Friday, January 6, 2012


Several factors increase an individual's risk of developing colorectal cancer. Having one or more of these factors will determine the age when you should begin screening, the frequency of screening, and the screening tests that are most appropriate.

Factors that increase risk — Several characteristics increase the risk of colorectal cancer. While each individual risk factor adds some risk, risk is substantially increased if several are present together.

Family history of colorectal cancer — Having colorectal cancer in a family member increases your risk of cancer if the family member is a first degree relative (a parent, brother or sister, or child), if several family members are affected, or if the cancers have occurred at an early age (eg, before age 55 years).

Prior colorectal cancer or polyps — People who have previously had colorectal cancer have an increased risk of developing a new colorectal cancer. People who have had adenomatous polyps before the age of 60 years are also at increased risk for developing colorectal cancer. Screening recommendations for these groups are discussed separately.

Increasing age — Although the average person has a 5 percent lifetime risk of developing colorectal cancer, 90 percent of these cancers occur in people older than 50 years of age. Risk increases with age throughout life.

Lifestyle factors — Several lifestyle factors increase the risk of colorectal cancer, including:

A diet high in fat and red meat and low in fiber

A sedentary lifestyle

Cigarette smoking

Large increase in risk — Some conditions greatly increase the risk of colorectal cancer.

Familial adenomatous polyposis — Familial adenomatous polyposis (FAP) is an uncommon inherited condition that increases the risk of colorectal cancer. Nearly 100 percent of people with this condition will develop colorectal cancer during their lifetime, and most of these cancers occur before the age of 50 years. FAP causes hundreds of polyps to develop throughout the colon.

Hereditary nonpolyposis colon cancer — Hereditary nonpolyposis colon cancer (HNPCC, also called Lynch syndrome) is another inherited condition associated with an increased risk of colorectal cancer. It is slightly more common than FAP, but is still uncommon, accounting for about 1 in 20 cases of colorectal cancer. About 70 percent of people with HNPCC will experience colorectal cancer by the age of 65. Cancer also tends to occur at younger ages. People with HNPCC are also at risk for other types of cancer, including cancer of the uterus, stomach, bladder, kidney, and ovary.

Inflammatory bowel disease — People with Crohn's disease of the colon or ulcerative colitis have an increased risk of colorectal cancer. The amount of increased risk depends upon the amount of inflamed colon and the duration of disease; pancolitis (inflammation of the entire colon) and colitis of 10 years' duration or longer are associated with the greatest risk for colorectal cancer. The risk of colon cancer is not increased in people with irritable bowel disease.

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