COLORECTAL CANCER RISK FACTORS

by Konstantin Monastyrsky

If anyone tells you that I am anti-colonoscopy, that person has only his/her financial and parochial interests in mind, not your health or wellbeing. In the right hands and with the right intent, colonoscopy is an essential and important, diagnostic tool, particularly for persons in the high-risk group, who should definitely get screened.

When it comes to traditional invasive colonoscopy, seek out a top-notch and responsible endoscopist, who, at the very least, won't miss polyps or tumors, or cut corners in all other conceivable ways. There is no extra cost for having it done right!

Avoid CT scans at all costs to prevent unnecessary exposure to x-ray radiation. An abdominal MRI scan without bowel prep is the safer (radiation-free) approach, but not without the risk related to false positive readings, which will still require patients to undergo invasive (i.e. traditional) colonoscopy.

Here are, what I believe, some well-justified reasons (risk factors) to submit yourself to a screening colonoscopy. Please note that most of these reasons are self-made, fiber-made, or doctor-made. To avoid getting on this long list one must start avoiding all these perils as early as possible. Here we go:

• Antibiotic treatments. If you took any broad-spectrum antibiotics for any condition within the last 10 years and experienced any colorectal disorder afterwards, or your stools match the number 1 to 3 on the BSF scale.
  Why: because antibiotics disrupt intestinal flora, the key protective factor from developing polyps and colorectal cancer. (This particular qualifier places a lot of people into a high-risk category — one more reason to avoid antibiotics for a trivial condition.)

• Hemorrhoidal disease. If you have hemorrhoidal disease and have to strain during defecation.
  Why: because your stool morphology is compromised, it is larger than normal and your colon membrane is continuously exposed to mechanical damage.

• Irritable bowel syndrome. If you‘ve been suffering from diarrhea- or constipation-dominant irritable bowel syndrome (IBS).
  Why: because it is caused by disbacteriosis (deficiency of intestinal bacteria), fermentation and large, impacted stools.

• Constipation, irregularity, stools less than daily. If you have a history of chronic or intermittent constipation.
  Why: because it indicates that your stool morphology is compromised by disbacteriosis.

• Amalgam (mercury) fillings. If you had or still have amalgam (black) fillings.
  Why: because mercury and other heavy metals in amalgam are carcinogenic compounds.

• Diverticular disease. If you have been affected by diverticular disease:
  Why: because of large stools.

• History of using laxatives and/or stool's softeners. If you have to take any laxative, including home remedies, such as prune or beet juice.
  Why: because you are affected by some or all of the above conditions.

• Inflammatory Bowel Diseases. If you have a history of inflammatory bowel disease, such as ulcerative colitis, Crohn‘s disease, and celiac disease.
  Why? These conditions increase the risk of colon cancer up to 32 times.

• Heredity. If your ethnic background is Ashkenazi Jew.
  Why: because Ashkenazi Jews are more susceptible to inflammatory bowel diseases from food allergies, particularly gluten, a plant-based protein from grains.

• Obesity, diabetes, and prediabetes. If you are overweight or obese, or have been diagnosed with diabetes or prediabetes.
  Why: because epidemiological studies demonstrate the connection between the occurrence of colon cancer and disorders of carbohydrate metabolism.

• Smoking. If you are a current or former smoker.
  Why: because smoking increases the statistical probability of colon cancer by 30% to 40%.

• Radiation exposure. If you have been exposed to radiation, particularly CT-scan (computer-assisted tomography).
  Why: because each scan increases the overall risk of cancer.

• History of colorectal polyposis. If you have an established history of colorectal polyps from prior examinations.
  Why: self-explanatory!

• Genetics. If you have been diagnosed with Familial Adenomatous Polyposis (FAP) or Hereditary Non-Polyposis Colon Cancer (HNPCC).
  Why: an unfortunate heredity.

• First-degree relatives with the history of colorectal cancer. If your first-degree relative younger than 60 or two first-degree relatives of any age have been diagnosed with colon cancer or had polyps.
  Why: because of commonality of nutrition, genetics, and endemics.

• If you are hypochondriac.
  Why: Excessive Worrying Syndrome (EWS) elevates the level of stress hormones, which in turn impede circulation and immunity which in turn may cause cancer.

• Side-effects of computed tomography. If you have had a virtual colonoscopy already performed.
  Why: because it disrupts stool morphology, intestinal flora and exposes you to excessive radiation.

• Side-effects of colorectal endoscopy. If you already have a regular colonoscopy performed.
  Why: because colon lavage disrupts intestinal flora and compromises stool morphology. When should I get screened for colon cancer immediately?

• Sudden change in bowel habits. If you suddenly develop a change in bowel habits, such as absence of stools for several days followed by diarrhea.
  Why: this condition is called paradoxical diarrhea and it indicates colon obstruction. The obstruction may be caused by a tumor or hardened stools.

• Severe colorectal disorders. If you feel an incomplete emptying accompanied by narrow stools, bloating, fullness, and cramps.
  Why: this may indicate a partial obstruction of stools by a tumor.

• Fecal blood. If you suddenly have tarry (black) stool or streaks of blood on stools but unrelated to hemorrhoids and straining.
  Why: that‘s for a specialist to find out. It may also indicate a bleeding in the upper digestive tract. Keep in mind that tarry stools can be caused by foods such as licorice, beets, blueberries, and red meat, by bismuth medicines such as Pepto-Bismol, by iron-containing supplements and by lead poisoning.

• Unexplained nausea and/or vomiting. If you are experiencing nausea and vomiting accompanied by absence of stools or diarrhea.
  Why: this may indicate intestinal obstruction but not necessarily related to a tumor.

• Severe anemia and/or fatigue. If you are affected by chronic fatigue and/or severe anemia.
  Why: blood loss, malnutrition, metastases affecting the liver and many other factors.

• Unexplained sexual urge, urinal obstruction. If you are a man and experience a continuous sexual urge or have unexplained difficulty urinating.
  Why: a tumor may be putting pressure on the prostate gland, bladder and/or urethra.

• PMS-like symptoms. If you are a woman and experience PMS-like abdominal cramps, particularly past menopause.
  Why: a tumor may be putting pressure on the genitourinary organs located in the same abdominal cavity.

• Abdominal wall stiffness. If your abdominal wall suddenly becomes stiffer, as if you‘ve been exercising your abs.
  Why: it may indicate tumor growth, colon obstruction, metastases or ascites — the accumulation of fluid in the peritoneal cavity caused by cancer. Also may suggest ovarian cancer.

• Unexplained weight gain. If you are gradually gaining weight without any changes in diet.
  Why: extra weight may reflect intestinal obstruction caused by the overgrown tumor, and/or ascites (accumulation of fluids in peritoneal cavity, not necessary related to colon cancer.)

• Unexplained weight loss. If you begin losing weight without any changes in diet.
  Why: the liver may be affected by a cancer, and is unable to assimilate dietary fat, protein, and carbohydrates, or a tumor itself may cause protein and fat wasting.

Keep in mind that some or all of the above symptoms may also accompany genitourinary cancers and some other conditions. This seems like a lot of reasons, and it is. If you wish to avoid them — and most people under 50 easily can — study and follow recommendations in this section, on this site, and in Fiber Menace.