Modifiable risk factors for colon cancer

Although the specific mechanisms have not been fully elucidated, certain aspects of a Western diet and lifestyle play a critical role in the development of colon cancer. A likely important factor is energy balance; a high body mass index, the tendency of central deposition of adiposity, and physical inactivity increase the risk of colon cancer, possibly through their effects on hyperinsulinemia. Beyond their role in energy balance, it is unclear if macronutrients influence the risk of colon cancer, although some evidence suggests that red meat, especially processed meats, and highly refined carbohydrates may be deleterious. A strong benefit of fiber and fruits and vegetables has not been confirmed in most recent studies, though some evidence indicates that folate may be beneficial. High intakes of alcohol and smoking also appear to increase risk, while use of aspirin and other nonsteroidal anti-inflammatory drugs and postmenopausal estrogens may be beneficial.