Simple Tips to Avoid Colon Cancer – And How to Make Sure Your Colonoscopy Is Accurate

Dr. Janet Zand
March 17, 2019


A disease that we typically associate with midlife and beyond is on the rise among people in their 20s and 30s. And it’s killing over 50,000 people every year in the U.S. alone.

Fortunately, these numbers are spurring researchers to go beyond recommending screenings. They’re now seeking to identify prevention steps they can recommend as well. Here’s what this deadly disease is – and what you can do to avoid it.

Many people dread their 50th birthdays for a variety of reasons. Reaching the half-century mark is definitely something to celebrate. But I understand not being thrilled to have hit the point in life at which colon cancer screenings are most commonly recommended.

Colonoscopies are never going to be fun. But you can take some of the stress out of them by taking steps to protect your colon health.

This Food Reduces Colon Cancer Risk

We always have to start with diet – especially when it comes to preventing colon cancer. Of course, the foods we introduce to our colon will have a significant impact on our health. But some are certainly better than others.

In particular, we need high-fiber foods like vegetables. You don’t need me to tell you that vegetables are good for you. But researchers are finding that one category of vegetables in particular can make a significant difference in your gut health.

Yep, we need to talk about kale. Kale’s 15 minutes of fame may have ended. But this leafy green and other cruciferous vegetables still deserve plenty of accolades.

Researchers at the Francis Crick Institute have found that when we digest vegetables from the Brassica genus, such as kale, cabbage, and broccoli, we produce something called indole-3-carbinol (I3C). And according to their study in mice, I3C reduces inflammation in the gut and risk of colon cancer.

I3C does this by activating aryl hydrocarbon receptor (AhR), a protein that communicates with the immune system. AhR talks to the epithelial cells that line the gut. It helps keep them from mounting an unnecessary immune response.

The researchers studied mice that are unable to make AhR in their guts. Sure enough, they quickly developed gut inflammation that led to colon cancer. But when the researchers enriched the mice’s diets with I3C, their guts stayed healthy. When they tried again with mice who were already developing colon cancer, the mice also fared better. They developed significantly fewer tumors. And more of the tumors they did develop were benign.

The researchers plan to move on to conducting studies in humans. But they don’t think anyone should wait for their results before eating more vegetables. We already know that vegetables are good for you and your colon. The researchers are just trying to pinpoint exactly how and why they work. I3C and AhR seem to be key aspects of the protective process.

Of course, we could all stand to eat more vegetables. But I have good news for you if you have more of a sweet tooth. Fruit may also help reduce gut inflammation. In particular, strawberries offer not just fiber but also important phenolic compounds that keep inflammation in check.

A research team at the University of Massachusetts Amherst focused on strawberries in their quest to identify foods that can help alleviate inflammatory bowel disease (IBD), which can contribute to colon cancer. They picked strawberries in part because, well, people like them. They’re an easier sell than broccoli or kale.

Fortunately, the team picked a winner. They tested strawberries in four groups of mice. One group served as the control. These healthy mice ate a regular diet. The other three groups of mice had IBD. One group also ate a regular diet. For the other two groups, whole strawberry powder made up 2.5% or 5% of their diets. The researchers intentionally picked low amounts to correspond to what humans might reasonably expect to eat.

They found that the strawberries did indeed help the mice. The mice just had to eat the human equivalent of three-quarters of a cup of strawberries a day to benefit. This amount reduced symptoms of weight loss, bloody diarrhea, and colonic inflammation.

One of the reasons strawberries are beneficial is that they help reverse imbalances in gut bacteria. You probably know by now that such imbalances can affect many aspects of our health. The gut itself is certainly no exception!

Beyond Diet – This Activity Boosts Good Gut Bacteria

Eating a high-fiber diet that includes plenty of fruits and vegetables will help balance your microbiome. Fiber offers “prebiotics” that feed friendly bacteria. And a good probiotic will boost friendly strains as well. But believe it or not, so will exercising.

Researchers first discovered this surprising connection in mice. They tried transplanting fecal material from mice that exercised and those that didn’t into sedentary germ-free mice. These germ-free mice didn’t have their own gut microbiota. Instead, they took on characteristics of their donors.

The mice that received the microbiota from the mice that exercised fared much better. Their guts had more friendly bacteria that produced a short-chain fatty acid called butyrate. Butyrate is great for the gut. It helps keep the intestines healthy, reduces inflammation, and boosts energy. The mice were also less susceptive to IBD. 

The researchers were so impressed with these results that they wanted to see what effects exercise would have on gut microbiota in humans. They recruited 18 lean and 14 obese adult participants. Despite their difference in body composition, all of the adults led sedentary lifestyles.

