Who is at high risk for developing colorectal cancer?

People at high risk for colorectal cancer include those who have already had colon polyps, those who have had breast or female genital cancer, people whose parents or siblings have had colorectal polyps or cancer, and those who have had inflammatory bowel disease for a long time.
Age is the single most important risk factor for colorectal cancer. Although colorectal cancer can strike at any age, 91 percent of new cases and 94 percent of deaths occur in individuals older than 50. ASGE recommends screening begin at age 50 for individuals at average risk. For individuals with a family history, screening should begin at age 40, or at an age as recommended by their doctor. Some experts suggest that African-Americans should begin screening at age 45. Individuals with other risk factors such as inflammatory bowel disease may also require earlier screening. Patients should speak with their doctor about when to begin screening.

Colorectal cancer incidence and mortality rates are currently highest in African-American men and women. Those of Eastern European Jewish descent currently also have a higher rate of colon cancer than Caucasian men and women. However, because of disproportionate screening, minorities, particularly African-Americans and Hispanics, are more likely to be diagnosed with colon cancer in advanced stages. As a result, death rates are higher for these populations.

There is increasing evidence that obesity is associated with an increased risk of colorectal cancer. A diet made up mostly of foods that are high in fat, especially from animal sources, can increase the risk of colon cancer. People who are not active have a higher risk of colorectal cancer. Engaging in at least moderate activity for 30 minutes or more on five or more days per week will reduce colon cancer risk.

Recent studies show that smokers are 30 to 40 percent more likely than nonsmokers to die of colorectal cancer. Moderate to heavy use of alcohol, or four or more drinks per week, has also been linked to colorectal cancer.

A personal history of colon cancer or intestinal polyps and diseases such as inflammatory bowel disease -- both chronic ulcerative colitis and Crohn's disease -- increase a person's risk of developing colorectal cancer. Patients with both inflammatory bowel disease and a specific liver disease called primary sclerosing cholangitis (PSC) are at very high risk of colorectal cancer.

A person who has a specific inherited gene syndrome, such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC), is at increased risk for developing colorectal cancer. People with a strong family history of colon cancer are also at increased risk for developing colorectal cancer.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)

To put it simply, all adults are at risk for colorectal cancer, even those that live healthily.

Some people are at very high risk. They have a particular gene mutation that predisposes them to developing multiple polyps. These are hereditary syndromes such as familial adenomatous polyposis, hereditary nonpolyposis colorectal cancer syndrome and MutY homolog (MUTYH) polyposis.

The risk is also high, almost doubled, in people with a diagnosed first-degree relative (mother, father, sister, brother, child), especially if the relative was diagnosed before the age of 50. Ulcerative colitis and Crohn's disease, types of inflammatory bowel diseases, also up the risk.

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Daniel Labow, MD
Surgical Oncology
There are certain family-related syndromes that increase someone’s risk for colon cancer. One is called HNPCC or lynch syndrome, another is Familial Adenomatous Polyposis syndrome. Certainly a thorough family history is important to determine your own risk. It does not always have to be colon cancer in the family to increase your risk. Make sure you discuss with your primary MD and perhaps a colonoscopy earlier than 50 years old is recommended.

Colon cancer can affect anyone, but it's more common in people who eat a Western diet or have a family history. In this video, Sharmila Anandasabapathy, MD, a gastroenterologist, discusses who is most at risk for colon cancer.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.