Colorectal Cancer – The Power of Balance – Fibre and Gut Health
While genetics play a role, lifestyle choices make a big difference to the risk of developing colorectal cancer, says Lorraine Govender, National Manager: Health of the Cancer Association of South Africa (CANSA), of one of the top five most common cancers in South Africa.
#ColorectalCancerAwareness #ActiveBalancedLifestyle #LowerCancerRisk
According to the latest edition of the National Cancer Registry (2022), 4 684 new cases of colorectal cancer were reported in 2022. It is the second most common cancer affecting men, with a 1:76 estimated lifetime risk, and the third most common cancer among women, with a lifetime risk of 1:124.
“The good news is that adopting healthy habits can help to reduce the risk of colorectal cancer as well as improve overall wellbeing,” says Govender.
The power of balance
While this year’s World Health Day, on 7 April, focuses on improving maternal and newborn health under the banner of ‘Healthy beginnings, hopeful futures’, it also offers the opportunity to reflect on good health for the whole family.
“The theme, which aims to focus attention on reducing preventable deaths and prioritising the wellbeing of mothers and babies, is not far removed from one of the key messages that CANSA continuously emphasises,” adds Govender, “which is, prevention is better than cure.”
One of the recommended ways in which to avoid cancer is through positive lifestyle choices. “It’s about making small, consistent lifestyle changes that can make a big difference,” shares Govender.
Areas of focus that are recommended include eating smart, physical movement, maintaining a healthy weight, and quitting harmful habits like smoking and drinking alcohol.
Lots of fibre is recommended
While most of these areas are self-explanatory, eating smart in terms of preventing colorectal cancer refers specifically to maintaining good gut health. Along with reducing the amount of red and processed meat consumed, staying hydrated and amping up intake of foods that contain probiotics and prebiotics, like certain types of yoghurt with added cultures, South Africans also need to make sure they get enough dietary fibre. Dietary fibre is often referred to as the ‘seventh nutrient’ and is derived from sources, such as, cereals, grains, vegetables, fruit, legumes and nuts.
A 2025 umbrella review in the Food and Nutrition Research Journal (1) reveals that the higher the dietary fibre intake, the lower the risk of several cancers, particularly in the digestive, reproductive and urinary systems.
There is strong evidence that eating 90 grams of whole-grain food daily, reduces the risk for colorectal cancer by 17 percent. What’s more, eating greater amounts every day, reduces the risk even further. This was published in the Third Expert Report, titled Diet, Nutrition, Physical Activity and Cancer: A Global Perspective, which is a comprehensive resource developed by the World Cancer Research Fund and the American Institute for Cancer Research (6).
The two main types of fibre found in food are soluble and insoluble, with the former dissolving in water and the latter not. Soluble fibre forms a gel-like material in the stomach that slows down digestion. It can help lower cholesterol and blood sugar. Soluble fibre is typically found in oats, peas, beans, apples, bananas, avocados, citrus fruit, carrots, barley and psyllium.
Insoluble fibre supports the movement of material through the digestive system and adds bulk to stool. So, it can be helpful for people who have constipation or don’t regularly pass stool. Some good sources of insoluble fibre are wholewheat flour, wheat bran, nuts, beans, and vegetables, such as, cauliflower, green beans and potatoes. Most high-fibre plant foods contain both soluble and insoluble fibre. The amount of each type of fibre varies with the type of plant, such as whether it’s a fruit, vegetable or whole grain. But you can get both types of fibre by eating a variety of fibre-rich foods.
CANSA recommends, when buying food, read the labels and check for the grams of fibre per serving or per 100g. Select food that has high fibre content or 6g per 100g, with the source of fibre being 3g or more per 100g.
Also, early detection
“Making positive lifestyle choices notwithstanding, regular screening is also critical,” shares Govender. “Colorectal cancer often develops without symptoms in its early stages, and we know that early detection of any type of cancer can save lives.”
Screening options include stool tests and a colonoscopy or sigmoidoscopy. Faecal Occult Blood (FOB) tests are available at R100 at CANSA’s Care Centres. This is a self-testing home kit designed to detect the presence of hidden or ‘occult’ blood in stools which may be significant in the screening for early detection of colorectal cancer.
Anyone aged 45 and older, or those with a family history of colorectal cancer are urged to consult their general practitioners or clinics about screening options. In addition, everyone is advised to listen to their bodies and to recognise symptoms which could include changes in bowel habits – diarrhoea or constipation; blood in stool or rectal bleeding; unexplained weight loss; and persistent abdominal pain or discomfort.
Take charge of your health
A balanced lifestyle, informed choices, and regular screenings can help lower the risk for colorectal cancer. Eat well, stay active, and prioritise your wellbeing.
References
- Food & Nutrition Research 2025, 69: 11034- http://dx.doi.org/10.29219/fnr.v69.11034
- British Journal of Nutrition , Volume 122 , Issue 6 , 28 September 2019 , pp. 605 – 615 DOI: https://doi.org/10.1017/S0007114519001454
- Dietary Reference Intakes for energy, carbohydrate, fibre, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). National Academies of Sciences, Engineering, and Medicine. https://nap.nationalacademies.org/read/10490/chapter/1.
- https://longevity.stanford.edu/lifestyle/2024/04/08/what-is-fibre-and-why-is-it-important-for-the-microbiome/
- https://www.aicr.org/research/the-continuous-update-project/colorectal-cancer/
- Hullings, A. G., Sinha, R., Liao, L. M., Freedman, N. D., Graubard, B. I., & Loftfield, E. (2020). Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort. The American Journal of Clinical Nutrition, 112(3), 603-612. https://doi.org/10.1093/ajcn/nqaa161
(For more information, please contact Lucy Balona, Head: Marketing and Communication at CANSA at email lbalona@cansa.org.za. Call 011 616 7662 or mobile 082 459 5230.)
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