When teaching a community group about measures to prevent colon cancer, which instruction should the nurse include?
A. “Limit fat intake to 20% to 25% of your total daily calories.”
B. “Include 15 to 20 grams of fiber into your daily diet.”
C. “Get an annual rectal examination after age 35.”
D. “Undergo sigmoidoscopy annually after age 50.”
Correct Answer: A. “Limit fat intake to 20% to 25% of your total daily calories.”
To help prevent colon cancer, fats should account for no more than 20% to 25% of total daily calories and the diet should include 25 to 30 grams of fiber per day. Long-chain n-3 fatty acids have been suggested to play a protective role in colorectal cancer development in laboratory and animal studies, with the mechanism of action conjectured to be inhibition of the cyclooxygenase-2 (COX-2) enzyme and the production of arachidonic acid (n-6) derived eicosanoids.
Option B: Many observational studies have reported an inverse association between dietary fiber and CRC risk, with a relative reduction of up to 40%, although a few large cohort studies reported small, statistically null associations. A large pooled analysis of thirteen prospective cohorts suggested that dietary fiber intake was inversely associated with CRC risk in age-adjusted analyses.
Option C: A digital rectal examination isn’t recommended as a stand-alone test for colorectal cancer. All new CRC cases should be universally screened for DNA mismatch repair/microsatellite status, and RAS/BRAF mutational testing when considering for prognostic and predictive of chemotherapy efficacy. In almost all patients, a diagnostic or screening colonoscopy is required for tissue biopsy pathological confirmation of colon carcinoma.
Option D: For colorectal cancer screening, the American Cancer Society advises clients over age 50 to have a flexible sigmoidoscopy every 5 years, yearly fecal occult blood tests, yearly fecal occult blood tests PLUS a flexible sigmoidoscopy every 5 years, a double-contrast barium enema every 5 years, or a colonoscopy every 10 years.
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