Stop Colorectal Cancer

What Makes You High-Risk?

Q. So what is it that makes you high-risk for colon cancer?

You're considered high-risk if you have a first-degree family member (that's mom, dad, brother, sister) with colon cancer or polyps. If that's the case, we start the screening 10 to 15 years before your family member was diagnosed or by age 50, whichever comes first. So let's say your mother was diagnosed with cancer or polyps at 55, we'd start your screening at 45 or even 40.

Another high-risk group is people who've had breast cancer or another malignancy. A lot of these risk factors for colon cancer apply to multiple cancers. The same environmental things, genetic things, some of which are as of yet undiscovered, that increase your risk for one cancer can also increase your risk for another type of cancer. We follow our ladies who've had breast cancer very carefully, and we frequently start to screen them for colon cancer earlier than 50.

Also high-risk are people who have inflammatory bowel disease or IBD -- not to be confused with IBS, irritable bowel syndrome. We're talking Crohn's disease or ulcerative colitis, and these two conditions, which are frequently diagnosed before your 30s, increase the risk of colon cancer dramatically. If people have had either of those, we recommend annual colonoscopy in those patients at any age.

There is also a higher incidence of colon cancer in African-Americans, and we're not sure why. Our genetics are 99 percent the same, so it's very hard to say whether there's a genetic reason or if it's about lifestyle. It could be about less access, if African-Americans are less likely to get screened, or it could be about diet or physical activity. There have been studies that suggest we should do screening at 45 in African-Americans too. But again, the guidelines haven't changed.