By Dr. Lauren Gresham / Special to the Herald

It’s unlikely that most of you associate the month of March with colorectal cancer.

But March is in fact Colorectal Cancer Awareness Month, so I figured this would be a great opportunity to share practical tips for preventing colorectal cancer.

According to the World Health Organization, colorectal cancer, which starts in the colon or the rectum, is the third most common in the world. In 2018 alone, there were 1.8 million new cases and 861,000 deaths. Those high numbers emphasize why this is an important disease to understand and work to prevent.

Some of the risk factors for colorectal cancer cannot be changed, but there are a few that are modifiable. If you have a strong family history of colorectal, breast or ovarian cancer, it is possible that you have inherited one of the genetic syndromes associated with colorectal cancer.

Additionally, if you have a diagnosis of any inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, you are at increased risk of colorectal cancer. If this applies to you, please discuss this with your doctor because your screening recommendations will likely be different than others without these concerns.

Being obese is a risk factor for developing colorectal cancer. Obesity also increases the risk of dying from colorectal cancer. Luckily, physical activity is protective and, in my opinion, much easier to modify than body size. (Longterm studies about effective weight loss strategies are few and far between.) The average colorectal cancer risk reduction from physical activity is around 27%.

Ideally, find physical activity that you enjoy, because the odds are, if you enjoy the activity, you will likely continue to exercise.

A diet high in red and processed meats is associated with more colorectal cancer. This is particularly true if the meat is charred, fried or cooked on very high temperatures. There appears to be a dose-response relationship, meaning that the more that you eat red and processed meats, the higher your risk becomes.

Conversely, eating more fruits and vegetables is associated with a reduced risk of colorectal cancer. Fruits and vegetables are naturally high in fiber, which is the bulky, indigestible parts of foods. Fiber acts like a broom for our digestive system, sweeping out material and aiding healthy bowel movements.

Getting sufficient omega-3 fatty acids in our diets, which is high in fish such as salmon and sardines, is also protective against colorectal cancer.

Other things that reduce our risk for colorectal cancer include limiting our alcohol intake to no more than one serving of alcohol per day and not smoking, which increases our risk for basically every type of cancer.

There are a variety of nutrients that have associations with decreasing our risk of colorectal cancer, including folic acid, calcium, magnesium, vitamin D and vitamin B6, which for me, further emphasizes that a healthful diet high in fruits and vegetables is important.

An excellent colorectal cancer prevention plan should also include screening tests, which for those of us with average risk usually begins at age 50. The gold standard of colorectal cancer screening is a colonoscopy.

During a colonoscopy, a camera is inserted through the anus to visualize the entire colon. Through the procedure, doctors are able to perform important interventions, such as the removal of polyps, so it has a therapeutic value that the other screening tests cannot provide. Most colon cancers arise from polyps and most polyps take around 10 years to transform from an abnormal growth to cancer, which is why most of us only need repeat colonoscopies every 10 years.

Other screening tests that patients may request include a stool test that looks for blood in the feces and computerized tomography of the colon. While these tests are certainly better than no screening, these tests require follow-up colonoscopies if they find anything abnormal and they are not as precise.

The vast majority of patients report that the worst part of a colonoscopy is not the actual procedure itself, but the preparation for it. The preparation requires the patient to take intense laxatives the day before to clean out their colon.

While taking intense laxatives and having someone put a camera into my butt sounds really unpleasant, colonoscopies save lives. In fact, studies show that mortality may be reduced by up to 60% when you follow the recommended colonoscopy schedule.

Between diet, physical activity and screening recommendations, there is a lot you can do to reduce your risk of colorectal cancer.

Dr. Lauren Gresham is a licensed naturopathic physician and community health education specialist. She holds a doctorate in naturopathic medicine and a master’s degree in public health from Bastyr University. Learn more about her by visiting www.nutimahealth.com.