He also noted that colorectal cancer takes such a deadly toll because it usually has no identifiable symptoms and often goes undetected until it is too late to treat. Declaring this important month gives Americans hope in research and the fight against this cancer.

Colorectal cancer and colon cancer are often used interchangeably. To clarify, colon cancer begins in the colon, while colorectal cancer starts in the rectum. Both are considered colorectal cancer and may cause similar symptoms. They can be diagnosed using the same screening methods but differ in treatment.

According to the American Cancer Society (ACS), the estimated number of new colon cancer cases in the U.S. for 2021 will be 104,270, while the estimated number of new rectal cancer cases will be 45,320. Expected to cause 52,980 deaths in 2021, colon cancer and rectal cancer are now the third leading cause of cancer-related deaths in the U.S. Here are some tactics and tips from the experts at Gastro MD to lower your risk for colorectal cancer:

1. Separate the truth about colorectal cancer from myth

Your best defense against colon or rectal cancer starts with learning the truth behind the common misconceptions and learning more about detection. Colonoscopy is a procedure used to see inside the colon and rectum and detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer and helps doctors diagnose unexplained changes. While some people are at higher risk because of their lifestyles and genetics, colorectal cancer can be preventable. If found early, it is highly treatable.

2. Get colorectal cancer screening  

Colorectal cancer can be treated if detected early enough. You don’t have to wait until the recommended age of 45 to get tested. If you have a family history of colorectal cancer or a personal history of inflammatory bowel disease, consult your doctor, who will likely recommend screening.

3. Maintain a healthy weight

Many diseases and cancers are linked to being overweight or obese. Excess fat in the body affects your metabolism and reproductive cycles. It can cause chronic inflammation and higher insulin levels in the body, which are believed to help certain cancers develop. Eat a nutritious diet and exercise regularly to achieve an ideal weight for your height.

4. Eat foods good for your colon

Eating foods that improve the health of your colon may help prevent colon cancer. Build a diet that is high in protein, vitamin E, vitamin B, and fiber. Studies show inflammation can cause the development of cancer. So you should eat foods that reduce inflammation, such as fresh fish high in omega-3 fatty acids, leafy green vegetables, tomatoes, fruits like strawberries and almonds. Many experts would say that it’s best to avoid processed meats due to the added chemical preservatives.

5. Drink and smoke in moderation or not at all

Alcohol consumption and smoking boost your risk of severe diseases, including colon cancer. The risk for developing colorectal cancer increases as we age is due to lowered immunity. Combine that with smoking and alcohol, and healthy cells in the colon are more likely to develop mutations in their DNA, resulting in cancerous cells that multiply and form tumors.

To learn more about the different screenings performed by gastroenterologists, contact Gastro MD in Tampa. We strive to build a community of cutting-edge clinical gastroenterology practices and set the standards in digestive health care.

The findings were published online in CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society.

The American Cancer Society recommends:

• Adults ages 45 and older with an average risk of colorectal cancer undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) exam, depending on patient preference and test availability.

The change in starting age is designated as a “qualified recommendation,” because there is less direct evidence of the balance of benefits and harms, or patients’ values and preferences, related to CRC screening in adults aged 45-49. Most studies have included adults only aged 50+. The recommendation for regular screening in adults aged 50 years and older is designated as a “strong recommendation,” on the basis of the greater strength of the evidence and the judgment of the overall benefit.

• As a part of the screening process, all positive results on non-colonoscopy screening tests should be followed up with timely colonoscopy.
• Average-risk adults in good health with a life expectancy of greater than 10 years should continue colorectal cancer screening through age 75. Clinicians should individualize colorectal cancer screening decisions for individuals ages 76 through 85, based on patient preferences, life expectancy, health status, and prior screening history. Clinicians should discourage individuals over age 85 from continuing colorectal cancer screening.

The recommended options for colorectal cancer screening are: fecal immunochemical test (FIT) annually; high sensitivity guaiac-based fecal occult blood test (HSgFOBT) annually; multi-target stool DNA test (mt-sDNA) every 3 years; colonoscopy every 10 years; CT colonography (CTC) every 5 years; and flexible sigmoidoscopy (FS) every 5 years.

The new guideline does not prioritize among screening test options. Given the evidence that adults vary in their test preferences, the guidelines development committee emphasized that screening rates could be improved by endorsing the full range of tests without preference. The American Cancer Society has developed new materials to facilitate conversations between clinicians and patients to help patients decide which test is best for them.

“When we began this guideline update, we were initially focused on whether screening should begin earlier in racial subgroups with higher colorectal cancer incidence, which some organizations already recommend,” said Richard C. Wender, M.D., chief cancer control officer for the American Cancer Society. “But as we saw data pointing to a persistent trend of increasing colorectal cancer incidence in younger adults, including American Cancer Society research that indicated this effect would carry forward with increasing age, we decided to reevaluate the age to initiate screening in all U.S. adults.”

