Prevention Critical to Addressing Early Colorectal Cancer

Over the past decade, there has been an increase in many types of cancer among younger adults, including colorectal cancer. Raul Bosio, MD, a colorectal surgeon with ProMedica Physicians General Surgery, considers this a problem associated to many factors, including the amount of chemicals our body is exposed to daily.

These chemicals are in the food we eat, the water we drink and the air we breathe. While you may not be able to avoid chemicals altogether, there are preventive measures you can take.

Why Colorectal Cancer is on the Rise in Younger Generations

Dr. Bosio has noticed a notable rise in younger patients in recent years. “Several years ago, most of my patients were in their 60s or elder. Now, possibly a third to half of my patients are in their late 40s to early 50s,” Dr. Bosio shares. “I’ve seen patients as young as 18 with colon cancer.”

Dr. Bosio shares that while we don’t know exactly what is causing this rise in colorectal cancer cases among young adults, he believes there is a correlation to the increase in chemicals we are exposed to.

According to cancer.gov, studies have shown a link between an unhealthy diet and higher rates of colorectal cancer, and lab studies on mice have shown that poor gut bacteria can intensify inflammation which can generate harmful chemicals that promote cancer. Environmental chemicals have also been shown to mutate DNA and cells colon and rectum of mice.

Over time, we have added more preservatives, more antibiotics, more pesticides and more disinfectants to our food and water supplies to be able to accommodate for increased need and convenience. While these chemicals may be necessary to prevent sickness and infection among animals and humans alike, Dr. Bosio believes we are seeing the negative side effects in other forms.

It takes food anywhere from two to three days to move through your digestive tract – traveling through approximately 22 feet of small intestine in an average of two hours. However, it can stay in the colon, that is only five feet in length, for an average of two to three days. “Any chemicals found in the food you eat sit in your colon for 48 to 72 hours. That’s a long time for the lining of your colon to be exposed to these chemicals,” Dr. Bosio explains.

Ultimately, this results in these chemicals affecting the genes in the colon cells, and as they become abnormal, the colon cells start changing towards developing precancerous features. That is when polyps can develop, which if left untreated, can lead to colorectal cancer.

“In a healthy colon, the cells in the lining of your bowel are constantly dying and replacing themselves. When you have abnormal cells, this doesn’t happen. These bad cells don’t die. On the contrary, they multiply and transform into cancer cells,” Dr. Bosio shares.

A Preventive Approach

“There are chemicals in all foods – even healthy foods. Even water has chemicals,” Dr. Bosio shares. This means that even if you eat healthy, exercise and drink lots of water, it’s impossible to avoid all the chemicals that may wreak havoc on your digestive system.

Knowing that it’s near impossible to avoid all chemicals, we must take a preventive approach.

Before an abnormality becomes colon cancer, it starts with a polyp. A colon polyp is a precursor to colon cancer. Typically, it takes colon polyps five to 10 years to develop into colorectal cancer. This means that you have five to 10 years from the formation of a polyp to get it removed before it turns into cancer.

How are colon polyps detected?

Colon polyps may be detected through colon cancer prevention or screenings. Dr. Bosio explains that any test is better than no test at all. However, the best way to prevent colon cancer is through a colonoscopy. Other colon cancer screenings, such as stool tests, may detect precancerous colon polyps. However, some of the best tests available can miss polyps up to 60% of the time.

Dr. Bosio explains that while a stool test may be able to detect cancer, he compares the ineffectiveness of stool tests in prevention with this relatable analogy: “If there was an amazing deal on a car, but I told you it’s only going to start 40% of the time, would you still buy it?”

The Importance of Colonoscopies

To reduce colon cancer, we must take preventive measures to prevent colon cancer before it happens rather than just screening to detect cancer that is already there. Colonoscopies detect colon polyps and colon cancer 95 – 98% of the time.

In most cases of cancer, you cannot prevent it, you are left with the hope of early detection. However, because colon cancer develops from a polyp in the colon, you can discover the polyp and get it removed before it becomes cancerous. 

Following the recommended screening guidelines for colonoscopies is the best way to prevent colon cancer.

When should I get a colonoscopy?

Don’t wait until you have symptoms. If you have an average risk of developing colorectal cancer, you should get your first coloscopy at 45 years old. If you have a family history of colon cancer or colon polyps, you should get your first coloscopy at 45, or 10 years before your family member’s diagnosis, whichever comes first.

If a member of your family had colon polyps but not colon cancer, you are still considered high risk. Remember, colon polyps are a precursor to colon cancer. Follow the screening guidelines for someone with a family history.

Individuals with colon cancer often experience little to no symptoms. So, waiting until you have symptoms to get a colonoscopy is not a good idea. 

However, if you are experiencing symptoms of colon cancer, such as blood with the stool, constipation one day and diarrhea the next, abdominal pain or excess gas, you should talk with your doctor about scheduling a colonoscopy right away no matter your age.

“Advocate for your health. If you think that something might be wrong, ask your provider to perform a preventive colonoscopy,” Dr. Bosio encourages.

Current recommendations encourage individuals to get colonoscopies regularly until age 75. However, Dr. Bosio shares that if you’re otherwise healthy, he recommends continuing them until you’re at least 85.

Raul Bosio, MD
Dr. Bosio is a colorectal surgeon with ProMedica Physicians General Surgery. View his profile.