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Risk Assessment - Colorectal Cancer

Directions: Complete the following quiz to assess your own risk for developing colorectal cancer.

1. Are you 50 years of age or older?
Yes
No

2. Have you ever had polyps or cancer of the colon or rectum?
Yes
No

3. Do you have parents, grandparents, brothers or sisters who have had polyps or cancer of the colon or rectum?
Yes
No

4. Have you ever been told that you have ulcerative colitis or Crohn’s Disease?
Yes
No

5. If you are female, have you ever had breast, uterine or ovarian cancer?
Yes
No

6. How often do you participate in exercise (walk, swim, bike, run, aerobics, etc)?
Never
Once or twice a week
At least 3 times a week

7. How many servings of fruits and vegetables do you eat, on an average?
1-6 per week
1-4 per day
5 or more per day

8. How many times a week do you eat red meat?
4 or more
1 to 3
none

9. Do you smoke?
Yes
Used to smoke, but I quit
No

10. How often do you drink alcohol?
4 times a week or more
3 times a week or less
Never

11. How much of your daily calories come from fat?
More than half
20 - 50%
Less than 20%

12. How often do you take a multivitamin with folic acid or folate in it?
Never
Several times a week
Daily


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