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June 17 2016

What is my risk of inheriting colon cancer?

By Daniel Mulkerin, MD

By now, most people have heard the message: As your 50th birthday draws near, you ought to be on the phone scheduling your first colonoscopy.

This screening tool for colon cancer has been a great success story. In the past 15 years or so, colorectal cancer rates and deaths in the United States have been dropping as more and more people are screened. The screenings can disclose pre-cancerous polyps, which are then removed during the quick and painless procedure.

So if you are turning 50, congratulations. Now schedule that colonoscopy appointment to give yourself the gift of cancer prevention.

Some people shouldn’t wait until age 50 for their first colonoscopy. Five to 10 percent of all colorectal cancers are hereditary, caused by a gene or genes inherited from your parents. You should talk with your physician if members of your family have had colon cancer.

Your physician will especially want to know if you have any first-degree relatives who have had colon cancer. These include your parents, siblings and children. Your physician also will want to know the age at which the cancer was diagnosed and whether there were multiple people in your family who had colorectal cancer. In general, you should be screened by colonoscopy 10 years earlier than the age when your family member was affected. So if your mother was diagnosed with colon cancer at age 45, you should begin regular screenings at age 35.

Your risk of colorectal cancer also is increased if you have relatives who have had pre-cancerous polyps removed during their colonoscopies. Colon cancer begins as polyps, so even if a relative had polyps but no cancer, your physician needs to know this. If a relative had the good fortune to have colon cancer prevented by the removal of polyps, you now need to be checked for them, too.

An additional benefit of colonoscopy is that it can give your family members the gift of cancer prevention by warning them not to put off their own colonoscopies.

At the UW Cancer Center at ProHealth Care, Christopher Hake, MD, and his team of genetic counselors are experts at evaluating family risks for the major types of inherited colon cancers. Genetic counselors can help you decide whether you and your family members should be tested for several genes known to predispose you to colorectal cancer.  If your family is found to have these genes, screening via colonoscopy may be recommended for children as young as 10.

Another group at high risk and in need of early screening are people with inflammatory bowel disease, such as chronic ulcerative colitis and Crohn’s disease. Both conditions increase the risk of colorectal cancer.

Except for people with the inherited types of cancer and underlying colon conditions, colon cancer is mostly a result of aging, our American diet and a sedentary lifestyle.

For most of us at normal risk, there are things we can do to prevent colon cancer well before our 50th birthday. We know that eating diets rich in fresh fruits and vegetables can prevent colon cancer. Regular physical exercise and maintaining a lean body weight also are helpful in preventing colorectal cancer.

If you are concerned about whether you have a higher than normal risk of developing colorectal cancer, the first step is sharing your family history with your physician. If you are at average risk, exercise, eat well and don’t forget your first colonoscopy at age 50.

To learn more about colorectal cancer and identifying your risk factors, complete an online health risk assessment at ProHealthCare.org/KnowYourRisk.

Daniel Mulkerin, MD, is a medical oncologist and medical director at UW Cancer Center at ProHealth Care.


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For more than a century, ProHealth Care has been the health care leader in Waukesha County and surrounding areas, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes ProHealth Waukesha Memorial Hospital, ProHealth Oconomowoc Memorial Hospital, ProHealth Rehabilitation Hospital of Wisconsin, ProHealth Medical Group, the UW Cancer Center at ProHealth Care, Moreland Surgery Center, ProHealth AngelsGrace Hospice, ProHealth Home Care, ProHealth West Wood Health & Fitness Center and ProHealth Regency Senior Communities. Learn more at ProHealthCare.org.