Colorectal Cancer Screening

This is your best bet of preventing colorectal cancer and reducing your risk.

Screening is a process in which doctors use specific tests to detect pre-cancerous lesions (e.g. polyps) and treat these to prevent the actual cancer from forming. For screening to be effective, the disease (i.e. colorectal cancer) has to be common (it is the MOST common cancer in Singapore) and ideally should be performed on those who do not yet have any symptoms of the disease.

For colorectal cancer, the best screening test is the Colonoscopy.

Colorectal cancer starts as small non-cancerous growths on the inner lining of the colon or rectum. These are called polyps. They seldom cause symptoms due to their small size and usually take months to years to ever become a cancer. Regular screening is therefore your best chance of detecting these ‘silent’ polyps before they transform into cancer. Removing them early will therefore prevent cancers from forming in the first place.

Colorectal cancer as seen during Colonoscopy

One should come for a colonoscopy by the age of 45 years old OR 10 years before the youngest cancer in the family, whichever is earlier. If you already have symptoms like pain, bleeding, change in bowel habits (i.e. irregular patterns, flipping between constipation and diarrhoea) or weight loss, you should come to speak to our doctor early and have a discussion about doing a colonoscopy.

Factors that you cannot change or modify

You cannot change your family tree and these have genetic risks that are passed down from one generation to another.

1. Age

All those aged 45 years old and above are at increased risk of having colorectal cancer.

2. Family history of Colorectal Cancer or Polyps

Those with a family history will have a higher risk of developing colorectal cancer themselves. The more family members and the closer they are to you (eg. immediate siblings or parents), the higher the risk you have of getting this cancer.

3. Personal History of Inflammatory Bowel Disease (IBD)

Long-standing IBD (e.g. ulcerative colitis) increases the risk of developing colorectal cancer.

4. Inherited Syndromes or Gene-related Risk

Although only a small percentage, gene-related issues in the family can also increase the risk of colon cancer greatly. Usually such individuals can develop cancer at a much younger age, even in their 20s or 30s.

Factors you can modify to reduce your risk

There are things you can do to reduce your risk of colorectal cancer. These relate to your lifestyle choices.

These are 5 factors that you should pay attention to:

1. Smoking and Alcohol Consumption

Smoking and excessive alcohol intake are bad for your health. It also increases your risk of developing colorectal and many other cancers. The best thing to do is quit smoking and drink only occasionally and not in large quantities.

2. Diabetes

People with diabetes are also susceptible to getting cancer, especially those whose diabetes is not well controlled. Diabetics therefore must ensure that their condition is monitored closely and that their medications and diet are optimised.

3. Bodyweight

Being obese or overweight increases your risk of having colorectal cancer, regardless of gender. Know your ideal weight and ensure that you keep to it through a combination of eating a balanced diet and regular exercise.

4. Well-Balanced Diet

People who take a balanced diet comprising a good mix of fibre and meat have a lower chance of developing colorectal cancer. There is no guarantee and even vegetarians can get colorectal cancer, due to factors you cannot change as above. To reduce the overall risk, one should also avoid eating processed foods (e.g. fast foods) or preserved foods, as well as deep-fried or barbecued foods.

5. Regular Physical Activity

Avoid a sedentary lifestyle, i.e. do not be a couch potato! Increasing your physical activity level can lower your risk of having colorectal cancer. You should maintain an active lifestyle with regular exercise of at least 3 times per week lasting at least 30 minutes each time. Remember that exercising regularly is not an excuse to eat anything you want!

Good Food Choices for Lowering Your Colorectal Cancer Risk

A balanced diet is key to a healthy life. This balance is different for everyone and must be individualized. But there are some foods that are particularly important, these include:

1. Dairy Foods

According to recent studies, calcium-rich foods like dairy products (milk, yogurt, cheese) can reduce the risk of forming polyps (adenomas), some of which can develop into colorectal cancer.

