Gut Issues Might Be Bigger Than You Think

In today’s health care, it’s not just about exercise or eating right; screening for various diseases is also crucial to prevent and treat them early. One significant cancer to be aware of is colorectal cancer. This type of cancer is not only common but often shows no symptoms in the early stages, leading to detection when the disease has already progressed.

The Importance of Colorectal Cancer Screening

Colorectal cancer is one of the most common cancers and often presents no symptoms in its early stages. By the time symptoms appear, the cancer may have already advanced, making treatment more difficult. Early detection or identification of precancerous stages significantly increases the chances of successful treatment, emphasizing the critical importance of regular screening.

Statistics of Colorectal Cancer

In 2016, the United States reported 95,270 new cases of colon cancer and 39,220 new cases of rectal cancer. In the same year, there were 49,190 deaths due to colorectal cancer. In Thailand, colorectal cancer is the fourth most common cancer, with 11,496 new cases and 6,845 deaths annually, following liver, lung, and breast cancers. The mortality rate from colorectal cancer has decreased with the implementation of screening and early prevention through polypectomy (removal of polyps).

Risk Factors for Colorectal Cancer

Non-Modifiable Risk Factors

• Age: The risk of colorectal cancer increases significantly after the age of 40, with more than 90% of cases occurring in individuals over 50.
• Family History: Individuals with a family history of colorectal cancer have a 20% higher risk of developing the disease.
• Inherited Genetic Risk: Approximately 5-10% of colorectal cancer cases are due to inherited genetic mutations, such as Familial adenomatous polyposis (FAP) and Hereditary nonpolyposis colorectal cancer (HNPCC).
• Personal History of Adenomatous Polyps: Neoplastic polyps can potentially develop into colorectal cancer in the future.
• Personal History of Inflammatory Bowel Disease: Chronic inflammatory conditions like Ulcerative colitis and Crohn’s disease increase the risk of colorectal cancer by 4-20 times.

Environmental Risk Factors

• Diet: High-fat diets, red meat, processed meat, and high-temperature cooking methods increase the risk of colorectal cancer.
• Physical Activity and Obesity: Regular exercise and maintaining a healthy weight can reduce the risk.
• Smoking: Cigarette smoking increases the risk of colorectal cancer and adenomatous polyps.
• Heavy Alcohol Consumption: Alcohol consumption increases the risk due to the presence of acetaldehyde, a carcinogenic substance.

Symptoms of Colorectal Cancer

Common symptoms include:

• Blood in stool, anemia
• Abdominal pain, constipation, alternating constipation and diarrhea, or abdominal bloating
• Mucus or bright red blood in stool

Symptoms often appear when the cancer has already advanced.

Colorectal Cancer Screening Methods

There are two primary screening methods:

1. Stool Test: Checks for hidden blood in the stool. It is convenient but less accurate in detecting lesions. Annual testing is recommended if results are normal; if abnormal, a colonoscopy is advised.
2. Colonoscopy: Provides a detailed view of the colon to detect polyps or tumors. It is highly accurate and typically repeated every 5-10 years if results are normal.

Diagnosis and Treatment of Colorectal Cancer

Diagnosis primarily involves a colonoscopy, and if abnormal lesions are found, a biopsy is performed for further evaluation. Treatment often involves surgical removal of the tumor, with chemotherapy or radiation therapy depending on the stage and location of the cancer.

Prevention and Lifestyle Recommendations

• Regular exercise to maintain a healthy weight
• Consuming a clean diet rich in fiber, with fish as the primary protein source

While following these recommendations can reduce the risk of colorectal cancer, they cannot entirely prevent it. Regular screening remains crucial, especially for individuals over 50.

Beta-Glucans

Beta-glucans are natural substances known for their antioxidant properties and immune-boosting effects. Some studies suggest that beta-glucans may reduce the risk of certain cancers, but there is not enough evidence to conclusively state their effectiveness in preventing colorectal cancer. Therefore, they should be used in conjunction with medical screening and professional recommendations.

References

• Kanth, P., & Inadomi, J. M. (2021). Screening and prevention of colorectal cancer. BMJ, 374, n1855. doi:10.1136/bmj.n1855
• Przybyłowicz, K. E. (2021). A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis. Cancers, 13(9), 2025. doi:10.3390/cancers13092025
• BMC Gastroenterology. (2021). Risk factors for metachronous colorectal cancer and advanced neoplasia following primary colorectal cancer: a systematic review and meta-analysis.