Colorectal cancer incidence has declined steadily over the past two decades in people 55 and over due to screening that results in removal of polyps, as well as changes in exposure to risk factors, but there has been a 51% increase in colorectal cancer among those under age 50 since 1994. Death rates in this age group have also begun to rise in recent years, indicating that increased incidence rates do not appear to be solely the result of increased use of colonoscopy. A recent analysis found that adults born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer compared with adults born around 1950, who have the lowest risk.

While the colorectal cancer incidence rate among adults 45 to 49 is lower than it is among adults 50 to 54 (31.4 vs. 58.4 per 100,000), the higher rate in the 50-54 age group is partially influenced by the uptake of screening at age 50. Since adults in their 40s are far less likely to be screened than those in their 50s (17.8% vs. 45.3%), the true underlying risk in adults aged 45-49 years is likely closer to the risk in adults ages 50 to 54 than the most recent age-specific rates would suggest. Importantly, studies suggest the younger age cohorts will continue to carry the elevated risk forward with them as they age.

Organizations have increasingly relied on modeling to evaluate alternative CRC screening strategies, including variations in the age to start and stop screening. Two of three microsimulation models conducted for the 2016 United States Preventive Services Task Force (USPSTF) screening recommendations suggested that starting colonoscopy screening with an interval of 15 years at age 45 vs age 50 provided a slightly more favorable balance between the benefits and burden of screening. However, the USPSTF elected not to recommend the younger starting age in 2016, judging the estimated additional benefit to be “modest,” and also noting that one of the three models did not corroborate the additional benefit and there was a lack of empirical evidence to support the change.

A new modeling study commissioned by ACS for this review extended these analyses by incorporating more recent studies of the rising incidence trends in younger adults and showed that multiple screening strategies beginning at age 45, including colonoscopy at the conventional 10-year interval, had a more favorable benefit to burden ratio with more life-years gained compared with starting screening at age 50.

“One of the most significant and disturbing developments in CRC is the marked increase in CRC incidence – particularly rectal cancer –among younger individuals,” the authors concluded. “While the causes of this increase are not understood, it has been observed in all adult age groups below the age when screening has historically been offered, and is contributing significantly to the burden of suffering imposed by premature CRC mortality. Incorporating this epidemiological shift into contemporary modeling of CRC screening demonstrated that the benefit-burden balance is improved by lowering the age to initiate CRC screening to 45 years. Lowering the starting age is expected to benefit not only the segments of the population who suffer disproportionately from CRC – blacks, Alaska Natives, and American Indians – but also those individuals otherwise considered to be at average risk. Moreover, epidemiological trends in cohorts as young as those born in 1990 suggest that the higher risk of developing CRC will be a persistent concern for decades to come.”

A release from the American College of Surgeons quotes study author Ian Paquette, MD, FACS, an associate professor of surgery at the University of Cincinnati College of Medicine, as saying, “The enhanced recovery protocol provides clinical benefit by allowing surgical patients to recover quicker, use less narcotic medication, and have a smoother recovery that gets them out of the hospital and hopefully back to work sooner. This study shows there is financial benefit from using the standardized pathway as well.”

Enhanced recovery protocols that standardize surgical management of patients have been established by surgical specialty societies and individual institutions for many types of operations.

Already in use throughout Europe for several years, the enhanced recovery approach is now gaining momentum in the U.S. A similar program is now under way through the American College of Surgeons (ACS). In 2017, ACS, in collaboration with the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore, launched the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR). This new surgical quality improvement program is funded and guided by AHRQ.

The AHRQ Safety Program for ISCR is enrolling and supporting hospitals in implementing perioperative evidence-based pathways to meaningfully improve clinical outcomes, reduce hospital length-of-stay, and improve the patient experience.

Furthermore, guidelines for standardizing the care of colorectal surgery patients have been established by the American Society of Colon and Rectal Surgeons (ASCRS) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). These guidelines were updated in 2017.¹

Previous studies have shown that these protocols reduce overall complications and length of stay and improve patient satisfaction.^2,3 The studies have focused on clinical aspects of care, rather than cost, or they involved estimations of the cost of following a standardized protocol. This is one of the first published studies to detail the effect on cost of implementing a pathway for colorectal surgery patients.

Researchers from the University of Cincinnati study compared outcomes and costs for two groups of patients: 160 patients who underwent colorectal procedures one year before an enhanced recovery program was instituted in 2016 and 146 patients who had procedures in the year following universal adoption of the program. Patients in the study underwent operations to treat diverticulitis, colon polyp removal, cancer, inflammatory bowel disease, or prolapse. The enhanced recovery program standardized preoperative bowel preparation, fluid management, pain control, early ambulation, and return to a normal diet.

