Who Is At Risk of Colon Cancer?

Colon cancer, the third leading cause of cancer-related deaths worldwide, is a silent killer that sometimes displays no warning signs. We still do not know for sure what exactly causes colon cancer, but we do know that a person’s risk of developing colon cancer increases based on certain factors, such as age and family history. It is therefore recommended that all persons over age 50, who are not in any of the high-risk groups mentioned below, should undergo a colonoscopy and repeat every 10 years according to American Cancer Society. A colonoscopy is regarded internationally as the standard in screening to protect against colon cancer.

Who is in the high-risk group?

  • People who have direct relatives (e.g. mother, father, siblings) who have suffered from colon cancer are 2 – 3 times more likely than the general population to develop colon cancer.
  • People who have a history of other types of cancer in the family, such as uterine cancer, ovarian cancer or stomach cancer, are also more likely to develop colon cancer. If a person has many family members who have suffered from these other cancers, then that person’s risk of developing colon cancer increases accordingly.
  • People who suffer from chronic inflammatory bowel disease and have had symptoms for several consecutive years are 2 times more likely than the general population to develop colon cancer.

Symptoms of colon cancer

In some cases, colon cancer may not produce any identifiable symptoms, which means that the patient might be unaware of the condition. In other cases, the symptoms of colon cancer may be identifiable but indistinguishable from symptoms caused by other diseases. If you experience any of the following symptoms for more than two consecutive weeks, it is recommended that you visit your doctor for a diagnostic screening promptly:

  • Bleeding from the rectum or blood in stools (seek immediate medical attention)
  • Diarrhea, constipation, or bloating
  • Chronic stomach pain, especially in the lower abdomen
  • Feeling of constantly needing to pass stools or incomplete defecation (Tenesmus)
  • Change in bowel habits such as alternating between diarrhea and constipation
  • Changes in appearance of stool (separate hard lumps like nuts)
  • Feeling weak, fatigued, pallid
  • Unexplained weight loss

When to get screened?

A form of pre-cancerous lesion known as an adenomatous polyp will be detected. The polyp may be small at first, but will gradually grow larger, and can become cancerous within 3 – 5 years. If detected early, however, the polyp can be removed preventing potential colon cancer.

Women and men at high risk and a family history of colon cancer should start screening at 40 years of age, or 10 years earlier than the age a direct blood relative was diagnosed with colon cancer. For example, if a family member was diagnosed with colon cancer at the age of 65, then relatives should be screened at the age of 40, as getting screened at 55 may be too late.

How to get screened

The inside of the rectum and entire colon are examined using a long, lighted tube called a colonoscope. Patients sleep during the procedure under sedation. If pre-cancerous polyps are found, the doctor can remove them during colonoscopy. A colonoscopy is the most accurate of all diagnostic methods and offers the following benefits: no pain, no incision, and short time for preparation and procedure.

After your screening (As laid out by the American Cancer Society):

  • If the colonoscopy detects 1 – 2 polyps, it is recommended that a follow-up screening is conducted every 5 – 10 years.
  • If the colonoscopy detects 3 – 10 polyps, it is recommended that a follow-up screening is conducted every 3 – 5 years.
  • If the colonoscopy detects more than 10 polyps, it is recommended that a follow-up screening is conducted within 3 years.    
  • If the colonoscopy detects 1 polyp which is larger than 1 cm., follow-up screenings may be required every 3 years.
  • Patients whose screening detects no polyps should return for a follow-up screening in 10 years’ time.

Colonoscopy at Samitivej (in collaboration with Sano Hospital in Japan)

Samitivej has adopted Narrow-Band Imaging (NBI) International Colorectal Endoscopic classification (NICE) with magnification, the most validated classification system for colon cancer detection. Polyps frequently not detected with conventional white-light endoscopy equipment can often be seen by using this latest imaging technology. Light from blue and green wavelengths is used to optimize the visibility of tissue structures, so that lesions are detected earlier (even before polyps have developed) and an appropriate treatment plan can begin sooner.

  • More than 2,600 colonoscopies per year are performed at Samitivej Sukhumvit Hospital
  • 0 complications during and after colonoscopies
  • 36.4% Adenoma Detection Rate (ADR) vs. 25% industry average (as laid out by The American Society for Gastrointestinal Endoscopy)

This above information was gathered by Samitivej in 2016.

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During colonoscopy, if specialists find large flat polyps, Endoscopic Submucosal Dissection (ESD) technique will be applied to remove polyps without the need for open surgery. This minimizes surgical risks, removes the need for abdominal incisions (scarless), shortens hospitalization, and allows patients to recover much more rapidly. All of this enables patients to return to their normal lifestyle more quickly, reduces complications and increases safety levels. ESD is a new scarless surgical technique implemented by Samitivej Hospital as a results of its collaboration with Sano Hospital, Japan’s leading private hospital specialized and advanced in gastrointestinal (GI) endoscopy for advanced diagnosis and therapeutic via endoscopy.

Colon cancer results from a change in normal cells in the colon, continuously reproducing until they can no longer be controlled. This process may take years. In early stages, the cells may only appear as a normal polyp, but if allowed to grow further without treatment or removal, these polyps can eventually become cancerous. The exact cause of the disease is still not known, but a person’s risk of developing colon and rectum cancer is known to increase with age.  The condition is rarely found among adults aged 40 or less, but people aged 50 or more are two times more likely to develop colon cancer. As mentioned above, however, this does not mean that people below the age of 50 are at not a risk of developing colon cancer. In fact, statistics indicate that 1 in 7 patients receiving treatment for colon cancer treatment are younger than age 50.

Photo Credit: Karl-Heinz Kasper Flickr via Compfight cc

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