Your Guide to Colorectal Cancer Awareness and Prevention

A colorectal cancer awareness event at The Mount Sinai Hospital. Click here to learn more about colorectal cancer and early screening with Mount Sinai’s CHOICE Program. To discuss your screening options or if you have a referral, call 212-824-7887.

Colorectal cancer is the second leading cause of cancer deaths in both men and women in the United States. Although this cancer is highly treatable and preventable, about 140,000 Americans are diagnosed and more than 50,000 people die each year, according to the Centers for Disease Control and Prevention (CDC). In 2021, the United States Preventative Task Force updated its guidelines and lowered the starting age of screening from 50 to 45.

More than 93 percent of colorectal cancer cases occur in people 45 years old or older. More than 75-90 percent of colorectal cancer cases can be avoided through early detection and removal of pre-cancerous polyps, and as many as 60 percent of colorectal cancer deaths could be prevented if men and women over the age of 45 were screened routinely.

In the United States, more than half (55 percent) of all cases of colorectal cancer are attributable to lifestyle factors, such as an unhealthy diet, insufficient physical activity, high alcohol consumption, and smoking. Increasing screening to 80 percent of people could reduce the number diagnosed with colorectal cancer by 22 percent by 2030. But survey data indicates that screening prevalence among adults remains low in those aged 45 to 54.

In an effort to increase awareness and screening, Mount Sinai has expanded colorectal cancer awareness initiatives across all eight hospital sites during March to provide patients with access to health professionals to discuss prevention, screening options, and risk factors. Mount Sinai experts will be available to answer questions on diet, genetic counseling, the colonoscopy procedure, and ways to schedule and offer support after diagnosis.

Here are some prevention tips:

Schedule a Screening

A colonoscopy is the preferred screening method as it allows for both detection and removal of precancerous polyps during the same procedure. Other screening options include a flexible sigmoidoscopy, CT colonography, and home-based stool tests, including the fecal occult blood test (FOBT), fecal immunochemical test (FIT), and a combined fecal immunochemical test with DNA test (FIT-DNA test). Individuals should discuss all of these options with their doctor to find which method works best for their lifestyle.

Know Your Risk Factors 

Age: More than 90 percent of colorectal cancer cases occur in people 45 years old or older and death rate increases with age. In New York, 44 percent of those 45 to 54 are up to date with colorectal screening.

Family history:  As many as 1 in 3 people who develop colorectal cancer have other family members who have been affected by this disease. The risk is even higher if a relative was diagnosed under age 50 or if more than one first-degree relative (parent, sibling, or child) has been affected.

Racial and ethnic background: Colorectal cancer affects people of all races and ethnicities. However, colorectal cancer disproportionately affects the Black community, where the rates are the highest of any racial/ethnic group in the United States. Black individuals are most likely to be diagnosed with late-stage colorectal cancer. The incidence of this cancer in Black individuals is 15 percent higher than in white individuals. Death rates have declined in Black individuals by 3 percent. Colorectal cancer screening rates are now lowest among Asian Americans and Hispanic/Latino communities.

Lifestyle factors: Common lifestyle factors that may increase colorectal cancer risk include obesity; cigarette smoking; lack of exercise; overconsumption of fat, red, and processed meats; not eating enough fiber, fruits, and vegetables; and drinking alcohol excessively.

Pre-existing health conditions: Inflammatory bowel diseases (IBD), such as ulcerative colitis or Crohn’s disease, and less common genetic syndromes, such as familial adenomatous polyposis (FAP) or Lynch syndrome, significantly increase the risk of developing colorectal cancer. These patients are recommended to start screening at a younger age and more frequently.

Warning Signs and Symptoms 

• A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, lasting for more than a few days.
• Rectal bleeding, dark stools, or blood in the stool.
• Cramping or abdominal pain.
• Weakness and fatigue.
• Unintended weight loss.