Cancer Prevention

Many factors play a role in cancer development, but several lifestyle changes can help with gastrointestinal cancer prevention, and may include:

Cancer Prevention Diet:

Eat a well balanced diet high in fruits and vegetables, low in saturated fat and red meat, and a low sodium diet may help reduce the risk of developing cancer.

• Avoid smoking
• Avoid excessive use of alcohol
• Regular exercise
• Keep normal weight

Medications:

Certain medications are known to decrease the risk of developing precancerous conditions, however there is no sufficient evidence to advice these medications in people with average risk of colon cancer. One of the most important drugs is aspirin. There is a whole host of conflicting evidence on the benefits versus the risk of this medicine to prevent many different cancers including bowel cancer and oesophageal cancer.

Screening and Surveillance

Screening:

Screening for GI cancer is an effective means of detecting the disease in its early and most curable stages. People with an average risk of colon or rectal cancer should consider screening beginning at age 50. People with a family history of colon or rectal cancer should consider screening at an earlier age. This usually starts 10 years before the age the family member was when they developed cancer. Your doctor may recommend regular screening even if you don’t have any symptoms of colon or rectal cancer if you are considered to be at risk.

In people at standard risk, several screening options include:

• annual or two yearly quantitative faecal imuunochemical testing (qFIT) which looks for tiny traces of blood in the stool. The results can be tuned to give a 99.9% certainty that the patient does not have bowel cancer. It is not very accurate when trying to detect colonic polyps (pre-cancerous growths).
• screening colonoscopy (this is routinely offered in the USA from age 45. This is not the case in the UK). This test is highly accurate for both cancer and polyps including very small ones. They can be removed during the procedure)
• virtual colonoscopy (a less invasive way to detect polyps. Whilst this test is accurate for cancer and large polyps it may miss small ones. If a polyp is found, then a colonoscopy is done to remove it).

Surveillance:

• If polyps are found at colonoscopy, there is a higher chance that new polyps will develop over time. Patients are therefore advised to undergo regular surveillance colonoscopy. The timing between colonoscopies depends on the number and size of polyps found.

Surgery:

• In certain unusual conditions such as familial adenomatous polyposis, or inflammatory bowel disease surgical removal of the entire colon and rectum can remove the risk of developing cancer.