Recent updated evidence from the United States National Health And Nutrition Survey (NHANES) show that the majority of US adults have more than one modifiable risk factor for colon cancer that needs attention (see article). While screening is advocated for prevention of colon cancer and supported by evidence from randomized controlled trials (1), we have shown that even after screening, those with poor risk profiles remain at elevated risk of colon cancer (2). In particular, and analyzing data from the Nurses’ Health Study, Wei and colleagues show that lack of physical activity, red meat consumption and high alcohol intake and lack of regular aspirin use, leave women who have been screened for colon cancer at substantially elevated risk of cancer in subsequent years.
What do we know about the US population and primary prevention of colon cancer?
Analyzing the NHANES data, Joshu and colleagues tracked colon cancer risk factors form 1999 to 2008 (3). Obesity, physical inactivity, red meat consumption, and alcohol intake, together account for more than 70% of colon cancer (4). Over this decade of repeated surveys the adult US population remained largely unchanged in their poor risk profile for colon cancer. 4 out of 5 US adults had one or more risk factors that could be modified. This was true for men and women, for White, Black, and Hispanic populations, and for each age group from 20 to 69. Almost 20% of adults have 3 or more modifiable risk factors. Thus they could take action now to lower their risk of colon cancer.
Why lower your risk?
Lifestyle changes significantly lower risk of colon cancer.
It is time to act on what we know and reduce the population burden of colon cancer - a leading cause of cancer mortality. In fact, treatment of colon cancer accounted or 11% of all US cancer care expenditures in 2010. That is some 14 billion dollars spent on treating a cancer that is highly preventable.
We can all take action now that will reduce the number of cases diagnosed over the coming years and the suffering that goes with this disease; save unnecessary expenditures; and improve quality of life.
For help identifying risk factors you can work on today, visit our award winning web site your disease risk .
Your Disease Risk
Your Disease Risk
1. W. S. Atkin, R. Edwards, I. Kralj-Hans, K. Wooldrage, A. R. Hart, J. M. Northover, D. M. Parkin, J. Wardle, S. W. Duffy, J. Cuzick, Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 375, 1624 (2010); published online EpubMay 8 (S0140-6736(10)60551-X [pii]10.1016/S0140-6736(10)60551-X).
2. E. K. Wei, G. A. Colditz, E. L. Giovannucci, C. S. Fuchs, B. A. Rosner, Cumulative Risk of Colon Cancer up to Age 70 Years by Risk Factor Status Using Data From the Nurses' Health Study. Am J Epidemiol, (2009); published online EpubSep 1 (kwp210 [pii]10.1093/aje/kwp210).
3. C. E. Joshu, G. Parmigiani, G. A. Colditz, E. A. Platz, Opportunities for the primary prevention of colorectal cancer in the United States. Cancer prevention research 5, 138 (2012); published online EpubJan (10.1158/1940-6207.CAPR-11-0322).
4. E. A. Platz, W. C. Willett, G. A. Colditz, E. B. Rimm, D. Spiegelman, E. Giovannucci, Proportion of colon cancer risk that might be preventable in a cohort of middle-aged US men. Cancer Causes and Control 11, 579 (2000).