The study found that the hospital length of stay was two days shorter for patients in the enhanced recovery group. Fewer patients in this group had lack of normal bowel function (6 percent vs. 20 percent). These patients were able to discontinue pain medication one day after surgery, compared with three days post-surgery for patients in the other group, and reduce narcotic use. Patients in the enhanced recovery program required 212 morphine equivalent units; patients in the other group required 720 morphine equivalent units.

Total direct hospital costs were $1,717 lower per patient in the enhanced recovery group, which translates into an annual savings of more than $250,000. Daily pharmacy costs per patient were higher ($477 vs. $318). However, total pharmacy costs were $325 less in the enhanced recovery group.

Findings from the study addressed two principal concerns associated with the adoption of enhanced recovery protocols for colorectal surgery patients. One is slow motility or ileus. “Surgeons would wait as long as possible to feed patients after colorectal surgery because of the feeling that the intestinal tract was not ready for food yet. We’ve seen in the literature that it’s very safe to feed patients immediately after their operations. By restricting fluids, changing the pain management regimen, mobilizing the patient sooner, and putting all these steps together as an organized pathway, we’re seeing that the return of normal gastrointestinal function is faster and patients get out of the hospital sooner,” Dr. Paquette said.

Enhanced recovery pathways have not been widely implemented because of the concern that they involve the use of high-cost pharmaceuticals. “Narcotics, which are commonly used in managing pain after surgery, are very inexpensive. Medications recommended in enhanced recovery protocols, such as intravenous acetaminophen, ibuprofen, and alvimopan, are expensive and increase daily pharmacy costs. Our study showed that the enhanced recovery pathway decreased total pharmacy cost as well as the total cost of hospitalization,” Dr. Paquette said.

“The evidence is overwhelming that enhanced recovery pathways lead to a better recovery, get patients back to a normal lifestyle in a quicker manner, and minimize the amount of narcotics, which may help with the ongoing opioid epidemic. This study shows they also lower hospital costs,” he concluded.

.
Colorectal cancer (cancer of the colon and rectum) incidence rates are on the rise in young and middle-aged adults. And these diagnoses rates are on the increase in younger adults at the same time that they have been decreasing in people over the age of 55.

Scientists and the medical community have been trying to identify why this is happening. And a new study led by the American Cancer Society (Journal of the National Cancer Institute, February 2017) has provided some disturbing statistics.

Read about their findings here; and learn more about the symptoms of colorectal cancer as well as recommendations to reduce your risk.
.

WHAT THE RESEARCH FOUND

The study, led by Rebecca Siegel, MPH of the American Cancer Society, examined different age categories of some 500,000 people who had been diagnosed with colon or rectal cancer.

Researchers found that colon cancer incidence rates had increased at a higher percentage rate for those ages 20 to 39. For that age category the incidence rate had increased 1% to 2% each year over the period studied, compared to ages 40 to 54, where the incidence rate had only increased 0.5% to 1%.

And rectal cancer incident rates also increased at a higher percentage in ages 20 to 39 compared to older populations. For ages 20 to 39, the incidence rate had increased 3% per year over the period studied; while for ages 40 to 54, the incidence rate had increased only 2% per year.
.

The risk of colorectal cancer was reported to be:
.

• If born in 1990 the risk of colon cancer was five per million people, versus three per million for those born in 1950
  .
• If born in 1990 the risk of rectal cancer was four per million, versus 0.9 per million for those born in 1950
  .
• Three in ten rectal cancer diagnoses were found to now occur in patients younger than age 55
  .

Note that while the risk for colorectal cancer in younger adults was found to be increasing, it is still very uncommon for someone under 50 to be diagnosed with the disease. 90 % of new cases are still found in those over age 50. However, the upward trend in younger adults is alarming.

Also of concern is that this type of “aging” disease is likely not on the radar of young adults or their doctors. For this and the other reasons noted below, colorectal cancer is often diagnosed late in this age population, when the disease may have spread and worsened.
.

Colorectal cancer often diagnosed late in younger adults

The main reason attributed to the decline in colorectal cancers for older adults is simple: screening. The American Cancer Society and medical community advocate regular colorectal cancer screening starting at age 50.

Younger adults, however, have no recommended screening unless they fit specific criteria of either having had a history of bowel disease themselves or having family members with colorectal cancer or specific genetic markers.

Because the disease is still uncommon in young adults, it is not part of the usual checkup conversation of many doctors; nor is it typically considered as a diagnosis. And because a person having the disease may not show any symptoms, it is difficult for a doctor to diagnose colorectal cancer without screening. Cost may also be an issue. Younger adults may not have insurance, or their insurance may not cover the procedure given their age or lack of ongoing symptoms.

