By the American Cancer Society // the Academy of Nutrition and Dietetics

Catch it Early and Reduce Your Risk

Colorectal cancer is the third most common cancer in both men and women in the US. Routine testing can help prevent colorectal cancer or find it at an early stage, when it’s smaller and easier to treat. If it’s found early, the 5-year survival rate is 90%. Many more lives could be saved by understanding colorectal cancer risks, increasing screening rates, and making lifestyle changes.

The 5-year survival rate is 91% if colorectal cancer is found at the local stage. However, only 38% of colorectal cancer cases are diagnosed at an early stage. This is partly due to low testing rates.

  • Older age
  • Personal or family history of colorectal cancer or polyps
  • Inflammatory bowel disease
  • Hereditary syndromes (such as Lynch Syndrome)
  • Type 2 Diabetes

Who Gets Colorectal Cancer?

Anyone can get colorectal cancer, but some people are at an increased risk.

Gender: Colorectal cancer is more common in men and than in women.

Race/Ethnicity: Colorectal cancer incidence rates are highest in African American men and women, followed closely by the American Indian/Alaska Native population. The rates of colorectal cancer in non-Hispanic White and Hispanic/Latino populations are lower than these populations.  Asian/Pacific Islander men and women have the lowest rates of colorectal cancer.

If You’re Age 45 or Older, Talk to Your Doctor About Getting Screened.

For average-risk individuals with no symptoms, testing should begin at age 45. If you have any of the risk factors or are experiencing symptoms, speak to your healthcare provider right away. Symptoms include rectal bleeding, blood in the stool, dark- or black-colored stools, change in shape of stool, lower stomach cramping, unnecessary urge to have a bowel movement, prolonged constipation or diarrhea, and unintentional weight loss.

Pros and Cons of Different Types of Screening Tests

Several types of screening tests can be used. Talk to your health care provider about which ones might be good options for you. No matter which test you choose, the most important thing is to get tested.

Stool-Based Tests

Guaiac-based Fecal Occult Blood Test/Fecal Immunochemical Test: Can detect blood in stool caused by tumors or polyps. Health care provider gives patient at-home kit.

Pros Cons

No bowel preparation

May miss some polyps/cancers

Sampling done at home

Colonoscopy needed if abnormal
 

Done every year

 

Multi-targeted stool DNA test (MT-sDNA): Looks for certain DNA changes from cancer or polyps. Health care provider has kit sent to patient.

Pros Cons

No direct risk to the colorectum

May miss some polyps/cancers

No bowel preparation

Colonoscopy needed if abnormal

Sampling done at home

Done every 3 years

Visual Examination Tests

Colonoscopy: Direct exam of colon and rectum. Polyps removed if present. Required for abnormal results from other tests.

Pros Cons

Can usually view entire colorectum

Can be expensive

Can biopsy and remove polyps

Higher risk than other tests

Done every 10 years

Full bowel preparation needed

 

CT Colonography: Detailed, cross-sectional, 2-D or 3-D views of the colon and rectum with an x-ray machine linked to a computer

Pros Cons
  • Fairly quick and safe
  • Still fairly new test
  • Can usually view entire colorectum
  • Can’t remove polyps during test
  • No sedation needed
  • Full bowel preparation needed
  • Should be done every 5 years
  • Colonoscopy needed if abnormal

What Can You Do About It

Reduce your risk by managing your diet, weight, and physical activity, and by avoiding tobacco and alcohol.

Diet

  • Eat more vegetables, fruits and whole grains.
  • Limit intake of red and processed meats, fried foods and high-calorie fats.

Weight

  • Get to and maintain a healthy weight.
  • Avoid weight gain as an adult.

Physical Activity

  • Increase intensity and amount of physical activity.
  •  Limit sedentary behavior and screen-based entertainment.

Lifestyle

  • Avoid tobacco.
  • Limit or avoid alcohol.

High-Fiber Nutrition Therapy

Fiber and fluid may help you feel less constipated and bloated and can also help ease diarrhea. Increase fiber slowly over the course of a few weeks. This will keep your symptoms from getting worse.

Tips for Adding Fiber to Your Eating Plan

  • Slowly increase the amount of fiber you eat to 25 to 35 grams per day.
  • Eat whole grain breads and cereals. Look for choices with 100% whole wheat, rye, oats, or bran as the first or second ingredient.
  • Have brown or wild rice instead of white rice or potatoes.
  • Enjoy a variety of grains. Good choices include barley, oats, farro, kamut, and quinoa.
  • Bake with whole wheat flour. You can use it to replace some white or all-purpose flour in recipes.
  • Enjoy baked beans more often! Add dried beans and peas to casseroles or soups.
  • Choose fresh fruit and vegetables instead of juices.
  • Eat fruits and vegetables with peels or skins on.
  • Compare food labels of similar foods to find higher fiber choices. On packaged foods, the amount of fiber per serving is listed on the Nutrition Facts label.
  • Check the Nutrition Facts labels and try to choose products with at least 4 g dietary fiber per serving.
  • Drink plenty of fluids. Set a goal of at least 8 cups per day. You may need even more fluid as you eat higher amounts of fiber. Fluid helps your body process fiber without discomfort.

