A Q&A with Dr. Emily Touloukian, DO from Coastal Cancer Center and Dr. Kathleen Raynor, MD from Strand GI Associates

Q: What are the most common risk factors for developing colon cancer? 

A: Risk factors for colon cancer can be divided into two categories: non-modifiable (things you cannot change) and modifiable (things you can change). Non-modifiable risk factors include age, family history of colon cancer or advanced adenomas in first-degree relatives, as well as genetic predispositions such as Lynch syndrome and familial adenomatous polyposis (FAP). Modifiable risk factors include a diet high in red and processed meats, obesity, physical inactivity, smoking, and alcohol consumption are all associated with an increased risk of colorectal cancer.

Q: At what age should people begin regular colon cancer screenings, and why is early detection important? 

A: Colon cancer screening should start at age 45 in people with average risk. The recent transition to an earlier age for screening came about because of the rising incidence of colon cancer being diagnosed in younger people. The early detection promoted by screening is a crucial step to finding colon cancers in earlier stages when they are more likely to be able to be cured and less likely to require extensive therapy.

Q: What are the different screening options available, and how do they compare? 

A:  Several different screening options are available for colon cancer, each with varying levels of effectiveness, preparation requirements, and testing frequency. Colonoscopy is a highly sensitive test for detecting both cancer and precancerous lesions. It is a procedure that allows the doctor to examine the inside of the colon for abnormalities that may indicate cancer or pre-cancerous lesions. Another option is a Fecal Immunochemical Test or Cologuard, a non-invasive stool test performed at home that can detect cancer and pre-cancerous polyps.

Q: Can you explain how lifestyle choices like diet and exercise impact colon cancer risk? 

A:  Maintaining a healthy lifestyle, including a diet low in red and processed meats, can reduce the risk of developing colon cancer, along with limiting alcohol consumption and avoiding tobacco use. Additionally, regular physical activity is inversely associated with colorectal cancer risk.

Q: How has treatment for colon cancer evolved in recent years, and what are the latest advancements? 

A:  Treatment for colon cancer has evolved significantly in recent years with advancements in both traditional treatments and the development of novel therapeutic approaches. Surgical techniques have become less invasive, radiation therapy has become more focused, and systemic treatments have become more individualized. The personalization of cancer treatments has become standard of care with the utilization of testing to evaluate cancers for specific abnormalities that can be targeted, allowing for a tailored approach to treatment that has the potential to avoid various side effects and provide the most effective treatment possible.

Q: Are there any myths or misconceptions about colon cancer that you frequently encounter? 

A:  One commonly encountered myth is that only older adults need to worry about colon cancer. While age is a significant risk factor, the incidence of colon cancer is rising in young adults, reflected in the lowering of the recommended age to start screening.

Q: What advice do you have for patients who may feel hesitant or nervous about getting screened? 

A: Feeling hesitant or nervous about getting screened for colon cancer is not uncommon. However, the benefits of screening and early detection cannot be under-emphasized. Multiple options exist, and the techniques and preparations for the tests have evolved and improved over time. Discussing concerns with the doctor performing your procedure or prescribing the test can also be helpful in alleviating concerns about the process.