All of these factors result in younger adults being diagnosed later, perhaps when symptoms have gotten excessive. When the younger adults are finally diagnosed, the disease may be more advanced, requiring more extensive treatments. According to the American Cancer Society’s study, people under the age of 55 are 58% more likely to be diagnosed with late-stage colorectal cancer than older adults.

The Colon Cancer Alliance responded to the new research by echoing the concern over late and inadequate diagnoses, saying, “We hear over and over again that members of our community are being misdiagnosed by those same medical professionals – being told they are too young for a colonoscopy because they aren’t 50 years old. And by the time the cancer is found, months later, it is too late.”
.

What are the symptoms of colorectal cancer?

There are often no symptoms or they are vague digestive issues such as constipation or diarrhea, but there are some signs young people should be aware of:
.

• Blood in your stools or dark stools
• Rectal bleeding
• Narrower than normal stools (thin like a pencil)
• A change in bowel habit that lasts for more than a few days (diarrhea, constipation)
• Unexplained abdominal pain, cramping
• Anemia
• Unintended weight loss
• A feeling that you need to have a bowel movement even after you’ve already had one
• Weakness and fatigue
  .

Note that these same symptoms can be caused by many other things including hemorrhoids, irritable bowel, inflammation, and other gastrointestinal issues.

Young people having a family history of colorectal cancer should talk with their doctors about their risk factor and potential screening. Note that while a family history may increase your risk, 85% of people diagnosed with colorectal cancer do not have a genetic link to it.
.

Can you reduce your risk?

Awareness, prevention, and early detection are the best defense.

Researchers do not know the precise cause of colorectal cancer. Most believe prevention is a combination of minimizing negative environmental exposures and optimizing healthy lifestyle factors such as diet and exercise. Obesity may play a role. While not proven to be a direct cause, researchers believe that the same poor lifestyle choices that increase one’s risk for obesity may also increase one’s risk for colorectal cancer.
.

Here are some general lifestyle guidelines recommended by the American Institute for Cancer Research:

Talk with your doctor about what lifestyle changes may be helpful for you.
.

• Stay at a healthy weight and lose the belly fat – Excess body fat results in an increased risk of colorectal cancer. Note that a 2014 study (The Lancet) found a 10% increase in risk for colon cancer for every five-point increase in body mass index.
  .
• Eat foods that fight cancer – Along with eating a healthy diet consisting of a lot of vegetables, cut back on your red meat and processed meat consumption. The AICR maintains information on various fruits, vegetables, spices, and other foods that have been identified as helping reduce one’s risk for diseases such as cancer. Blueberries, dark green leafy vegetables, garlic, and other food items are reviewed here. A Mediterranean diet may be preferred over a typical Western diet, and there is research currently underway to evaluate this. Calcium and Vitamin D are thought to be protective against colorectal cancer.
  .
• Eat plenty of fiber – Eating high fiber foods promotes good bowel function and is associated with reduced risk for a variety of diseases such as diabetes, hypertension, and heart disease. It may reduce the risk for colorectal cancer although studies have conflicted findings as to that point.
  .
• Be active – A sedentary lifestyle has been associated with greater risk for chronic disease.
  .
• Stop smoking – Longtime smokers have greater risks.
  .
• Show moderation with alcohol – Heavy drinking of alcohol appears to increase risk in men and may increase risk in women.
  .

Experts also suggest young people know their family history
.

It is important for people to know their family medical history in regards to many different diseases, but particularly helpful to know if anyone in your immediate family has been diagnosed with colon or rectal cancer. If family members have had other colon issues, or precancerous polyps have been found during a colonoscopy, that is also good information to have. There are a few hereditary conditions, one called familial adenomatous polyposis (FAP) and another called hereditary non-polyposis colon cancer (HNPCC), that can increase your risk. 5-10% of people diagnosed with colorectal cancer have this type of inherited gene mutation.
.

Screening

The best mode of prevention beyond awareness of possible symptoms is screening, and the best screening test is a colonoscopy.

This procedure can find and remove polyps found during the test. Polyps are growths that are found in the tissue lining of the colon or rectum. Colorectal cancer typically develops from a non-cancerous polyp. During a colonoscopy polyps can be removed, reducing the risk of the polyps turning cancerous. Your doctor will likely refer you to a gastroenterologist for the procedure.

The American Cancer Society’s recommendation is for screening starting at age 50. And while the society constantly reviews the incidence data and revises their policies, young adults today are not offered the screening on a routine basis. A colonoscopy is somewhat invasive and comes with minor risks. It is a substantial enough procedure that experts do not believe it could easily be made generally available.

There are other more limited tests, such as a fecal occult blood test (FOBT). This is a self-administered test that your doctor can give you to take home and later return a specimen for laboratory analysis. It can identify blood in the stool.

