Colon Cancer Risk Factors

Colon cancer is a leading cause of death by cancer. So it’s important to know if you have any colon cancer risk factors, and what steps to take to lower your risk.

At UVA Health, you’ll find experts who can create a special colon cancer screening plan if you’re at high risk. We can catch the cancer long before it turns deadly or even prevent it. You can also meet with a genetic counselor. These experts are a great resource if you’ve inherited a condition that puts you at a very high risk for colon or other cancers.

Am I at High Risk for Colon Cancer?

Certain things about you or your lifestyle (risk factors) can increase your chances of developing colon cancer. Colon cancer starts in the colon or rectum (large intestine), parts of our digestive system. It’s also called colorectal cancer. It usually starts as small growths called polyps. Over time, some polyps can turn into cancer. 

Colon Cancer Risk Factors

Some of these colon cancer risk factors you can't change. But some you can. 

Your Race & Ethnic Background: American Indian and Alaska Native people have the highest rates of colorectal cancer in the United States. African American men and women have the next highest rates.

Jews of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world.

Your Age: The risk of colon cancer goes up as you get older. Most cases happen in people over 50. But it’s also on the rise in those in their 20, 30s, and 40s.

Your Family History: Your risk is higher if someone in your family has had colon cancer, especially a parent, sibling, or child.

Personal History of Colon Cancer or Polyps: If a colonoscopy found polyps in your colon, you’re at a higher risk of developing colorectal cancer. This is especially true if lots of polyps were found and they:

  • Are large
  • Show signs of abnormal cell growth (dysplasia)

If you’ve had colorectal cancer, even if it was completely removed, you’re more likely to develop new cancers in other parts of your colon and rectum. The chances are greater if your first colorectal cancer was diagnosed when you were younger.

Inflammatory Bowel Diseases: Conditions like Crohn's disease or ulcerative colitis can increase your risk.

Type 2 Diabetes: Researchers think that a higher risk for colon cancer is linked to high levels of insulin in people with diabetes.

Having Your Gallbladder Removed If you’ve had your gallbladder removed (cholecystectomy), you have a slightly higher risk for colon cancer.

Lifestyle Factors: Eating a diet high in red meat and processed meat, being overweight, smoking, and not getting enough exercise — all of these can raise your risk. But these are colon cancer risk factors you can control.

How Can I Reduce My Colon Cancer Risk?

These steps can reduce your risk of colon cancer.

Get Screened: Screening tests can find colon cancer at an early stage or even precancer stage. Everyone needs to start screening by age 45. But you may need to start earlier if you have colon cancer risk factors. Talk to your doctor about when you should start screening and which colon cancer screening test is right for you.  

Stool tests like FIT or Cologuard are effective screening tools. But colonoscopy is usually the preferred screening if you’re at high risk for colon cancer. With colonoscopy, we can stop cancer before it starts. We can find, and remove, precancer polyps.  

Eat a Healthy Diet: Get plenty of fruits, vegetables, and whole grains in your diet. Cut down on red meat and processed meats.  

Enjoy Exercise: Aim for at least 30 minutes of moderate physical activity most days.    

Limit Alcohol: It’s best not to drink alcohol. But if you do, limit how much you drink. Men should have no more than 2 drinks per day, and women should have no more than 1.  

Quit Smoking: Smoking is linked to an increased risk of colon cancer.  

Know Your Family History: Talk to your family members about their health history. If you have a family history of colon cancer or polyps, your doctor may recommend:

  • Starting screening earlier than age 45.
  • Getting screened more often. If cancer tends to develop at young ages in your family, you may even want to talk with a genetic counselor about genetic testing.

Do I Need Genetic Counseling?

About 5% of people who develop colorectal cancer have inherited gene changes (mutations). Families who carry these altered genes have a very high risk of developing certain cancers. These gene changes lead to family cancer syndromes. A few rare inherited syndromes are linked with colorectal cancers. But the most common ones are:

  • Lynch syndrome (hereditary non-polyposis colorectal cancer, or HNPCC)
  • Familial adenomatous polyposis (FAP)

Genetic testing can uncover these syndromes. It involves taking a small sample of your blood. A genetic counselor at UVA Health can help you understand what having an inherited disorder means for your and your family’s health.

Learn more about who should get cancer genetic testing and counseling.  

Watch for Colon Cancer Symptoms

Colon cancer is on the rise in those under age 50. Whether you have a high risk or not, don't ignore symptoms like:

  • Changes in bowel habits
  • Blood in your stool
  • Abdominal pain
  • Unexplained weight loss

If you have any concerns, talk to your primary care provider right away.