For six weeks, these previously sedentary adults exercised three times a week for 30 to 60 minutes. Then they returned to their sedentary habits for another six weeks. They maintained their normal diets throughout the study.

Sure enough, after the six weeks of exercise, the participants’ butyrate levels went up. But when they returned to their sedentary habits, their levels dipped back down. The researchers conducted genetic tests that confirmed the participants’ microbiota was changing according to their activity levels.

Interestingly, the lean participants saw the biggest jumps in butyrate. They also had the lowest levels to begin with. So this study is an important reminder than being lean is not the same as being healthy. You may not need to lose weight. But you’ll still experience benefits to your health – especially your gut – if you exercise.

Avoid These Inflammatory Foods

So far, we’ve talked a lot about what you should do if you want to reduce inflammation in your gut. We also need to discuss what you should avoid. Unhealthy, inflammatory foods are an obvious culprit. But there’s another potential cancer trigger that may be lurking in your life. It could even be in something you thought was beneficial.

This possible trigger is iron. Manufacturers use a variety of iron compounds in supplements and even in fortified foods. They’re trying to fight iron deficiency. But new research suggests they may inadvertently be promoting colon cancer,

Researchers at Chalmers University of Technology in Sweden studied several of these compounds. They found that two of the compounds, ferric citrate and ferric EDTA, could increase a cancer biomarker in cultured human colon cancer cells. This occurred even when the researchers used low doses of these two compounds. In contrast, the iron compound ferrous sulphate had no effect.

It seems like an easy enough issue to resolve. Just choose products with ferrous sulphate, right? Unfortunately, many manufacturers don’t state what type of iron they use in their products. They just list “iron” or “iron mineral” on the label.

Unless you need iron for a specific reason, I recommend steering clear. Most postmenopausal women can skip it. If your doctor prescribes it, make sure you understand why. (Some kidney patients need it, for example.) And if you do require it, it’s worth tracking down ferrous sulphate.

The researchers do note that they found these effects when working directly with cancer cells. (They can’t subject actual humans to this test, for obvious reasons.) But they still think it’s a good idea to be careful with iron. In other words, don’t try testing this at home.

If you currently take a multivitamin, check the label carefully. Many contain iron, particularly those formulated for younger women. Look instead for products that don’t include iron at all, such as those Advanced Bionutritionals produces. If you’re postmenopausal, you’re likely getting all the iron you need from your diet.

Gut inflammation in any form can seriously diminish your quality of life. And when it leads to colon cancer, it can even be deadly. If you’re eating a high-fiber, low-sugar diet; taking a probiotic to increase your healthy bacteria; and exercising, you’re well on your way to having a healthy gut. But to add an extra layer of protection, try having a kale and strawberry salad or roasting up some broccoli for dinner. And check your supplements to make sure you’re not increasing your risk with something you thought was good for you.

Tips for Making Sure Your Colonoscopy Is Accurate

You should follow your doctor’s recommendations for colon cancer screenings, no matter how many vegetables you eat. I know they aren’t fun. But they can save your life. Unfortunately, colonoscopies aren’t always accurate. But you can take steps to improve the accuracy of your test. There are four things to consider for more accurate results:

Which doctor: Who does the best job, an internist or gastroenterologist? Studies show that an internist or family doctor is more likely to miss cancers than a gastroenterologist. Insist on a gastroenterologist.

Where: Which is best, going to a doctor’s office or a hospital? Choose the hospital. There’s a two to three times greater risk of missing a suspicious growth if your procedure is done in a doctor’s office rather than at a hospital. If a family doctor performs the procedure instead of a gastroenterologist, your risk of getting a false negative result almost doubles.

When: The time of day for your colonoscopy matters. Doctors are more alert in the morning than in the afternoon. In one study, there was a 2% higher rate of inaccuracy when the doctor performed the colonoscopy in the afternoon. That’s insignificant, you say? Not if your colonoscopy is one that failed and you suddenly find you have colon cancer. This is an avoidable risk.

Slow down: Doctors check for polyps in the mucous lining of the colon as the colonoscopy wand is withdrawn. One doctor might take only three minutes to withdraw the instrument. But another doctor could take longer than 15 minutes. Which is more likely to discover something suspicious? That’s right. The doctor who’s not in a hurry. In fact, doctors find four times as many polyps with the slower withdrawal times. Ask the gastroenterologist to take his or her time just to make sure they find anything that may be there.

You can prevent colon cancer. But it does take some vigilance on your part. Hopefully, these tips and recommendations will keep you from ever needing a follow-up visit after a screening.

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