Colorectal Cancer: Symptoms, Causes, Risk Factors, and Prevention
19 Jun, 2024
Dr. Divya NagpalColorectal cancer, also known as bowel cancer, is a type of cancer that starts in the colon or rectum. It ranks as the third most common cancer worldwide and is a significant health concern due to its impact on mortality and morbidity. Understanding the symptoms, causes, and risk factors is crucial for early detection and effective treatment. This blog aims to provide comprehensive insights into colorectal cancer to raise awareness and promote early diagnosis.
Symptoms of Colorectal Cancer
Early-stage colorectal cancer often does not present any symptoms, making regular screening vital. As the disease progresses, several signs may indicate the presence of colorectal cancer. These include:
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Changes in Bowel Habits: Persistent changes in bowel habits, such as diarrhoea, constipation, or a feeling that the bowel does not empty completely. This can also include more frequent bowel movements or changes in the consistency of stools.
Blood in Stool: The presence of blood in the stool, which may appear as bright red or very dark (melena). Bright red blood often indicates bleeding in the lower part of the colon or rectum, while dark blood suggests bleeding higher up in the colon.
Abdominal Discomfort: Cramping, pain, or bloating in the abdomen. This discomfort can be due to the cancer-causing a blockage or inflammation.
Unexplained Weight Loss: Significant weight loss without any known reason. This occurs because the cancer cells consume more energy, and the body may have a reduced ability to absorb nutrients.
Fatigue and Weakness: Persistent tiredness and weakness that does not improve with rest. This can be due to anaemia (a decrease in red blood cells) caused by chronic blood loss.
Narrow Stools: Stools that are narrower than usual, indicating a possible blockage in the colon.
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Causes of Colorectal Cancer
Colorectal cancer arises from a combination of genetic, environmental, and lifestyle factors. Here’s a concise overview of the primary causes:
1. Genetic Mutations
- Inherited Mutations: Conditions like Lynch Syndrome (HNPCC) and Familial Adenomatous Polyposis (FAP) significantly increase the risk.
- Acquired Mutations: Most cases result from mutations acquired over a lifetime due to environmental factors, lifestyle choices, or random DNA replication errors.
2. Lifestyle and Dietary Factors
- Diet: High consumption of red and processed meats increases risk, while diets rich in fruits, vegetables, and whole grains reduce it.
- Physical Inactivity: A sedentary lifestyle contributes to obesity, increasing cancer risk.
- Obesity: Excess body fat, especially around the abdomen, is linked to higher cancer risk.
- Smoking: Long-term smoking increases the likelihood of colorectal cancer.
- Alcohol: Heavy alcohol use is associated with increased risk.
3. Medical Conditions
- Inflammatory Bowel Disease (IBD): Chronic conditions like Crohn's disease and ulcerative colitis heighten risk due to long-term colon inflammation.
- Diabetes: Type 2 diabetes is linked to a higher risk of colorectal cancer.
4. Age and Family History
- Age: Risk increases significantly after 50, though younger adults are increasingly affected.
- Family History: A family history of colorectal cancer or polyps, especially in first-degree relatives, elevates risk.
5. Environmental Factors
- Radiation: Previous radiation therapy to the abdomen or pelvis increases risk.
- Occupational Hazards: Exposure to certain chemicals in industries like metalworking and rubber manufacturing may heighten risk.
Colorectal cancer is caused by a mix of genetic, lifestyle, and environmental factors. While some risks like age and genetics can't be changed, others, such as diet, physical activity, and smoking, can be modified to reduce risk. Regular screenings and a healthy lifestyle are essential for prevention and early detection. Consult your healthcare provider for personalized advice and screening recommendations.
Risk Factors for Colorectal Cancer
Understanding the risk factors associated with colorectal cancer can help in early detection and prevention. The main risk factors include:
Age: The risk of colorectal cancer increases with age, particularly after 50. However, rates are rising among younger populations, making awareness and screening crucial at any age.
Family History: Having a family history of colorectal cancer or polyps increases the risk. If you have a first-degree relative (parent, sibling, or child) with colorectal cancer, your risk is higher.
Genetic Predisposition: Certain inherited genetic mutations, such as Lynch syndrome (hereditary nonpolyposis colorectal cancer) and familial adenomatous polyposis (FAP), significantly increase the risk. Genetic counselling and testing can help identify these risks.
Personal History: A personal history of colorectal polyps or inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis, increases the risk. These conditions cause chronic inflammation in the colon, which can lead to cancer.
Diet: Diets high in red and processed meats and low in fibre can increase the risk. Processed meats have been classified as carcinogenic, and red meat as probably carcinogenic, by the World Health Organization.
Lifestyle Factors: Lack of physical activity, obesity, smoking, and heavy alcohol consumption are linked to a higher risk of colorectal cancer. A sedentary lifestyle and poor diet contribute to obesity, which is a known risk factor.
Type 2 Diabetes: People with type 2 diabetes have an increased risk of developing colorectal cancer. This may be due to insulin resistance and higher insulin levels, which can promote cancer growth.
Preventive Measures
While some risk factors, such as age and family history, cannot be changed, several lifestyle modifications can reduce the risk of colorectal cancer:
Healthy Diet: Eating a diet rich in fruits, vegetables, whole grains, and lean proteins while limiting red and processed meats. Foods high in fibre can help keep your digestive system healthy.
Regular Exercise: Engaging in regular physical activity to maintain a healthy weight. Exercise helps to reduce inflammation and improve immune function.
Avoiding Tobacco and Excessive Alcohol: Quitting smoking and limiting alcohol consumption. Both smoking and heavy alcohol use are linked to increased cancer risk.
Regular Screening: Undergoing regular screening tests, such as colonoscopies, to detect and remove precancerous polyps. Screening can prevent colorectal cancer by identifying polyps before they become cancerous.
Types of Screening Tests
Several screening tests can help detect colorectal cancer early:
Colonoscopy: A procedure in which a long, flexible tube with a camera on the end is inserted into the rectum to examine the entire colon. Polyps and some cancers can be removed during the procedure.
Fecal Occult Blood Test (FOBT): A test that checks for hidden blood in the stool, which can be an early sign of cancer.
Fecal Immunochemical Test (FIT): Similar to FOBT, this test detects blood in the stool but uses antibodies and is more specific to bleeding in the lower gastrointestinal tract.
Sigmoidoscopy: Similar to a colonoscopy, but only examines the rectum and the lower part of the colon.
CT Colonography (Virtual Colonoscopy): A CT scan that provides detailed images of the colon and rectum. Polyps and cancers can be detected, but a follow-up colonoscopy is needed to remove polyps.
Colorectal cancer is a serious disease, but early detection and lifestyle changes can significantly reduce the risk. Recognizing the symptoms, understanding the causes, and being aware of the risk factors are crucial steps in preventing and managing colorectal cancer. Regular screenings and a healthy lifestyle are essential components of colorectal cancer prevention. If you experience any symptoms or have risk factors, consult your healthcare provider for appropriate screening and guidance.
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