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Colon Cancer: Extraction Before Contraction


  • People who suffer from health conditions, such as diabetes and fatty liver disease, have a higher chance of developing colon cancer.
  • We can currently screen a person’s risk of carrying genetically transferable colon cancer genes, even when the patient’s ancestors have not suffered from the cancer themselves.
  • Colonoscopy is seen as the best form of colon cancer prevention because in cases where a polyp is found, doctors can remove the polyp straight away.


Colon cancer is a major cause of death worldwide, with cases continuously on the rise. Thailand is no different in this regard, with the number of colon cancer patients steadily increasing. There are very few symptoms in the early stages and the true causes remain unclear. Doctors, therefore, consider colon cancer as a silent danger that can affect people of any age or gender.

However, every cloud has a silver lining. This particular one comes as statistics which show that up to 90% of colon cancer cases begin with adenomatous polyps in the large intestines. This means that if one attends a screening early enough, doctors can remove the polyps before they develop into cancer.

Colonoscopy is the best form of prevention because in cases where a polyp is found, doctors can remove the polyp immediately. They then send it for laboratory analysis and if the results show early stage cancer, doctors can treat it immediately.

Is it true that we should wait until we are 50 before undergoing a colonoscopy?

For people in general who are not exposed to any other risk factors, yes it is.  Doctors recommend that a person gets a colonoscopy screen for precancerous polyps from the age of 50. However, as colon cancer is a deadly disease those in the high-risk category should screen sooner. 

Risk Factors that call for early screening


Risks increase based on a person’s genetics. Hence, those who have a family history of colon cancer are at a greater risk than those who do not. Other forms of genetically transferable health conditions that may also increase a person’s chances of developing colon cancer, for instance, familial adenomatous polyposis syndrome.


Moreover, patients with type 2 diabetes and a resistance to insulin have a higher risk of getting colon cancer. This means for those whose insulin levels are higher than the general population should screen sooner. This is because insulin stimulates tissue and cell growth, therefore causing any polyps to expand and develop into cancer at faster rates than usual. Type 2 diabetes patients, hence, have higher risks, first of getting the disease and then of it developing more rapidly.

Fatty Liver Disease

Another high risk group are people with non-alcoholic fatty liver disease (NAFLD). This group will have 1.6-1.8 times lower life expectancy than people without the condition. They also have a greater risk of developing chronic liver disease, liver cirrhosis, liver cancer and, unexpectedly, colon cancer. A research was carried out of a sample group of 1,200 people who were closely monitored with regular endoscopic intestinal inspections. Researchers split patients into two groups, those with fatty liver disease and those without. They found that both males and females with fatty liver disease were more likely to develop potentially cancerous adenoma polyps. Researchers, therefore, concluded that this group is much more likely to develop colon cancer.

Prevention is better than treatment

Colonoscopy is currently considered the best form of colon cancer prevention. However, an innovative new technique called oncogenetic screening is now available for use prior to colonoscopy. Such screening takes into account a person’s family tree, including immediate family and blood relatives. The reason for this is that, if doctors diagnose someone in the family with the disease, they can help other members of the same family prevent a repeat occurrence by using the oncogenetic screening technique. 

We are currently heralding a new era which relies on the principles of precision medicine. This means that we focus not solely on treatment but also aim to prevent the repetition of diseases and illnesses. This is because many people are unaware of genetic health disorders. For example, many may not realize that cancer can be transferred genetically, even though they may have wondered why a few of their family have suffered from the disease. In such cases, why wait for the disease to carry on its reign of destruction. Why wait for it to take away our loved ones?

The Thai medical industry has developed significantly in recent years. We are now able to screen for cancer ourselves and no longer depending on other countries to help analyze tissue samples. In fact, we are capable of screening for the 50 most common genes that are responsible for over 30 types of cancer. This means that when doctors identify risks, they can offer lifestyle advice and create effective treatment plans.

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Assoc. Prof. Teerha Piratvisuth, M.D. Summary: Internal Medicine Gastroenterology