When should I begin screening for colon cancer and what can I do to decrease my risk?

Patients at average risk for developing colon cancer should begin their screening at age 50. Those with a family history of colon polyps or colon cancer are at higher risk and should begin screening at age 40 or 10 years earlier than their relative, whichever comes first. African Americans are also considered to be at higher risk and are recommended by some societies to begin screening at age 45.

If you develop any potential symptoms of colon cancer, you need to seek medical attention sooner. Symptoms of colon cancer include abdominal pain, change in bowel habits, rectal bleeding, and weight loss, but cancer may be asymptomatic in early stages. Any patients with iron deficiency anemia (low iron levels) should also undergo an evaluation of the GI tract.

Known modifiable risk factors for colon cancer include smoking, obesity, diets high in fat and low in fiber, as well as diets consisting predominantly of red meats and processed meats. Several studies have explored the role of folic acid and non-steroidals in decreasing formation of polyps, which are the precursors to colon cancer.

Colonoscopy remains the best way to diagnose as well as prevent colon cancer through the earlydetection and removal of polyps. Alternatives to colonoscopy include hemoccult testing, fecal DNA testing, and imaging studies including CT (virtual) colonography. The risks and benefits of each test, and which one is most suitable for you, should be discussed with your medical provider.