Foods Recommended

Foods With at Least 4 g Fiber per Serving

Food Group Choose
Grains 1/3-½ cup high-fiber cereal
Dried beans and peas ½ cup cooked red beans, kidney beans, large lima beans, navy beans, pinto beans, white beans, lentils, or black-eyed peas
Vegetables 1 artichoke (cooked)
Fruits ½ cup blackberries or raspberries
4 dried prunes
 

Foods With 1 to 3 g Fiber per Serving

Food Group Choose
Grains 1 bagel (3.5-inch diameter)
1 slice whole wheat, cracked wheat, pumpernickel, or rye bread
2-inch square cornbread
4 whole wheat crackers
1 bran, blueberry, cornmeal, or English muffin
½ cup cereal with 1-3 g fiber per serving (check dietary fiber on the product’s Nutrition Facts label)
2 tablespoons wheat germ or whole wheat flour
Fruits 1 apple (3-inch diameter) or ½ cup applesauce
½ cup apricots (canned)
1 banana
½ cup cherries (canned or fresh)
½ cup cranberries (fresh)
3 dates
2 medium figs (fresh)
½ cup fruit cocktail (canned)
½ grapefruit
1 kiwi fruit
1 orange (2½-inch diameter)
1 peach (fresh) or ½ cup peaches (canned)
1 pear (fresh) or ½ cup pears (canned)
1 plum (2-inch diameter)
¼ cup raisins
½ cup strawberries (fresh)
1 tangerine
Vegetables ½ cup bean sprouts (raw)
½ cup beets (diced, canned)
½ cup broccoli, brussels sprouts, or cabbage  (cooked)
½ cup carrots
½ cup cauliflower
½ cup corn
½ cup eggplant
½ cup okra (boiled)
½ cup potatoes (baked or mashed)
½ cup spinach, kale, or turnip greens (cooked)
½ cup squash—winter, summer, or zucchini (cooked)
½ cup sweet potatoes or yams
½ cup tomatoes (canned)
Other 2 tablespoons almonds or peanuts
1 cup popcorn (popped)

High Fiber Sample 1-Day Menu

Breakfast
1/2 cup orange juice, with pulp
1/2 cup raisin bran
1 cup fat-free milk
1 cup coffee
Morning Snack
1 cup plain yogurt
2 cups water
Lunch
1 1/2 cups chili
1/2 cup kidney beans
1/2 cup soy crumble
2 tablespoons shredded cheese
8 whole wheat crackers
1 apple (with skin)
Evening Meal
2 ounces sliced chicken
1/4 cup tofu
2 cups mixed fresh vegetables
1 cup brown rice
1/2 cup strawberries
1 cup hot tea
Evening Snack
2 tablespoons almonds
1 cup hot chocolate

Daily Sum

Nutrient Unit Value
Macronutrients
Energy kcal 2058
Energy kJ 8620
Protein g 109
Total lipid (fat) g 53
Carbohydrate, by difference g 308
Fiber, total dietary g 57
Sugars, total g 95
Minerals
Calcium, Ca mg 1535
Iron, Fe mg 28
Sodium, Na mg 3269
Vitamins
Vitamin C, total ascorbic acid mg 86
Vitamin A, IU IU 18169
Vitamin D IU 168
Lipids
Fatty acids, total saturated g 16
Fatty acids, total monounsaturated g 19
Fatty acids, total polyunsaturated g 11
Cholesterol mg 131

High Fiber Vegan Sample 1-Day Menu

Breakfast
½ cup bran cereal
1 banana
½ cup blueberries
1 cup soymilk fortified with calcium, vitamin B12, and vitamin D
Lunch
½ cup chili with beans with:
½ cup tempeh crumbles
¼ cup crushed whole wheat crackers
1 apple
1 cup soymilk fortified with calcium, vitamin B12, and vitamin D
Evening Meal
1 veggie burger
1 whole wheat bun
1 leaf lettuce
1 slice tomato
Salad made with: 1 cup lettuce
¼ cup chickpeas
½ cucumbers
1 tablespoon italian dressing
1 cup strawberries
Evening Snack
¼ cup almonds
1 cup carrot sticks

Daily Sum

Nutrient Unit Value
Macronutrients
Energy kcal 1558
Energy kJ 6527
Protein g 77
Total lipid (fat) g 57
Carbohydrate, by difference g 208
Fiber, total dietary g 43
Sugars, total g 73
Minerals
Calcium, Ca mg 1209
Iron, Fe mg 23
Sodium, Na mg 1823
Vitamins
Vitamin C, total ascorbic acid mg 136
Vitamin A, IU IU 29397
Vitamin D IU 265
Lipids
Fatty acids, total saturated g 9
Fatty acids, total monounsaturated g 22
Fatty acids, total polyunsaturated g 21
Cholesterol mg 35

High Fiber Vegetarian (Lacto-Ovo) Sample 1-Day Menu

Breakfast
½ cup bran cereal
1 banana
½ cup blueberries
1 cup 1% milk
Lunch
2 slices whole wheat bread
2 tablespoons hummus
1 ounce cheddar cheese
1 leaf lettuce
2 slices tomato
½ cup vegetarian baked beans
1 orange
1 cup 1% milk
Evening Meal
Stir fry made with: ½ cup tempeh
½ cup brown rice
1 cup frozen broccoli
1 tablespoon soy sauce
¼ cup peanuts
1 pear
Evening Snack
6 ounces fruit yogurt
1 cup air popped popcorn

Daily Sum

Nutrient Unit Value
Macronutrients
Energy kcal 1786
Energy kJ 7476
Protein g 89
Total lipid (fat) g 52
Carbohydrate, by difference g 270
Fiber, total dietary g 40
Sugars, total g 133
Minerals
Calcium, Ca mg 1496
Iron, Fe mg 16
Sodium, Na mg 1889
Vitamins
Vitamin C, total ascorbic acid mg 176
Vitamin A, IU IU 7107
Vitamin D IU 269
Lipids
Fatty acids, total saturated g 16
Fatty acids, total monounsaturated g 19
Fatty acids, total polyunsaturated g 11
Cholesterol mg 59