Colorectal cancer is the third most prevalent cancer in the United States, however, it is possible to drive down its frequency and improve survivability outcomes. 

John Spannuth, ARNP, spoke with us about the importance of early screening and detection and explained which lifestyle behaviors can reduce risk. John is the lead provider for Vera Whole Health’s Minor & James Care Center and has worked in Seattle for six years.

Q: How can people embrace a more preventative and 

proactive role in their own health and wellness?


John: A lot of people don’t realize that their number one asset is their health until they have something such as a cancer diagnosis. I emphasize the importance of prevention. My personal approach, when working with a patient, is to tie their wellness into their birthday month. When that month arrives, they know it’s time to visit their doctor or nurse practitioner and complete  routine screenings to check where they fall  on the metric of health. 

These appointments should happen in addition to daily efforts, such as eating a healthy diet and getting exercise. Movement is key. In order to be more active, I recommend building movement into your routine. You can even take small steps, such as parking further from the store, or setting a timer reminding you to step away from your computer every 60-90 minutes. 

I should mention that smokers are at higher risk for many conditions and taking steps to quit can have a positive impact on overall health.

We’re also getting more information on the negative effects of sleep deprivation. Some people can function well on six hours of sleep, but the average person needs about eight hours of uninterrupted, good-quality sleep.

Q:  When it comes to the prevalence of colorectal cancer, how does it compare to other forms of cancer?

John: It’s the third most common diagnosis in both men and women in the United States. The American Cancer Society estimates that, in 2021, there will be 104,270 new cases of colorectal cancer.

Q:  How treatable is colorectal cancer when you get to it early?

John: If we do catch it early, it’s very treatable, and this is where screening becomes so important. There are different types of cancer and it depends on the size and type of the polyp (abnormal growth). Not all polyps are cancerous, and the removal of a precancerous polyp can actually prevent the development of cancer in that particular polyp. Though there are many variables, we’re seeing much more hope of survivability, even for advanced stages. 


Q: When and how frequently should patients get screened?

John: New guidelines are encouraging the conversation to begin at age 45 for both genders and all races.

It is, however, important to be aware of your own risk factors. Groups at higher risk for colorectal cancer include:

  • African Americans have the highest occurrence of colorectal cancer of all racial groups within the US, as well as the highest rates of mortality.
  • Ashkenazi Jews have some of the highest colorectal cancer rates of all the ethnic groups in the world  People with a family history, especially those with a first-degree relative (a father, mother, or sibling) who has been diagnosed with colorectal cancer at an early age.

Frequency varies depending on test results and type of test. For example: if a person has a colonoscopy at age 45 and finds no polyps or other risk factors, they should be good for the next 10 years. That’s assuming symptoms don’t develop and there’s no change in their medical situation. Don’t let expense be a factor in whether or not you get screened, as tests are covered by most insurance, including Medicare, Medicaid, and major insurance carriers.

There are also other testing options for patients who don’t want colonoscopies, or who wish to avoid going into an office because of COVID-19. One is the fecal immunochemical (FIT) test, which is a home test they can mail back to their provider’s office. If the test results come back negative, then they’re good for one year. The test is as sensitive and specific as a colonoscopy but has to be done annually. The Cologuard is another test that can be taken in the comfort of your home.

vera_Colorectal_Cancer_QA_graphic4Q: Outside of screening, are there other everyday steps people can take to reduce the likelihood of developing colorectal cancer?

John: There are many lifestyle-related factors that might be linked to colorectal cancer. Diet, weight, and exercise are deeply important. Health coaching can help with building healthier habits.

When it comes to diet, you should consider lowering your consumption of red meat and processed meat, such as hot dogs and lunch meats. The way meat is prepared also has an impact. If you’re grilling your meat and it’s getting burned to the point of turning black, that releases certain chemicals that might raise your cancer risk. You also want to make sure you eat plenty of fruits, vegetables, whole grains, and fiber.

The idea of body mass index (BMI) is sometimes antiquated and doesn’t provide the whole, clinical picture. However, where you carry your weight can have some correlation to cancer risk and exercise has been shown to have tremendous benefits. Moving your body and staying active boosts spiritual health, mental health, and physical health.

A low blood level of Vitamin D may also increase your risk. Many people have low levels of vitamin D and could benefit from daily supplements.  

We’ve also found that smokers have a 7-12 times higher risk of developing colon cancer. While you can’t change your genetics or stop yourself from aging, you can definitely control that risk factor by quitting smoking.

Q: Is there an aspect of colorectal cancer that’s somewhat of a lesser-known reality?

John: People hear the word “cancer” and they think it’s a death sentence. In truth, if it’s detected early, it’s very survivable. 

Also, when you speak with oncologists and people who work in cancer wards, treatment they’ve found a positive mental attitude can lead to better outcomes. There’s a productive impact when patients have support groups, stay active and engaged, and remain positive.

How is Vera Whole Health helping?

At Vera, our providers are working on removing barriers to getting people screened. We understand the importance of early detection. I especially like our model because it’s important to be able to connect with our patients, give them the time they need, and have these conversations. Otherwise, preventive care can get put on the back burner.

Are you interested in a conversation about preventative healthcare? Schedule an appointment with your Vera provider at

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