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Let’s Be Upfront About Colorectal Cancer

By Margaret Martin, RD, MS, LDN, CDCES January 19, 2023Nutrition Education Services Center Blog

Colorectal cancer is cancer of the large intestine (colon) or rectum. Discussing bowel health may make some uncomfortable, but screening and early detection greatly improve the outcomes for colorectal cancer. So, let’s be upfront about colorectal cancer and answer some common questions.

Who is diagnosed with colorectal cancer?     

Colon cancer is the third most common cancer (excluding skin cancers) in the United States. The American Cancer Society estimates that there were over 150,000 thousand new cases of colorectal cancer in 2022. Colorectal cancer can affect anyone, but there are certain factors that can increase the risk of diagnosis.

People with a personal history of ulcerative colitis or Crohn’s disease are at higher risk. Many lifestyle factors, such as diet, weight, exercise and alcohol and tobacco use, are linked to colorectal cancer risk. African Americans have the highest incidence and mortality rates of colorectal cancer (CRC) of any ethnic group in the United States. Read more about the risk factors here.

Chadwick Boseman, star of Black Panther, died in 2020 at the age 43, from stage IV colon cancer. His death has brought colorectal cancer from a personal, intimate issue to the spotlight with increased focus on screening and early detection.

While the risk of colorectal cancer increases as people age, cases of colorectal cancer in people in their 20s, 30s and 40s are on the rise. Many of these young adults don’t have the typical risk factors such as a family history, excess body fat, and heavy alcohol use or tobacco use, as noted in a Memorial Sloan Kettering Cancer Center study. A lack of clarity on which young people may be most at risk for colorectal cancer makes screening recommendations and early detection more challenging.


Colorectal cancer is easier to treat if diagnosed in the early stages. However, about 22% of colorectal cancer patients are diagnosed after the cancer has spread to distant parts of the body.

As I talk with patients and their caregivers, many tell me that they were too shy or uncomfortable to talk with their medical provider about their digestive symptoms and body issues. Symptoms seemed trivial or too personal to discuss, such as abdominal discomfort, change in bowel movements (“It’s probably just something I ate.”), fatigue (“Isn’t everyone tired?”) nausea, rectal bleeding, and weight loss (“I thought I could lose some weight.”). Note: Colorectal cancer does not always have symptoms, especially during the early stages. This is why screening is so important!

Some people are also scared of one common screening test called a “colonoscopy.” During a colonoscopy, the doctor inserts a small camera at the end of a long, flexible tube into the rectum. The doctor can also remove abnormal tissue or take a biopsy during the colonoscopy, if needed. The patient is usually sedated during the procedure. Although the thought of a colonoscopy may be uncomfortable, the test can prevent colorectal cancer by removing abnormal tissue before it becomes cancerous. And a colonoscopy can detect colorectal cancer early when it’s easier to treat. For some people, stool tests may also be an option for screening for colorectal cancer.

Do all people diagnosed with colorectal cancer need an ostomy?

New surgical procedures and early detection of cancer reduce the need for an ostomy. What is an ostomy? During some surgeries for colorectal cancers, the intestines or colon are re-routed to the outside of the body to allow for waste to leave the body. This process forms an ostomy or opening on the abdomen which empties into a disposable bag. An ostomy may be temporary or permanent. With the advances in ostomy management and lifestyle strategies, many people see their ostomy as a tool that allows them to live an active, fulfilling life. Read about one woman’s experience here: My Ostomy Saved My Life .

What lifestyle habits decrease the risk of colorectal cancer?

There are 5 areas in your lifestyle that can help you lower your risk for colorectal cancer:

  • Daily moderate physical activity
  • Higher fiber diet with whole grains and other foods with fiber (like plant-based eating )
  • Healthy body size
  • Limiting alcohol
  • Avoiding processed meats (meats processed with salt, smoke, or preservatives like nitrates)

Together we can get more comfortable with talking about colorectal cancer. The U.S. Preventative Services Task Force recommends that adults aged 45-75 be screening for colorectal cancer. Talk to your doctor about your risk for colorectal cancer and the best screening schedule and test for you. (Don’t worry—your doctor talks about things like this every day with many patients!)

If you or a loved one has been diagnosed with colorectal cancer, schedule a free nutrition consultation with one of our PearlPoint Nutrition Services® registered dietitians.


I Have Colorectal Cancer-What Should I Eat?

Colorectal Risk Reduction

Lifestyle and Colorectal Cancer











Margaret Martin, RD, MS, LDN, CDCES

Author Margaret Martin, RD, MS, LDN, CDCES

Nutrition Educator Margaret Martin is a Licensed Dietitian and Nutritionist in the State of Tennessee as well as a Certified Diabetes Educator. Margaret graduated from the University of Alabama with a Bachelor of Science in Dietetics and received her Master’s Degree in Nutrition Science & Public Health from the University of Tennessee. With more than 10 years of experience in Clinical Nutrition, Margaret has also worked in the insurance industry with WellPoint Inc. and Blue Cross Blue Shield providing telephonic nutrition consultations, service assistance, and web-based nutrition education. In her free time Margaret volunteers with the American Lung Association’s annual “Lung Force Walk" in Middle Tennessee. She belongs to the Oncology Nutrition & Diabetes Care and Education Dietetic Practice Groups of the Academy of Nutrition and Dietetics.

More posts by Margaret Martin, RD, MS, LDN, CDCES

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