Can colorectal cancer be prevented?

Regular screening is one of the most important ways to prevent colorectal cancer (colon and rectal).

"Colorectal cancer is the third-leading cause of cancer death in the U.S. And we expect about 50,000 people will die this year from colorectal cancer," says Dr. Lisa Boardman, a Mayo Clinic gastroenterologist.

Everyone at age 45 is recommended to begin regular screening. The U.S. Preventive Services Task Force updated its guidelines in 2021 to include starting screening five years earlier than the previous recommendation of 50, after studies showed increased rates of cancer in younger people.

"What we're seeing now is more people developing colorectal cancer under the age of 50. In fact, 10% of colorectal cancer cases now are going to occur in people who are under the age of 50," says Dr. Boardman.

Those at higher risk include African Americans, those with a family history of colorectal cancer or a genetic mutation that causes one of several hereditary conditions associated with the development of colorectal cancer. Certain health conditions like inflammatory bowel disease may also increase a person's risk. It's important to talk with your health care team to determine when to begin screening.

The goal for colorectal cancer screening is to identify colorectal cancer at an early stage before a person develops symptoms to increase a person's chances to be cured. Another benefit of screening it to find precancerous polyps and remove them so that they do not have the chance to turn to cancer.

There are multiple types of screening options, but colonoscopy is the most common screening test.

During a colonoscopy, a long, flexible tube, called a colonoscope, is inserted into the rectum. A tiny video camera at the tip of the tube allows your health care professional to detect changes or abnormalities inside the entire colon.

Your doctor may remove a polyp during a colonoscopy. Not all colon polyps develop into cancer, but most colon cancers begin as polyps.

Types of screening and recommended intervals include:

• Fecal immunochemical test (FIT), annually.
• High-sensitivity guaiac-based fecal occult blood test (HSgFOBT), annually.
• Multitarget stool DNA (MT-sDNA) test, every three years.
• Colonoscopy, every 10 years.
• CT colonography (CTC), every five years.
• Flexible sigmoidoscopy (FS), every five years.

How long you should continue regular colorectal cancer screening will depend on your age and results of your screenings. It's important to work with your health care team to determine what screening option is best for your individual risk factors.

These lifestyle changes also can play a role in reducing risks for colorectal cancer:

• Eat a low-fat, high-fiber diet.
• Avoid nitrite preserved foods like certain deli meats and sausages.
• Limit red meat intake.
• Eat fewer ultraprocessed foods.
• Take a multivitamin daily.
• Exercise most days of the week.
• Don't smoke.
• Limit alcohol consumption.
• Maintain a healthy weight.