If You Are At High Risk: Preventing And Treating Colorectal Cancer

Content provided by the Faculty of the Harvard Medical School

If you are at high risk

You have a higher than average risk of developing colorectal cancer if you have a personal or family medical history of the disease or if you have polyps or certain other health problems. In such cases, you should have colorectal cancer screening earlier and more often than people of average risk. It's also important to address the risk factors you can control: Cut back on red meat, exercise regularly, quit smoking, and maintain a normal weight.

Chemoprevention might also be helpful, especially folic acid in the form of a daily multivitamin. In addition, talk with your doctor about taking calcium, vitamin D, and aspirin or another NSAID. Population studies, which analyze the health and other characteristics of groups of people, have found that people who take these supplements or medications have a lower incidence of colorectal cancer. Efforts are under way to confirm the value of these and other chemopreventive agents in clinical trials (controlled experiments that compare the outcomes of people who take them with those who take a placebo). However, because clinical trials — the gold standard of medical research — have not yet confirmed that any drug or supplement can prevent colorectal cancer, these agents should not be used to replace proven protective measures, especially screening.

Prophylactic surgery is recommended for some people who are at very high risk for colorectal cancer — people with familial adenomatous polyposis (FAP), as well as people with ulcerative colitis who have symptoms of colorectal cancer. Without the surgery, people with FAP are certain to develop colorectal cancer. Fortunately, prophylactic surgery usually doesn't require a colostomy — a surgical procedure that reroutes a small portion of the colon to a newly made opening in the abdomen, through which stool passes and empties into a pouch.

Last updated:	April 09, 2009