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Preventing Colorectal Cancer

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Secondary prevention or screening
Tertiary prevention or surveillance

The purpose of primary prevention is to avert the appearance of colorectal cancer by changing dietary habits and following a healthy lifestyle.

While the impact of adopting these measures is unclear, the main recommendations in this regard are:

Moderate the consumption of red meats, processed meats and very well-done meats or which have been in direct contact with flames.

Follow a low-fat diet rich in fibre, fruits, vegetables, milk and dairy products.

Consume an adequate intake of folic acid, calcium and vitamin D.

Exercise and avoid overweight and obesity

Avoid tobacco use and alcohol consumption.

Even though taking acetylsalicylic acid and non-steroidal anti-inflammatory agents reduces the risk of developing colorectal cancer, the adverse cardiovascular, gastrointestinal and renal effects means the systematic use of these drugs to prevent colorectal cancer is not recommended.

Secondary prevention or screening

Secondary prevention or screening aims to detect the cancer or polyps in an early stage, before the symptoms start to appear (blood in stools, constipation, diarrhoea, anaemia, etc.). The purpose of screening tests is to prevent the appearance of colorectal cancer (by removing the precursory lesions or polyps before they degenerate into cancer) and to reduce the death rate associated with it (as the earlier the colorectal cancer is detected, then the greater the chances of being cured).

Screening strategies vary in function of each person’s risk of developing colorectal cancer:

Low-risk population. People under 50 with no personal history or cases of colorectal cancer in first-degree relatives (father, mother, brother) under 50 years of age, or no more than 1 first-degree family member of any age.

Population with a medium level of risk are people of 50 or more who present no other risk factors associated with colorectal cancer (neither any personal medical history of this cancer or with no cases of colorectal cancer in first-degree relatives under 50 years of age, or no more than 1 first-degree family member of any age. Members of this group (men and women aged 50–69 years) are advised to participate, every 2 years, in the colorectal cancer population screening programme which works by detecting faecal occult blood (FOB). The FOB test detects invisible traces of blood in stools, which can indicate the presence of a polyp or colorectal cancer; if blood is detected, then the patient should undergo a colonoscopy.

High-risk population. People with a history of colorectal cancer in at least one first-degree relative diagnosed before the age of 50, or with more than one first-degree relative affected, as well as those belonging to families with a diagnosis of hereditary colorectal cancer (for example, Lynch syndrome or familial adenomatous polyposis), have an increased risk of developing colorectal cancer. In these cases, follow-up with colonoscopies in specialized units is recommended.

Tertiary prevention or surveillance

Tertiary prevention or surveillance in patients who have already suffered polyps or colorectal cancer aims to avert the consequences associated with the development of these lesions. This group of patients should therefore receive colonoscopic surveillance to detect if the cancer reappears or any new polyps as early as possible.