Colorectal Cancer-Essential Know How!
Understanding Colorectal Cancer
The Rising Prevalence of Obesity
Colorectal cancer is a type of cancer that starts in the colon (the large intestine) or rectum, the final sections of the digestive tract. It typically begins as small, benign growths called polyps on the inner lining of the colon or rectum. Most of these polyps are harmless, but over time, some can turn cancerous through a process known as the adenoma-carcinoma sequence over a period of 10–20 years.
Genetic changes in the cells lining the colon or rectum drive this progression—often involving mutations in pathways normally regulating cell growth, followed by issues with genes that control cell division and cell death.
Early detection via screening (like colonoscopies to remove polyps) can often prevent it from developing into invasive cancer.
Colon Cancer vs. Colorectal Cancer: Know the Difference
It’s essential to distinguish between “colon cancer” and “colorectal cancer.” While these terms are often used interchangeably, they refer to different aspects of the disease. Colorectal cancer encompasses tumors in both the colon and rectum, each with its unique characteristics and treatment considerations.
Characteristics in common:
- Symptoms of both colon and rectal cancer include bloody feces, constipation, gas pain, bloating, and abdominal discomfort.
- Both cancer types have similar risk factors and genetic abnormalities that drive their growth.
- Screening for both colon and rectal cancer consist of stool testing and endoscopic examination.
Distinct differences:
- Colon cancer occurs in the first and longest region of the large intestine, while rectal cancer starts growing in the last few inches.
- Rectal cancer is more likely to spread outside of its primary location since it is closer to other organs, and the rectum lacks a protective outer covering.
- Rectal cancer is more likely to recur locally.
- Rectal cancer cells tend to spread through the circulation and lymph system to the lungs and brain, whereas colon cancer more frequently tends to spread to the liver.
- Patients with cancer low in the rectum are more likely to require a permanent colostomy.
- Both types of cancer require surgery and, depending on the stage, chemotherapy. However, surgical procedures and chemotherapy drug types vary depending on the cancer type. Radiation is mainly solely used in the treatment of rectal cancer.
Understanding Risk Factors: What Puts You at Risk for Colorectal Cancer?
Why do some people develop colorectal cancer while others do not? There are several risk factors to consider, ranging from non-modifiable factors like age and family history to modifiable lifestyle choices such as diet and exercise. Understanding these risks empowers you to make informed decisions about your health.
Non-modifiable risk factors
- Age older than 40 years: We can´t stop growing older, but we can participate in the colon cancer screening program.
- Someone in the family also has developed colon cancer: It is important to talk about cancer instead of concealing it.
- Having a personal history of colorectal cancer: Even after an early detection and curative treatment, a second colon cancer is more likely. Controls are therefore important.
- Having a personal history of polyps in the colon, ulcerative colitis or Crohn’s Disease: More frequent screening for colon cancer is recommended by the guidelines.
Modifiable risk factors include:
Obesity: Reduce excess weight results in risk reduction for colorectal cancer, and for many other diseases as well.
A diet high in fat and red meat and low in fruits and vegetables: People who eat mainly vegetables and put meat on their table only up to three days in a week are less likely to develop colorectal cancer.
Sedentary lifestyle: The more hours people sit, the higher is their risk to develop colorectal cancer. Get up!
Tobacco use: Stop smoking benefits lungs, heart, and lower the colorectal cancer risk.
Alcohol consumption: Cancer rates of the gastrointestinal tract are lower in persons who don´t consume alcohol.
How Frequent is Colorectal Cancer?
Colorectal cancer is the third most common cancer and the second leading cause of cancer-related deaths worldwide. It predominantly affects individuals aged 50 and above, though there is a rising burden among adults 30–50 years old in some settings.
Among Arabs, colorectal cancer (CRC) is one of the most common cancers, and its annual rates are climbing fast. In the UAE, this is driving up the overall cancer burden—it’s now the top cancer in men and the third most common in women.
Colon Cancer in Younger Populations
Particularly in Arab regions, there has been a concerning rise in cases among younger populations. Factors such as genetic predisposition, unhealthy lifestyle choices, and environmental influences have contributed to this alarming trend. Therefore, in UAE regular screening starts earlier than in European countries, as early intervention is crucial in identifying and treating colon cancer in its nascent stages, offering patients a higher chance of survival.
Colorectal Cancer Screening
Unfortunately, colorectal cancer is often detected ad an advanced stage. Yet treatment of colorectal cancer works much better—and can often cure the disease—when the tumor is detected in the early stages. In places with organized screening programs, regular checks are the best way to spot it early and even prevent it by removing precancerous growths before they turn cancerous. Studies show this screening approach lowers both new cases and deaths from the disease.
Colorectal Cancer Screening: Available, But Still Rarely Used in UAE
In the UAE, screening procedures are available, but their use is still rarely used. According to a 2023 study by Latifa Alsaad and Jayadevan Sreedharan from the College of Medicine at Gulf Medical University in Ajman, United Arab Emirates, the prevalence of colorectal cancer screening is a mere 9.1%. Although this was more than Saudi Arabia, the United States and Spain had far higher screening rates (38 and 80%, respectively). The main factors impeding the practice of colorectal cancer screening include the doctor’s failure to offer a screening test, anxiety over positive test findings, test discomfort, pain issues, and a lack of knowledge about CRC screening.
Without enough information on colorectal cancer and its possible dangers, people could not see the value of getting screened. They could fail to recognize the importance of screening because they underestimate the frequency and possible severity of colorectal cancer. A barrier to attend screening may also be insufficient knowledge about the many CRC screening choices and techniques such as sigmoidoscopy, colonoscopy, or fecal occult blood test (FOBT) as an alternative.
Seize the Opportunity to Avoid Colorectal Cancer!
n the UAE, all residents aged 40 and above are strongly advised to undergo routine colorectal cancer screening to improve early detection and survival rates. Recommended methods include an annual Fecal Immunochemical Test (FIT) or a colonoscopy every 10 years, with higher-risk individuals (family history/polyps) advised to consult doctors for more frequent screening tests.
For more details about the Colorectal Cancer Screening Guideline in UAE read here.
For more information about colorectal cancer, check out:
Suffering from Colorectal Cancer? TheKnowHow Independent Second Opinion
We at TheKnowHow empower patients with the knowledge they need to make informed decisions. Our unbiased oncology specialists provide a fresh perspective on treatment choices, fully explaining the benefits and drawbacks of each available option. TheKnowHow report does not just add another opinion, add another choice, and makes decisions even harder. We help you understand your condition and your options, and we guide you through the decision-making process.
A contribution by Dr. Gabriele Stumm
@TheKnowHow
