FAQs Common Colorectal Cancer Questions If I have a colorectal problem or disorder, am I automatically at risk for colorectal cancer? Different cancers have different risk factors, and there are several risk factors that have been associated with colorectal cancer. In general, your risk of developing colorectal cancer increases with age, especially after age 50. If you or a member of your immediate family has a history of colorectal, breast, uterine, or ovarian cancer, or inflammatory bowel disease, you may have an increased risk of developing colorectal cancer. The risk increases if the relative(s) had the disease before age 60. Two genetic syndromes that cause an increased risk for colorectal cancer are familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC). In addition to family history, Jewish people of Eastern European descent known as Ashkenazi Jews have a higher risk of colorectal cancer. If you experience rectal pain, spasm, bleeding, mucus discharge, or a change in bowel habits, you may be at risk for more serious colorectal disease. Those who are physically inactive, obese, diabetic, smoke, or have heavy use of alcohol are also at an increased risk for colorectal disease. At what age should I have a colonoscopy? If you are not at increased risk, you should have your first colonoscopy at age 50. It should be repeated every 5 to 10 years thereafter. Experts advise that African Americans begin regular colonoscopy screening earlier at age 45. For moderate risk patients (such as those with a family history of colon cancer), colonoscopy screening should begin at age 40, 10 years earlier than the youngest age at which colon cancer was diagnosed in the family. Screenings should be done at regular intervals, as determined by you and your physician. For patients with a hereditary predisposition to colon cancer, high risk screening recommendations are provided by the Cancer Genetics Program. Should I be concerned if one or more of my family members had polyps? Certainly you may be concerned if any family members have polyps. The level of concern depends on many things, including how closely related you are to the family member, the age at which your relative developed polyps, the type of polyps, and the number of polyps. In general, multiple polyps, polyps at a young age, or polyps in a close relative may increase your risk of colorectal disease. If there is a personal or family history of more than ten polyps and/or polyps at a young age, you may benefit from a genetic cancer risk evaluation. Should I be concerned if I don't have a bowel movement every day? Not necessarily. Just because you don't have a bowel movement every day does not mean you are at risk for colorectal disease. It depends on the frequency of your bowel movements over a lifetime. If it is your regular pattern to have a bowel movement every 2 days, and that is how you have always been, then there is nothing to worry about. You should be concerned is if there is a change in your regular bowel habits. Is there a special diet I should follow to avoid having colorectal problems? A diet rich in fruit, vegetables, grain products, and foods from other plant sources appears to be best, as it not only decreases your risk of colorectal disease, but can also reduce the risk of heart disease, high blood pressure and diabetes. Fruits and vegetables contain antioxidants, which help protect the body from many diseases, including cancer. Saturated fats, especially those from animal sources such as red meat and processed meat, do not contain antioxidants, and can increase the risk of colorectal cancer. They may be broken down in the body to carcinogens, which increase the chance of cells becoming cancerous. Studies are show that diets high in calcium may also reduce the risk of colon cancer. I have ulcerative colitis. How often should I have a colonoscopy? Ulcerative colitis increases your risk of colon cancer. For the first 10 years of disease activity, the risk of cancer is about the same as in the general population. After 15 years, the incidence of cancer rises and annual (yearly) colonoscopy with surveillance biopsies for dysplasia (precancerous change) is indicated.