Colorectal Cancer: Risk Factors, Screening Recommendations and Preventative Measures

Colorectal cancer is one of the most preventable yet deadly forms of cancer, making early detection through screening a critical tool in saving lives. While the disease often develops silently, showing little to no symptoms in its early stages, routine screening can identify precancerous polyps and detect cancer before it spreads, dramatically improving outcomes.

Jeremiah Pamer, DO, with EvergreenHealth Primary Care, Redmond Town Center, sat down with Check-Up Chat to talk about important information surrounding colorectal cancer, including risk factors and screening recommendations.

Risk Factors and Screening Recommendations

Colorectal cancer poses a risk to everyone, but individual risk factors vary based on age, location and other factors. In the U.S., colorectal cancer is the fourth most commonly diagnosed cancer, with over 150,000 cases and nearly 53,000 deaths predicted in 2024, according to the National Institutes of Health (NIH).

While the risk generally increases after age 50, there has been a concerning rise in cases among younger individuals. This trend led to the 2021 adjustment of the recommended screening age from 50 to 45, emphasizing the growing importance of early detection for younger populations.

Additional considerations come into play, per Dr. Pamer. For individuals with a first-degree family member diagnosed with colorectal cancer, screening typically begins 10 years before the age of the family member's diagnosis. For example, if a parent was diagnosed at 45, screening should start at 35. If the diagnosis age is over 45, screening begins at 40. It's crucial for those with a family history of colorectal cancer to discuss screening plans with their physician.

Also, individuals with certain genetic syndromes, Crohn's disease, ulcerative colitis or a history of colon surgery are at higher risk and require earlier and more frequent monitoring, often with a referral to gastroenterology for specialized screening. These preventative measures are essential to managing and reducing the risk of colorectal cancer.

EvergreenHealth has multiple providers who offer colorectal screenings, giving you convenient options for advanced, personalized care.

Symptoms of Colorectal Cancer

Symptoms that you may experience include diarrhea, constipation, narrowing of stools (pencil stools), an ongoing sensation of needing a bowel movement that isn't relieved, rectal bleeding with bright red blood or blood in your stool, which may appear dark brown or black if bleeding occurs higher in the digestive tract.

Other symptoms to monitor for are cramping or abdominal pain, weakness, fatigue and unintended weight loss. While these symptoms can have many other causes, they warrant a visit to the doctor for evaluation and further planning to rule out colorectal cancer.

"One of the reasons why colorectal cancer is so dangerous in the younger population is that symptoms can have a wide variety of reasons that are outside of colorectal cancer where they first come on," said Dr. Pamer.

Colonoscopy is considered the "gold standard" of colorectal cancer screening, although there are other tests available. Dr. Pamer reinforces why screening is an important step people can take in order to catch cancer in its earliest stages.

"As a primary care doctor, a large part of my role in health care is organizing and directing preventative care," said Dr. Pamer. "Now, something like pancreatic cancer, which is a very lethal cancer but relatively rare, thankfully, is difficult to screen for. On the other hand, cervical cancer, prostate cancer, breast cancer, lung cancer, skin cancer, while quite common are also detectable at an early stage, just like colorectal cancer. These are the cancers we screen for regularly."

Preventative Measures and Lifestyle Factors

Certain lifestyle factors can increase the risk of colorectal cancer, but many are modifiable, providing opportunities for prevention. Key risk factors include a sedentary lifestyle, diets low in fruits, vegetables, and fiber but high in fats and processed meats, obesity, alcohol consumption and tobacco use.

To lower the risk, increased physical activity is crucial, alongside dietary changes such as boosting fiber intake, which could include supplements, consuming more fruits and vegetables and incorporating calcium, vitamin B6, vitamin D and magnesium.

Foods like garlic and fish rich in omega-3 fatty acids may also offer protective benefits.

Interestingly, regular coffee consumption has been associated with a lower risk, offering good news for coffee lovers. By addressing these lifestyle factors, individuals can significantly reduce their risk of colorectal cancer while improving overall health.

"So many times, we can get stuck in a rut where we begin to worry about the things we can't control. Family history, this and that, and that should be addressed. You should talk about it with your physician, absolutely. But we can also really focus on the modifiable risk factors, things we can control. I would like a larger portion of my practice to be on that aspect," said Dr. Pamer. "Ultimately, we should control the things we can and have peace with the things we can't."

This article has been adapted from the Check-Up Chat with EvergreenHealth Podcast ""Early Screening Guidelines for Colorectal Cancer." Find more Check-Up Chat episodes.