Colorectal cancer (CRC) is being diagnosed with increasing frequency in India and across the world, with a concerning rise in cases among younger individuals as well. However, there is a reassuring side to this trend: most colorectal cancers develop slowly from benign polyps, making the disease largely preventable. Through simple lifestyle changes, better awareness of early symptoms, focused gut health management and timely screening, the risk of CRC can be significantly reduced – often before cancer has a chance to develop.

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Dr Seema Jagiasi, a medical and haemato-oncologist at MOC Cancer Care Centre, spoke to HT Lifestyle about the rising incidence of colorectal cancer in India, emphasising that it is highly preventable with simple lifestyle modifications. She outlines five evidence-based strategies, tailored to Indian lifestyles, that can significantly reduce risk.

Prioritise fibres and plant-based foods

Choosing colon wellness habits like prioritising foods rich in fibres can help reduce the risk of colorectal cancer. Dr Jagiasi explains, “Higher consumption of plant foods (including fruits, vegetables, legumes and whole grains) is connected with a lower chance of colorectal cancer while a diet rich in red and especially processed meats increases the risk.”
She recommends focusing on dals, vegetables, millets and whole-grain rotis and restricting processed meats like sausages and deli meats. She adds, “Minimise high-heat cooking of meat and replace some meat servings with fish, paneer, pulses or legumes. Strive to boost fibre intake to 25-35 g/day.”

Lifestyle changes

Dr Jagiasi recommends adopting a lifestyle that supports healthy weight management while limiting alcohol and tobacco use, noting that excess body weight and regular alcohol consumption are well-established contributors to an increased risk of colorectal cancer. She advises, “Regular aerobic activities (like walking, cycling, yoga or sports) combined with resistance training help lower this risk and support weight control.”

According to the oncologist, simple measures such as walking for 30-45 minutes daily, reducing alcohol intake and avoiding smoking are not only feasible and cost-effective, but are also supported by the World Cancer Research Fund and robust observational research.

Preventive screening

Dr Jagiasi highlights that preventive screening can save lives because CRC often shows up as polyps long before symptoms appear. Screening can detect these polyps and early cancer stages when medical intervention is most successful.

She points out, “Even though India lacks a screening program, major oncology bodies and relevant Indian research highlight that organised screening (stool tests or endoscopy) for high-risk groups substantially reduces mortality. International recommendations suggest starting screening at age 45 for those at risk (with a family history). Indian patients ought to consult their healthcare providers to determine which test (colonoscopy or flexible sigmoidoscopy) and scheduling are most appropriate for them.”

Recognising symptoms early

The oncologist states that early colorectal cancer may not show symptoms at first but when they do appear, it is important to address them at once. According to Dr Jagiasi, the symptoms include alterations in bowel routines (such as diarrhea, constipation or thinner stools), visible or hidden blood in stool, unexplained iron-deficiency anemia, abdominal discomfort or unintended weight loss.

She stresses, “In India timely assessment of these signs, rather than postponing, greatly improves the likelihood of early detection and successful therapy. Persistent rectal bleeding or a new lasting change in bowel habits demands attention.”

Support gut microbiome

Dr Jagiasi recommends prioritising fibre-rich and fermented foods to support gut microbiome diversity, noting that emerging research links alterations in the gut microbiome to the onset of colorectal cancer.

She explains, “Extended or repeated antibiotic usage, diets low in fibre and eating processed foods may harm gut bacteria; conversely dietary fibre, legumes and customary fermented foods (such as curd, properly prepared idli/dosa batter and fermented pickles) promote diversity. While probiotic supplements are an area of ongoing research, promoting fibre-rich, minimally processed traditional diets and avoiding unnecessary antibiotics are practical steps for gut health.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.