Researchers continue to work on other less invasive screening tests such as the relatively new Cologuard stool test. This is also a self-administered test that your doctor can give you to take home. The stool specimen is examined in a lab where blood can be identified but also, specific DNA markers for cancer can be found. With both the FOBT and the Cologuard test, any positive findings for cancer must be followed up with a colonoscopy for validation of diagnosis and to find and remove polyps.
.

For more information check out:

The American Cancer Society

American Gastroenterological Association

Results from the randomized, single-blind study were presented on October 17^th at the American College of Gastroenterology 2016 Annual Scientific Meeting, in Las Vegas, NV, by principal investigator, Douglas K. Rex, M.D., Distinguished Professor of Medicine, Indiana University School of Medicine.

A release from Bioscribe Public Relations quotes Dr. Rex as saying, “Approximately 40% of those who ought to have a colonoscopy avoid the procedure, and the top reason cited for their avoidance is the prep. Results from this study show that this innovative investigational product performed as well as or better at colon cleansing than two currently available colonoscopy prep formulations. Moreover, the higher levels of patient satisfaction reported by those who used the lead ECP formulation in the trial suggest this new approach to colonoscopy prep may have a positive impact on patient willingness to undergo this potentially life-saving colorectal cancer screening procedure.”

The study tested six formulations of ECP, using different doses of the active ingredients integrated within different meal kit menus, randomized against two U.S. Food and Drug Administration-approved active comparators. The primary outcome was the proportion of subjects with an endoscopic visibility rating of excellent or good based on the Aronchick scale. Secondary endpoints included segment-by-segment endoscopic visibility based on the Ottawa scale, as well as safety, tolerability and reports of patient experience. Fifty-one patients were treated with ECP and 14 with active comparators.

In the top three most effective formulations of ECP, 90.6% (29 of 32) of patients had a rating of excellent or good. With ColonaryConcepts’ lead formulation, 93.3% (14 of 15) of patients had a rating of excellent or good, with 40 of 45 colon segments rated as excellent or good on the Ottawa scale. For the comparator products, 85.7% (12 of 14) had a rating of excellent or good. There were no serious adverse events across any of the treatment groups. The proportion of patients reporting being satisfied or extremely satisfied with the experience of using the lead ECP formulation was nearly double that for those using the standard preps, 64.3% versus 33.3%.

“We are very pleased with the efficacy and safety results of this study, which clearly support advancing this product to a Phase 3 trial,” said Corey A. Siegel, M.D., M.S., a co-founder of ColonaryConcepts, and Director of the Inflammatory Bowel Disease Center at the Dartmouth-Hitchcock Medical Center and Associate Professor of Medicine at The Geisel School of Medicine at Dartmouth.

“The ECP approach allows patients to eat solid food bars and drink palatable low-volume beverages, a patient-friendly design that participants in the study clearly favored over conventional preps,” comments Dr. Siegel. “Patients participating in the study were nearly four times more likely to recommend ECP to their friends and family as compared to the standard colonoscopy prep.”

“Colonoscopy is still recognized as the gold standard – the best way to catch this cancer at an early stage. The medical community has called for an increase in colorectal cancer screening overall, both through the recent recommendations of the Cancer Moonshot Blue Ribbon Panel and the National Colorectal Cancer Roundtable’s call for 80% screening by 2018,” said Joshua Korzenik, M.D., a co-founder of ColonaryConcepts, and Faculty Member at Harvard Medical School and the Director of the Brigham and Women’s Hospital Crohn’s and Colitis Center. “By making the preparation for the procedure easier, we believe ECP can lower patient resistance to colonoscopies, and thus can help attain these important public health goals.”

A release from the university explains that the study examined over 5,100 men and women who had been diagnosed with colorectal cancer within the past six months, along with an additional 4,000 men and women with no history of colorectal cancer to serve as a control group. Participants reported their daily consumption of boiled (espresso), instant, decaffeinated and filtered coffee, as well as their total consumption of other liquids. A questionnaire also gathered information about many other factors that influence the risk of colorectal cancer, including family history of cancer, diet, physical activity and smoking.

The release quotes Stephen Gruber, MD, PhD, MPH, director of the USC Norris Comprehensive Cancer Center and senior author of the study, as saying,”We found that drinking coffee is associated with lower risk of colorectal cancer, and the more coffee consumed, the lower the risk.”

The data showed that even moderate coffee consumption, between one to two servings a day, was associated with a 26 percent reduction in the odds of developing colorectal cancer after adjusting for known risk factors. Moreover, the risk of developing colorectal cancer continued to decrease to up to 50 percent when participants drank more than 2.5 servings of coffee each day. The indication of decreased risk was seen across all types of coffee, both caffeinated and decaffeinated.

“We were somewhat surprised to see that caffeine did not seem to matter,” Gruber said. “This indicates that caffeine alone is not responsible for coffee’s protective properties.”

