Survey reveals lack of awareness among Americans regarding modifiable risk factors for colon cancer.

A considerable number of Americans are unaware that certain lifestyle habits—such as drinking alcohol and a lack of physical activity—can augment the chances of developing colorectal cancer, the Ohio State University Comprehensive Cancer Center has revealed through a new study.

The findings of the study resonate with the lack of information observed by specialists when discussing the risk factors of colon cancer with their patients.

“We often address risk factors as fixed aspects, but many of them are alterable through proper education,” explained Matthew Grossman, MD, a specialist in interventional endoscopy and gastroenterology at the Atlantic Digestive Health Institute in New Jersey.

The lack of knowledge about the risk factors of colorectal cancer, commonly referred to as colon cancer, could be a major cause of the rising cases of this disease.

“The fact that we can control many of these factors makes this situation even more worrisome,” Suneel Kamath, MD, a gastrointestinal oncologist at Cleveland Clinic, commented. “The main conclusion [from this study] is that we can prevent many of the cases of colon cancer diagnosed in America.”

The study revealed the highest level of unawareness among Black and Hispanic individuals, suggesting a higher likelihood of colon cancer cases within these communities. “The lack of knowledge definitely contributes to the higher rates of colon cancer cases in the Black and Hispanic populations,” stated Kamath.

Following this, specialists elaborate on the modifiable risk factors for colon cancer, early colon cancer screening, and how to raise awareness about these risk factors.

The recent study enrolled approximately 1,000 U.S. adults to understand their knowledge level about the risk factors of colon cancer. The data was collected through a platform that carries out nationwide probability-based studies; 976 people responded over the internet, and 30 replied over the phone. The data was collected in early February 2024.

It’s widely accepted that four lifestyle habits (alcohol consumption, inactivity, obesity, and unhealthy diet) can impact the risks of colon cancer, as stated by Kamath. However, this new study exposed gaps in common knowledge.

Just over half of the participants (51%) did not associate alcohol consumption with colon cancer. Meanwhile, 42% did not link inactivity with colon cancer, 38% did not believe obesity is associated with colon cancer, and 37% did not think a poor diet is correlated with colon cancer.

These lifestyle behaviours have also been connected to other types of cancer. Alcohol consumption alone can increase the risk of several types of cancer, including breast cancer, esophageal cancer and liver cancer among others. The Department of Health and Human Services' National Toxicology Program recognises alcohol consumption as a known human carcinogen.

Similarly, indulging in unhealthy food and drinks (such as sugar-sweetened beverages and ultra-processed foods) and avoiding physical exercise can lead to weight gain and obesity, which can increase the risk of other cancers like uterine cancer and breast cancer. Particularly, red and processed meats are associated with colon cancer.

The lack of awareness regarding these risk factors could be unquestionably linked to the escalating rates of the disease, especially among young people, added Kamath. Colorectal cancer is the third leading cancer in America, and early-onset instances have been rising since the mid-1990s.

In 1995, 11% of the people diagnosed with advanced-stage colorectal cancer were under 55 years of age; by 2019, this figure rose to 20%. This increase stems not only from a lack of awareness about the risk factors but also because young people are not regularly screened for this disease. Furthermore, they may be less inclined to seek medical help when they notice warning signs.

“We recently discovered a new epidemic of young people being diagnosed with colon cancer,” warned Grossman. “People should start considering these risk factors from an early age.”

Colon cancer might also disproportionately affect Hispanic and Black Americans due to a lack of awareness. Furthermore, Black Americans exhibit higher mortality rates from the disease, and the fastest increase in colon cancer rates is seen among Hispanic Americans compared to other ethnic groups.

In light of the increased frequency of colon cancer detection among younger demographics, the recommended age for commencing regular colonoscopies—the most reliable screening method for colon cancer—was recently lowered from 50 to 45 years old.

However, some individuals might require screening at an even earlier age. If there is a history of colon cancer in your family, or if polyps have been detected during colonoscopies of your parents or siblings, it might be advisable to consult with your doctor about undergoing a colonoscopy earlier than suggested, Grossman advised.

Similarly, if you have other risk factors like inflammatory bowel disease (IBD) or certain genetic syndromes (familial adenomatous polyposis or hereditary non-polyposis colorectal cancer, also known as Lynch syndrome), you should also get screened earlier and more frequently.

Aside from risk factors, any of the following warning signs of colon cancer should prompt a discussion with your doctor, said Grossman.

The new survey underscores the need for educational movements that can help people learn the risk factors and warning signs of this disease. “Advocacy campaigns, both from the government and nonprofit groups, can be very effective for raising awareness about colon cancer risk factors,” said Kamath.

Simply put, knowing about these modifiable risk factors could save lives. “We have an excellent opportunity to educate the public that alcohol, obesity, overweight, poor diet, and physical inactivity all increase the risk of colon cancer,” said Kamath. “We could prevent many colon cancer diagnoses.”