  • Guaiac fecal occult blood test (gFOBT): An at-home kit that checks for blood in your stool
  • Fecal immunochemical test (FIT): Detects blood in the stool via antibodies

Every 3 Years:

  • FIT-DNA, commercially known as Cologuard: An FIT test that also checks for cancer cells via altered DNA in the stool every three years. This test can be expensive.

Every 5 Years:

  • Flexible sigmoidoscopy: A short flexible tube with a camera to check the last portions of the colon, known as the sigmoid and the rectum. This test should be done every five to 10 years with a FIT every year.
  • CT Colonography: A CT scan of your colon.

Every 10 Years:

  • Colonoscopy

If any of the tests above are positive, the next step would be to get a colonoscopy, which is the most sensitive and specific test of them all. People must be screened regularly until the age of 75 at the intervals stated above. If you need to be screened at closer intervals due to your risk factors or a suspicious polyp, your gastroenterologist will let you know.

What is a Colonoscopy and How Do I Prepare for One?

A colonoscopy is a common gastrointestinal (GI) procedure in which an endoscope, which is a long, flexible tubular instrument with a camera, is inserted into the colon via the rectum to identify and subsequently remove any polyps.  These polyps are then sent into a lab to be analyzed for any precancerous or cancerous cells. Preparation involves drinking laxatives the day before to clean your colon in order to find all the polyps present.

Signs and Symptoms of CRC

  • Blood in the stool or toilet
  • Unexplained weight-loss
  • Change in stool consistency or bowel habits such as diarrhea and constipation
  • Fatigue
  • Persistent stomach pain, gas, or cramps

CRC and Obesity

Excess weight and obesity increase the risk of many cancers such as endometrial cancer, kidney cancer, pancreatic cancer, and colorectal cancer. Obesity increases the risk of developing colorectal cancer by 30%. There are multiple ways to define obesity. It can be defined as having a Body Mass Index (BMI) of 30 or a waist to hip circumference ratio (WHR) of equal to or greater than 0.85 in women or 0.90 in men. A high BMI increases the risk of CRC in males, while a high WHR increases the risk in females.

Foods that Can Increase Your Risk for CRC

  • Red meat: beef, pork, lamb, veal, goat
  • Sugary drinks such as sodas and juices
  • Processed foods: Hot dogs, bacon, salami, frozen meals, ramen
  • Processed or refined grains: white bread, white rice, white flour

Lifestyle Practices that Can Prevent CRC

  • Maintain a healthy weight for your height with a BMI of less than or equal to 24.9 and/or a WHR of less than or equal to 0.85.
  • Exercise regularly for at least 150 to 240 minutes a week.
  • Follow appropriate colon screenings outlined above. See your gastroenterologist if you have any questions.
  • Stop smoking if you currently smoke.
  • Limit alcohol consumption to 2 drinks a day if you’re male, or 1 drink if you’re female.
  • Consume fruits, vegetables, and whole grains in your daily diet.
  • Incorporate about 30g of fiber per day into your diet along with adequate water consumption of at least 80-100 fl. oz. a day. Examples of fiber include bran cereal, oatmeal, broccoli, beans, lentils, and prunes.
  • Take a daily multivitamin, supplement your vitamin D levels if you are deficient, and add probiotics to your regimen.
  • Get a good night’s rest of at least 7-8 hours each day and decrease disruptions to your circadian rhythm, such as working at night.

About the Author:
Sindhura Kolli, MD, is a board-certified Internal Medicine Physician and Clinical Assistant Professor at the NYU Grossman School of Medicine. Dr. Kolli is also a graduate of the Clinical Obesity Fellowship at NYU. Her research interests include topics in gastroenterology, clinical obesity, and preventative care.