Colorectal cancer prevention: what you need to know

Colorectal cancer is the second-leading cause of cancer-related deaths in the United States, but it also is one of the most preventable cancers. The American Cancer Society estimates that more than 150,000 people will be diagnosed with colorectal cancer in 2024, and about 52,000 deaths will occur from the disease. However, Baylor Medicine experts say that with regular screenings, lifestyle changes and early detection, many cases can be prevented or treated successfully.

The role of diet in colorectal cancer prevention

Eating a diet rich in fiber and low in processed foods can significantly lower your risk of colorectal cancer. High-fiber foods, such as fruits, vegetables, whole grains and legumes, promote healthy digestion and help reduce inflammation in the gut.

“Processed meats, such as bacon, hot dogs and deli meats, have been linked to an increased risk of colorectal cancer,” said Dr. Atif Iqbal, associate professor and chief of the Section of Colorectal Surgery at Baylor College of Medicine and colorectal surgeon at Baylor Medicine. “Limiting red meat intake and incorporating more plant-based proteins can make a difference.”

Additionally, maintaining a healthy weight and reducing alcohol consumption can help lower cancer risk. Studies show that obesity and excessive alcohol intake are associated with a higher likelihood of developing colorectal cancer.

Understanding genetic risk factors

A family history of colorectal cancer increases the risk of developing the disease. Those with a parent, sibling or child diagnosed with colorectal cancer before age 60 should discuss genetic testing and early screening options with their doctor.

“If you have a strong family history of colorectal cancer or a genetic condition like Lynch syndrome or familial adenomatous polyposis, genetic counseling is important not only to better understand your risk but also the implications for your immediate family,” said Dr. Yesenia Rojas-Khalil, assistant professor of surgery in the Division of Surgical Oncology and colorectal surgeon at Baylor Medicine. “Early detection is critical for those with hereditary risks.”

Colorectal cancer often develops without noticeable symptoms in its early stages, making regular screenings crucial.

Colonoscopies remain the gold standard for detecting and removing precancerous polyps before they turn into cancer.

“There’s a misconception that colonoscopies are painful or unnecessary, but they are actually one of the most effective tools we have for preventing colorectal cancer,” Iqbal said. “Most patients tolerate the procedure well, and it can save lives.”

For those who are hesitant about a colonoscopy, stool-based tests, such as the fecal immunochemical test, like Cologuard, offer noninvasive screening options. However, if these tests detect abnormalities, a colonoscopy still is required for further evaluation.

When and how often to get screened

The American Cancer Society recommends that people at average risk of colorectal cancer begin screening at age 45. Individuals with a family history of the disease or other risk factors, such as Crohn’s disease or ulcerative colitis, may need to start earlier.

“For most people, a colonoscopy every 10 years is sufficient, but those with higher risk factors may need more frequent screenings,” Iqbal said. “Your doctor can help determine the best screening plan for you.”

Advances in colorectal cancer treatment

For those diagnosed with colorectal cancer, treatment options continue to evolve. Minimally invasive techniques, such as robotic and laparoscopic surgery, offer quicker recovery times and less postoperative pain.

Surgeon-controlled robotic surgery is the most advanced aspect of minimally invasive surgery, said Dr. Punam Amin, assistant professor of surgery and colorectal surgeon at Baylor Medicine.

During robotic surgery, small incisions – often referred to as poke hole incisions – are made in the abdomen to place ports and instruments, to which the robotic system connects. The surgeon then sits at a console to control the robotic instruments with precision.

“The benefit of robotic surgery and smaller incisions is that patients are able to recover in a two-to-three-day fashion,” Amin said. “Patients have minimal pain and are able to be up and out of bed with the return of bowel function in a timely manner.”

These advancements in minimally invasive surgery improve patient outcomes, reduce complications and shorten hospital stays compared to traditional open surgery.

Additionally, clinical trials are expanding access to cutting-edge treatments. Patients who qualify for trials may benefit from new therapies that are not yet widely available.

“Clinical trials are essential for advancing colorectal cancer treatment,” Iqbal said. “If you’re diagnosed, it’s worth discussing with your doctor whether a trial could be an option.”

Surgeons at Baylor are currently studying how circulating tumor DNA (ctDNA) in the blood can guide postsurgical treatment decisions for colon cancer patients, including the need for chemotherapy and the most effective type of chemotherapy.

Know the warning signs

Recognizing early symptoms of colorectal cancer can lead to earlier diagnosis and better outcomes. Symptoms to watch for include:

• Changes in bowel habits, such as persistent diarrhea or constipation
• Blood in the stool
• Unexplained weight loss
• Abdominal pain or cramping
• Fatigue or weakness

With early-onset colorectal cancer rising among individuals aged 20 to 45, there may be reasons to consider screening before the recommended age of 45.

“If you notice any of these symptoms, don’t ignore them, even if you are not at the recommended age for screening,” Iqbal said. “See your doctor and get evaluated as soon as possible.”

Take control of your colorectal health

Colorectal cancer is highly preventable with a proactive approach to health. Eating a balanced diet, exercising regularly, knowing your family history and keeping up with recommended screenings are key steps to reducing risk.

“Screening saves lives,” Rojas-Khalil said. “Talk to your doctor about the best options for you, and don’t delay your screening.”

By Tiffany Harston, senior communications specialist in the Michael E. DeBakey Department of Surgery