Risk Factors for Rectal Cancer

three members of Gastroenterology including Chief Mark Schattner

Mark Schattner, Chief of Gastroenterology, with his colleagues Smrita Sinha and Delia Calo. MSK gastroenterologists have expertise in advanced endoscopic techniques to screen and care for people with colorectal cancer.

Understanding your risk factors for rectal cancer can help you keep healthy habits and have more-informed discussions with your doctor about colorectal cancer screening.

You can control some risk factors for rectal cancer but others you can’t.

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What are the risks for rectal cancer that I can control?

The following risk factors increase your chance of developing rectal cancer:

  • a diet high in red, processed, or charred meats
  • a lack of exercise
  • obesity, particularly extra fat around the waist
  • smoking (studies show that smokers are 30 to 40 percent more likely to die of colorectal cancer)
  • drinking too much alcohol
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What are the risks for rectal cancer that I can’t control?

Age

Most rectal cancers occur after age 50 (unless there is a family history of the disease or a hereditary cause). However, in recent years there has been a troubling rise in rectal cancer rates among people as young as their 20’s and 30’s.

Learn more about Rectal Cancer Before 50.

Family History of Lynch Syndrome or Familial Adenomatous Polyposis

Some inherited disorders dramatically increase your risk of developing rectal cancer. These include Lynch syndrome and familial adenomatous polyposis. Learn more about these and other inherited conditions that affect your risk of rectal cancer as well as our genetic testing services.

History of Cancer

If you’ve had rectal cancer before, you’re at an increased risk of developing it again.

History of Inflammatory Bowel Disease

Inflammatory bowel diseases, such as ulcerative colitis and Crohn’s colitis, increase your risk of rectal cancer.

Family History of Cancer

You have an increased risk of rectal cancer if:

  • a close family member, such as a parent or sibling, had rectal cancer before age 50
  • several blood relatives have had rectal cancer
  • there is a family pattern of certain other cancers, including endometrial, ovarian, gastric, urinary tract, brain, and pancreatic cancers
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How can I lower my risk of rectal cancer?

MSK recommends these healthy habits, which may lower your risk of rectal cancer:

  • Eat more fruits, vegetables, and fiber and less animal and dairy fat. The American Cancer Society recommends that you eat at least five servings of fruits and vegetables each day. Choosing such foods as beans and whole-grain bread, cereal, grain, rice, and pasta is a great way to improve your diet. Foods rich in calcium and folic acid (such as legumes, citrus, and broccoli) may also reduce your risk of rectal cancer.
  • Exercise regularly. Even moderate regular physical activity — such as taking the stairs instead of the elevator, raking leaves, or walking — can help reduce your risk of rectal cancer.
  • Maintain a healthy weight. Obesity is an important risk factor for rectal cancer.
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Does aspirin reduce the risk of rectal cancer?

Some people who regularly use aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) may have a lower risk of rectal cancer and polyps. Aspirin may also help prevent polyp growth in people who were previously treated for early-stage rectal cancer or who previously had colorectal polyps removed.


You should only take aspirin under a doctor’s direction. Research suggests that not all people benefit. NSAIDs can have serious side effects. Aspirin can cause stomach bleeding in some people, and drugs such as celecoxib (Celebrex®) may increase the risk of heart attack and stroke.

Studies have suggested that aspirin can reduce the risk of cancer, but there can be serious side effects from taking it every day.
Does an Aspirin a Day Reduce the Risk of Colorectal Cancer?
MSK gastroenterologist Robin Mendelsohn weighs in on the possible benefits and drawbacks of using aspirin to reduce the risk of colon and rectal cancer.
Learn more
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Does hormone replacement therapy reduce the risk of colorectal cancer?

Hormone replacement therapy (HRT) consists of estrogen and progesterone. Women who use HRT after menopause may have a reduced risk of rectal cancer. However, HRT can potentially cause other health problems. Talk to your doctor to learn more about the benefits and risks of HRT.

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