Just because Colorectal Cancer Awareness Month (read: March) is over doesn't mean it's out of our minds — after all, the lifetime risk of developing colorectal cancer is ~1 in 23 for men and ~1 in 25 for women.

Because of these statistics, it’s highly recommended to begin screenings at age 45 (if not before, depending on your personal risk). The good news? There are a number of screening options available.

We recently asked Greenvillians/Soda Citizens to send us their colon health and screening questions for this month’s installment of Prisma Health On Call. And here with the answers are Drs. Balbir Singh Minhas, gastroenterologist, and Melissa Ann Hite, colon and rectal surgeon.

What is the leading risk factor for colon cancer? Publishing reminder: H2 on web, H3 in NL

"There is not one single greatest risk factor for colon cancer. Instead, multiple factors contribute to raising or lowering your risk. Some of these risk factors can’t be changed, such as genetics, family history, and medical problems such as inflammatory bowel disease. There are some risk factors that up your chances of developing colon cancer that are based off your health and lifestyle, however. These include a diet low in fiber and high in red and processed meat, alcohol intake, smoking, obesity, and a sedentary lifestyle."

If you’re not 45 and insurance does not cover the screening, are there any home screening kits you recommend?

"Cologuard is the most frequently used home kit. Other older tests like Guaiac/FIT tests for occult blood are no longer recommended or used by most. Learn more about why colonoscopies are usually considered more effective than at-home colon cancer tests here."

Are there less invasive colonoscopies that can still be as thorough and effective as the current standard?

"No. Optical colonoscopy is the gold standard as it has ability to remove polyps, the precursors for colon cancer. Nervous about the procedure? Find more information that may ease your mind, here on Flourish.”

What are the three best preventative measures that research has shown to lower your risk and help prevent colon cancer?

"To keep your risk of colon cancer as low as possible, it’s important to eat healthy, avoid smoking or using any kind of tobacco products, and exercise regularly. About 70% of colorectal cancer can be avoided by making these lifestyle changes. Learn more about colon health here."

What are some typical early symptoms of colon cancer in a person under 40?

"For younger people, common symptoms are rectal bleeding, changes in bowel habits, abdominal pain, unexplained weight loss, and fatigue. Learn more about colon cancer in young people here."

Have you personally researched the correlation of parasites in the colon and the effects it has on colon cancer?

"I personally have not researched this. There is ongoing research looking at the gut microbiome and how it is related to colon cancer. Current research shows that most likely there is a dysregulation in the microbiome that contributes to things like chronic inflammation and promotes carcinogenesis, ultimately increasing the risk of cancer development. There are many different parasites that can live in the GI tract and affect the gut microbiome, so naturally, there is an aim to prove that certain bacteria and parasites can cause colon cancer. However, being able to prove causation and not just correlation is very difficult. There are a few parasites that have been directly identified to cause other types of cancer, such as bile duct cancer and bladder cancer. However, there is no specific microbial pathogen that has been directly linked to colon cancer."

Is colon cancer associated with any other health conditions?

"There are certain inherited colon cancers, such as Lynch syndrome or several different types of polyposis syndromes. In many of these inherited colon cancers, there are risks of cancers in other parts of the body as well. In addition, obesity is associated with an increased risk of colon cancer as well as inflammatory bowel disease."