Coffee contains many elements that contribute to overall colorectal health and may explain the preventive properties. Caffeine and polyphenol can act as antioxidants, limiting the growth of potential colon cancer cells. Melanoidins generated during the roasting process have been hypothesized to encourage colon mobility. Diterpenes may prevent cancer by enhancing the body’s defense against oxidative damage.

“The levels of beneficial compounds per serving of coffee vary depending on the bean, roast and brewing method,” said first author Stephanie Schmit, PhD, MPH. “The good news is that our data presents a decreased risk of colorectal cancer regardless of what flavor or form of coffee you prefer.”

This extensive study was conducted by a research team led by Gad Rennert, MD, PhD, director of the Clalit National Israeli Cancer Control Center in Haifa, Israel, together with investigators at USC Norris. One advantage of this large, population-based study is that the results are representative of many coffee-drinking populations.

“Although coffee consumption in Israel is less common and with more type-variability than in the United States, our results indicate similarities in risk reduction with use consumption of various types of coffee,” Rennert said.

“While the evidence certainly suggests this to be the case, we need additional research before advocating for coffee consumption as a preventive measure,” Gruber added. That being said, there are few health risks to coffee consumption, I would encourage coffee lovers to revel in the strong possibility that their daily mug may lower their risk of colorectal cancer.”

Colorectal cancer is the third most common cancer that is diagnosed in both men and women in the United States, with nearly five percent of men and just over four percent of women developing the disease over their lifetime. The American Cancer Society (ACS) estimates that in the United States, over 95,000 new cases of colon cancer and 39,000 new cases of rectal cancer will be diagnosed in this year alone.

Screening saves lives

Colorectal cancer usually starts from polyps or other precancerous growths in the rectum or the colon (large intestine). People with precancerous growths or signs of colorectal cancer don’t always show symptoms. That’s why screening is important—doctors can see and remove growths or suspicious tissue before they become cancerous.

Your risk for colorectal cancer increases if you:

Smoke

Have a history of inflammatory bowel disease, ulcerative colitis, or Crohn’s disease

Have a family history of colorectal cancer

Have a personal history of colorectal cancer or colon polyps

Have certain genetic syndromes (for example, Lynch or FAP)

Have diabetes

You should see your doctor also if you have any of these symptoms, even though they do not necessarily indicate colorectal cancer:

A change in bowel habits (for example, diarrhea, constipation, feeling that the bowel does not empty all the way)

Bright or dark blood in stool

Stools narrower than usual

Frequent gas pains, bloating, fullness, or cramps

Weight loss for no known reason

Feeling very tired

Vomiting

When and how should I get screened?

You should begin getting screened at age 50 if you are at average risk of developing colorectal cancer. However, some people at higher risk for colon cancer may need to be screened earlier and some may need to undergo more frequent screening. Discuss with your doctor the best strategy for you. Here are several options:

A colonoscopy— A doctor uses this thin tube with a light and lens to look inside the rectum and colon for growths, other abnormal tissue, or cancer. You will need to prepare for the test and will be sedated during it.

Routine screening: every 10 years.

Flexible sigmoidoscopy—A doctor uses a thin tube with a light and lens to look inside the rectum and lower third of the colon for growths, other abnormal areas tissues, or cancer. This thin tube may also include a tool for removing abnormal tissue for examination. You will need to prepare for the test.

Routine screening: every 5 years.

Fecal blood test (gFOBTor FIT test)—Using an at-home kit from your physician, you take a sample of your stool and return it to a lab, where it is checked for hidden blood, sometimes a sign of cancer. If blood is found, you will need a colonoscopy to find out why.

Routine screening: once a year.

Stool DNA test —Using an at-home kit from your physician, you take a sample of your stool and return it to a lab, where it is checked for blood as well as for genetic changes sometimes found in cancer and precancer cells. If the test is positive, you will need a colonoscopy.

Routine screening: every 3 years.

Computed tomography colonography or “virtual colonoscopy”—An X-ray imaging procedure that produces 2D and 3D views of the colon from the rectum to the lower end of the small intestine as well as some visualization of the small bowel. The colon will be gently and temporarily inflated with air through a thin tube tip placed in the rectum. You will need to prepare for the test.

Routine screening: every 5 years.

Remember to ask your doctor about colorectal cancer screening.

“Regular screening, beginning at age 50, is the key to preventing colorectal cancer,” said Alberto Gutierrez, Ph.D., an FDA expert on screening devices. “People at higher risk of developing colorectal cancer should begin screening at a younger age, and may need to be tested more frequently. Currently, individuals have several options for testing based on their risks and preferences. You should talk with your doctor to determine which screening program is right for you.”

What’s the good news?

More people who get the disease are surviving or are surviving longer with the help of screening, surgery and/or drugs approved for the treatment of patients with colorectal cancer. Because not all populations react the same way to every treatment, scientists are also developing “companion diagnostics,” tests to determine, for example, if a mutation in a particular gene found in tumors will render a drug effective, ineffective, or even harmful among certain groups.

