A 53-year-old man presents to his primary care provider for an annual check-up. During the course of the exam, a prostate exam and guiac test is performed. The guiac is positive. There are no signs or symptoms of rectal bleeding (including hemorrhoids), but he remembers having a tarry black stool a couple of times earlier in the month. He does have a family history of colon cancer, and he had a negative baseline/screening sigmoidoscopy at age 50. Basic blood work: CBC is unremarkable except a mild normochromic, normocytic anemia and a sed rate of 90, chemistry profile is normal. CT of the abdomen reveals unusual thickening in the cecum. He is referred to gastroenterology for a colonoscopy, which reveals a 3cm tumor in the cecum and the bowel wall appears intact. The tumor was removed, but after further work-up, 2 regional nodes are positive for cancer. No metastses were noted by PET scan.

His wife ask: a. What are the risk factors for colon cancer (i.e. role of fat, fiber, alcohol, antioxidants, genetics)? Explain the connection for each using your patho.

b. Based on this information, what are simple things they can do to minimize risk?