2. Whole Grains

Whole grain foods (oatmeal, brown rice, and whole wheat bread) contain important protective nutrients like magnesium and fiber, which help to maintain good bowel movement and keep your intestines healthy.

3. Beans

Beans and legumes (soybeans, peas, and lentils) are a rich source of fiber, protein, vitamin B, and E. The flavonoids and antioxidants found in beans and legumes are also protective against colorectal cancer.

4. Multi-Coloured Fruits and Vegetables

Colourful fruits and vegetables contain phytochemicals, which have antioxidant properties that help to reduce inflammation in the body, thus helping to lower your risk of cancer.

5. Fish

Many fish, especially salmon, are rich in omega-3 fatty acids, which have anti-cancer growth properties. It is recommended that you take 80-100g daily for good health.

Foods to Be Eaten in Controlled Portions Only

1. Red Meats

Red meat by itself is not unhealthy. Taking lean red meat is a healthier option. More importantly, the method in which it is cooked also influences cancer risk, e.g. barbecued and deep-fried styles of cooking meat is unhealthy and should be limited. Therefore, it is advised to eat read meats in moderation, perhaps up to 2 to 3 times a week or not more than 18 ounces weekly.

2. Processed Foods and Meats

All processed foods (vegetables or meat) are prepared and preserved with chemicals which can increase your risk of cancer. The regular consumption of these foods, including sausages, bacon, ham, burgers, salted vegetables etc. can increase the chance of cancer from increased exposure to such chemicals in the body.

3. Items High in Refined Sugar, Caffeinated drinks, and Other Sugary Beverages

The excessive consumption of sugary foods, artificial sweeteners, caffeine, soft drinks, sweetened juices, and other sugary beverages also increases the risk of cancer. Therefore, it is best to avoid or minimize intake of such beverages.

4. Alcohol

Drinking alcohol daily may increase the risk of colorectal cancer by up to 20-40%. Alcohol should only be consumed sparingly.

We are what we eat. So, eat wisely since a Healthy Gut is a Healthy Life!

The burning question is, “how can we reduce our risk of getting colorectal cancer naturally?”. Studies have shown that engaging in regular physical exercise can lower colorectal cancer risks by as much as 15%. A study involving 1.4 million participants also highlighted that those with the lowest levels of physical activity had higher rates of colorectal cancer.

How Does Exercise Help to Reduce the Risk of Colorectal Cancer?

Obesity and a sedentary (‘couch potato’) lifestyle are risk factors of colorectal cancer. Those who exercise less tend to be more obese and overweight, hence putting them at higher risk of getting this cancer.

Research shows that exercise can lower your risk of developing colorectal cancer in the following ways:

• Improving immune function
• Reducing inflammation
• Reducing the time food stays in your colon, therefore reducing intestine exposure to potential carcinogens (cancer causing chemicals) in the food we eat
• Lowering levels of certain hormones, including insulin and oestrogen, that may contribute to the development and growth of cancer
• Decreasing growth factors associated with the development and growth of cancer

Recommended Exercise Plans (Intensity & Duration)

The type of exercise, intensity, and duration is still the subject of intense research. Remember to always consult your doctor before you start any exercise plan. This will vary from person to person, depending on your age and overall physical health. As with any exercise plan, you should always start slow and increase the intensity when the body has built up endurance.

Generally, at least 30 minutes of exercise 3 times a week is a good start. Good exercises to try are those which can help you work up a good sweat, such as walking, swimming, running, cycling, skipping, or hiking.

Our doctor personally prefers the outdoors to any gym, for a good dose of fresh air and to enjoy the scenery!

How Do Exercises Help Colorectal Cancer Survivors After Treatment?

Research has also shown that regular exercise helps to reduce the risk of cancer relapse by as much as 50%. Even colorectal cancer survivors who have undergone chemotherapy or radiotherapy can decrease their risk of relapse by doing moderate walking regularly, according to several case studies.

As such, consistent physical workouts adjusted to your age and physical health, is a good way to reduce the risk of colorectal cancer recurrence, in a natural way.

Stay healthy and have fun doing it!