Researchers study new ways to prevent, treat, and manage the disease. Patients who want to know about clinical trials—research studies that involve people—may want to discuss this option with those close to them and with their doctor.

How can I reduce my risk?

A number of factors may put you at risk for colorectal cancer: your age, medical history, race or ethnicity. But you can reduce that risk. Here’s how:

Exercise regularly and vigorously

Maintain a healthy diet (high in vegetables and fruits; low in red and processed meats)

Maintain a healthy weight

Limit the amount of alcohol you drink

Don’t smoke and avoid second-hand smoke

For more information about treatments for colorectal cancer, call 1-800-4-CANCER.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products. Click here for more updates.

A release from Texas A&M reports that the research was funded by the California Dried Plum Board and presented at the 2015 Experimental Biology conference in Boston.

The release quotes Dr. Nancy Turner, Texas A&M AgriLife Research professor in the nutrition and food science department of Texas A&M University, College Station, as saying, “Through our research, we were able to show that dried plums promote retention of beneficial bacteria throughout the colon, and by doing so they may reduce the risk of colon cancer.”

According to the American Cancer Society, colon cancer is the third leading cause of cancer-related deaths in the U.S. when men and women are considered separately, and the second-leading cause when the figures are combined. During 2015, colon cancer is expected to cause about 49,700 deaths nationwide.

A good amount of research has already shown that one’s diet can alter the metabolism and composition of colon microbiota, which has major implications for disease prevention and treatment, Turner said.

She said there are trillions of bacteria in the intestinal tract and so far more than 400 individual species have been identified. Previous research has shown that disruptions to the microbiota are involved in the initiation of intestinal inflammation and recurrence of inflammatory bouts that can promote development of colon cancer.

“Our research explored the potential cancer-protective properties of dried plums using a well-established rat model of colon cancer,” she said. “Dried plums contain phenolic compounds, which have multiple effects on our health, including their ability to serve as antioxidants that can neutralize the oxidant effect of free radicals that can damage our DNA.

“The hypothesis we tested in this experiment was that consumption of dried plums would promote retention of beneficial microbiota and patterns of microbial metabolism throughout the colon. If it did this, then it might also help reduce the risk of colon cancer.”

“The microbiota are involved in the health of the host organism through physical interactions and, indirectly, through their metabolism,” said Derek Seidel, a doctoral graduate student and research assistant for Turner who assisted in the study. “The rats were fed a control diet or a diet containing dried plums, and both diets were matched for total calories and macronutrient composition so that the effect due to diet would be attributed to compounds uniquely found in the dried plums.”

The intestinal contents and tissues from different segments of the colon were examined. Results showed that the dried plum diet increased Bacteroidetes and reduced Firmicutes – the two major phyla of bacteria in the gut – in the distal colon without affecting the proportions found in the proximal colon. However, animals consuming the control diet had a lower proportion of Bacteroidetes and increased Firmicutes in the distal colon.

Another observation made was rats consuming dried plums had significantly reduced numbers of aberrant crypts, aberrant crypt foci and high-multiplicity aberrant crypt foci compared to control rats.

“These aberrant crypt foci are one of the earliest observable precancerous lesions and are often considered to be a strong indicator for cancer development,” Seidel said.

Turner said these data support the hypothesis that dried plums protect against colon cancer, which may be due in part to their ability “to establish seemingly beneficial colon microbiota compositions in the distal colon.

“From this study we were able to conclude that dried plums did, in fact, appear to promote retention of beneficial microbiota and microbial metabolism throughout the colon, which was associated with a reduced incidence of precancerous lesions.”

She said while additional research is needed, particularly in human studies, the results from this study are exciting because they suggest that regularly eating dried plums may be a viable dietary strategy to help reduce the risk of colon cancer.

The researchers made the discovery while investigating the potatoes’ effect using petri dishes and mice. The investigators said the potatoes targeted the cancer’s stem cells.

Colon cancer is the second leading cause of cancer-related deaths in the U.S. and responsible for more than 50,000 deaths annually, according to the American Cancer Society.

Attacking stem cells is an effective way to counter cancer, according to Jairam K.P. Vanamala, associate professor of food sciences, Penn State and faculty member at the Penn State Hershey Cancer Institute.

“You might want to compare cancer stem cells to roots of the weeds,” Vanamala said. “You may cut the weed, but as long as the roots are still there, the weeds will keep growing back and, likewise, if the cancer stem cells are still present, the cancer can still grow and spread.”

The researchers, whose findings were published in the Journal of Nutritional Biochemistry, used a baked purple potato because potatoes are widely consumed and typically baked before they are consumed, especially in western countries. They wanted to make sure the vegetables maintained their anti-cancer properties even after cooking.

