Understanding Colorectal Cancer: Risk Factors and Prevention Strategies

March is colorectal cancer awareness month. Colorectal cancer, a prevalent and potentially fatal form of cancer, affects millions of Americans. We discuss key takeaways in understanding the risks involved and ways that you can protect yourself. 

• Colorectal cancer risk increases with age, and certain habits like diet, obesity, physical inactivity and smoking.
• Some people are predisposed to colorectal cancer due to genetics, while others face a higher risk with preexisting conditions such as type 2 diabetes or inflammatory bowel disease.
• Maintaining a healthy lifestyle and regular colon screenings can help prevent colorectal cancer.

“Oklahomans have some of the highest rates of colorectal cancer in the country,” says Dom Burneikis, M.D., a colorectal surgeon with INTEGRIS Health Baptist Medical Center. “The good news is, there are more options for effective colorectal cancer screening and early detection than ever before. Talk to your doctor to come up with a screening plan that will work best for you.”

In this blog, Burneikis explains why understanding the risks associated with colorectal cancer and being proactive about prevention are crucial steps in reducing its impact on health and well-being. 

Why does colorectal cancer occur?

The bottom line: DNA carries the necessary information for cells to replicate and divide accurately. Faults or mutations in specific genes can disrupt the normal functions of cells, leading to uncontrolled growth and the formation of tumors that become cancerous. 

• The great majority of colorectal cancers start as endoscopically detectable polyps.
• Colon polyps are growths that develop on the inner lining of the colon or rectum.
• Over time, these polyps can accumulate DNA changes or mutations and transform into cancerous tumors.

A candid discussion: Larae Sorrels was 27 years old when she experienced a bowel obstruction that turned out to be colon cancer. This is her story.

Colorectal cancer risk factors

What to know: DNA changes that cause colorectal cancer stem from a variety of factors, including genetic mutations, environmental influences and lifestyle choices.

• Modifiable risk factors include obesity, smoking, alcohol, sedentary lifestyle and diet.
• Risk factors you cannot change include age, genetic factors, history of inflammatory bowel disease, ethnicity, race and family history.

Modifiable risk factors

Obesity increases the risk of getting colorectal cancer because it can alter hormone levels.

• Insulin and leptin, two hormones that regulate energy levels and blood sugar, can cause abnormal cell growth in the colon.
• People with obesity are 30 percent more likely to develop colorectal cancer, according to a March 2023 study.

Smoking is linked to a 59 percent heightened risk of colorectal cancer.

• Harmful chemicals in cigarettes can damage cells and tissues of the colon.
• People who smoke are more likely to develop larger and a higher number of colon polyps.

Alcohol use has been linked to an increased risk of colorectal cancer. 

• Moderate to heavy drinking caused a 47 percent increase in colorectal cancer among women and a 26 percent increase in colorectal cancer among men, according to a study in Korea.
• Frequent alcohol use can cause chronic inflammation and also impact the body’s absorption of essential nutrients.

Dietary choices contribute to colorectal cancer in many ways. For every 10-gram increase in daily dietary fiber, there is a seven percent lower risk of colorectal cancer according to the American Institute for Cancer Research (AICR).

• Consuming 100 grams of red meat daily may elevate the risk of colorectal cancer by 17 percent, according to a study by the International Agency for Research on Cancer (IARC).
• Consuming 50 grams of processed meat daily may raise the risk of colorectal cancer by approximately 18 percent.
• A diet high in saturated fats can alter gut bacteria, increase cholesterol levels and induce inflammation, heightening the risk of colorectal cancer.
• Research suggests that insufficient vitamin D levels are linked to a 31 percent increased risk of colorectal cancer.

A sedentary lifestyle increases the risk of any type of cancer, including colorectal cancer.

• A lack of exercise can cause hormone levels to fluctuate. High hormone levels can increase your cancer risk.
• Not exercising can cause weight gain, and carrying extra weight can produce more estrogen and insulin production (hormones that can fuel cancer growth).

Unmodifiable risk factors

Age impacts the risk of colorectal cancer, as risk increases the older you get.

• Majority of cases are diagnosed in people 65 and older.
• However, young people are still at risk.
• 20 percent of diagnoses in 2019 were in people under the age of 55, according to the American Cancer Society.

Genetic mutations, such as those inherited from family members or acquired over time, can play a significant role in the development of colorectal cancer. 

• Mutations in specific genes, such as APC, KRAS and TP53, can disrupt the normal regulation of cell growth and division, leading to the formation of tumors.
• Inherited genetic syndromes such as Lynch syndrome and familial adenomatous polyposis (FAP) significantly elevate the risk of developing colorectal cancer.

Medical history that includes inflammatory bowel disease (Crohn's disease or ulcerative colitis) is a prominent risk factor.

• Chronic inflammation that occurs from IBD damages cells in the colon, which increases the likelihood of genetic mutations and the development of cancerous cells.

Certain racial and ethnic groups have a higher incidence of colorectal cancer. 

• African American and American Indian populations are at the greatest risk of developing colorectal cancer.

Family history accounts for about five to 10 percent of colorectal cancer cases.

• A first-degree relative (parent, sibling or child) who had colorectal cancer are most at risk.

Explore more: People in their 20s and 30s are diagnosed with colorectal cancer more than ever before.

Prevention strategies for colorectal cancer

The bottom line: To reduce the risk of colorectal cancer, it’s important to make dietary changes, lifestyle adjustments and be proactive with your overall health.

• Prioritize vegetables, fruits and whole grains, as these have been linked with a decreased risk of colorectal cancer.
• Fruits and vegetables high in calcium and vitamin D (oranges, figs, broccoli, leafy greens) are especially helpful in lowering colorectal cancer risk.
• Limit red meat, processed meats and added sugars.
• Strive for at least 150 minutes of moderate-intensity exercise per week.
• It is best not to drink alcohol as even light-to-moderate alcohol use is associated with an increased risk of colorectal cancer. That risk goes up considerably with moderate and heavy drinking.
• Prioritize screenings, as colonoscopies play a vital role in the early detection and prevention of colorectal cancer.

Are you at risk? Take our colorectal cancer risk assessment to help determine your chances of developing colorectal cancer.

If you’re over the age of 45 or fall under one of the at-risk categories mentioned above, it’s time to contact your provider and schedule a colonoscopy. Your primary care physician who can refer you to a gastroenterologist or colorectal surgeon. Meet our gastroenterologists and surgeons who specialize in colonoscopies.

Get a Colonoscopy and Get Peace of Mind

Early detection makes all the difference when it comes to colorectal cancer. Either talk to your primary care physician for a referral or make an appointment with any of our gastroenterologists directly. Schedule your screening today.

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