According to a news release from Penn State, in their initial study the researchers found that the baked potato extract suppressed the spread of colon cancer stem cells while increasing cell deaths. Researchers then tested the effect of whole baked purple potatoes on mice with colon cancer and found similar results. The portion size for a human would be about the same as eating a medium size purple-fleshed potato for lunch and dinner, or one large purple-fleshed potato per day.

According to the researchers, there may be several substances in purple potatoes that work simultaneously on multiple pathways to help kill the colon cancer stem cells, including anthocyanins and chlorogenic acid, and resistant starch.

“Our earlier work and other research studies suggest that potatoes, including purple potatoes, contain resistant starch, which serves as a food for the gut bacteria, that the bacteria can covert to beneficial short-chain fatty acids such as butyric acid,” Vanamala said. “The butyric acid regulates immune function in the gut, suppresses chronic inflammation and may also help to cause cancer cells to self-destruct.”

In addition to resistant starch, the same color compounds that give potatoes, as well as other fruits and vegetables, a rainbow of vibrant colors may be effective in suppressing cancer growth, he added.

“When you eat from the rainbow, instead of one compound, you have thousands of compounds, working on different pathways to suppress the growth of cancer stem cells,” said Vanamala. “Because cancer is such a complex disease, a silver bullet approach is just not possible for most cancers.”

The next step would be to test the whole food approach using purple potatoes in humans for disease prevention and treatment strategies. The researchers also plan to test the purple potatoes on other forms of cancer.

Using evidenced-based foods as a proper cancer prevention strategy could complement current and future anti-cancer drug therapies. Vanamala said that foods could actually offer a healthier way to prevent cancer because they often have limited side effects compared to drug treatments.

“Indeed, we have seen that the animals that consumed purple potatoes are healthier compared to animals that received drug treatment,” said Vanamala.

Purple potatoes could be potentially used in both primary and secondary prevention strategies for cancer, Vanamala suggested. Primary prevention is aimed at stopping the initial attack of cancer, while secondary prevention refers to helping patients in remission remain cancer-free.

The patients, all of them treated with surgery and chemotherapy for stage III colon cancer, had the greatest benefit from consuming four or more cups of coffee a day (about 460 milligrams of caffeine), according to the study, which was published in the Journal of Clinical Oncology. These patients were 42 percent less likely to have their cancer return than non-coffee drinkers, and were 34 percent less likely to die from cancer or any other cause.

Two to three cups of coffee daily had a more modest benefit, while little protection was associated with one cup or less, reported the researchers, led by Charles S. Fuchs, MD, MPH, director of the Gastrointestinal Cancer Center at Dana-Farber. First author is Brendan J. Guercio, MD, also of Dana-Farber.

According to a release from institute, the study included nearly 1,000 patients who filled out dietary pattern questionnaires early in the study, during chemotherapy and again about a year later. This “prospective” design eliminated patients’ need to recall their coffee-drinking habits years later – a source of potential bias in many observational studies.

“We found that coffee drinkers had a lower risk of the cancer coming back and a significantly greater survival and chance of a cure,” Fuchs said. Most recurrences happen within five years of treatment and are uncommon after that, he noted. In patients with stage III disease, the cancer has been found in the lymph nodes near the original tumor but there are no signs of further metastasis. Fuchs said these patients have about a 35 percent chance of recurrence.

As encouraging as the results appear to be, Fuchs is hesitant to make recommendations to patients until the results are confirmed in other studies. “If you are a coffee drinker and are being treated for colon cancer, don’t stop,” he said. “But if you’re not a coffee drinker and wondering whether to start, you should first discuss it with your physician.”

Fuchs said the study is the first to study an association between caffeinated coffee and risk of colon cancer recurrence. It adds to a number of recent studies suggesting that coffee may have protective effects against the development of several kinds of cancer, including reduced risks of postmenopausal breast cancer, melanoma, liver cancer, advanced prostate cancer.

Fuchs said the research focused on coffee and other dietary factors because coffee drinking – in addition to possibly being protective against some cancers – had been shown to reduce the risk of type 2 diabetes. Risk factors for diabetes – obesity, a sedentary life style, a Western diet high in calories and sugar, and high levels of insulin – are also implicated in colon cancer.

In analyzing the results of the new study, Fuchs and his colleagues discovered that the lowered risk of cancer recurrence and deaths was entirely due to caffeine and not other components of coffee. He said it’s not clear why caffeine has this effect and the question needs further study. One hypothesis is that caffeine consumption increases the body’s sensitivity to insulin so less of it is needed, which in turn may help reduce inflammation – a risk factor for diabetes and cancer, Fuchs said.

Other than drinking coffee, Fuchs said, people can take other measures to reduce cancer risks – avoiding obesity, exercising regularly, adopting a healthier diet, and eating nuts, which also reduce the risk of diabetes.