SUBJECT: MARCH - COLORECTAL (LARGE INTESTINE) CANCER AWARENESS MONTH
March is designated as "Colorectal Cancer Awareness Month" to enhance cancer awareness, emphasize the importance of colorectal cancer screening, and promote the adoption of healthy lifestyle habits that can reduce an individual's risk of developing colorectal, rectal, or anal cancer through various activities.
Colorectal cancers are among the most commonly diagnosed cancer types worldwide and in our country. In our country, colorectal cancer ranks as the third most common cancer type in both men and women. Globally, 1.9 million new colorectal cancer cases and over 900,000 deaths due to colorectal cancer are reported annually.
The incidence of colorectal cancer is higher in Europe, North America, Russia, Australia, and New Zealand compared to Asia and Africa. This geographical disparity is thought to be influenced by dietary habits, environmental exposure, and genetic predisposition. Colorectal cancer is rare in individuals under the age of 40, but its incidence begins to rise after the age of 40-50, with approximately 85% of cases occurring in individuals aged 50 and above.
Polyps and cancers of the large intestine often remain asymptomatic until they grow significantly. Screening programs enable the detection and treatment of adenomatous polyps (premalignant) and early-stage localized cancers before they progress to malignancy.
Colorectal cancer is a highly treatable disease when diagnosed at an early stage. Numerous studies have demonstrated that the implementation of screening programs significantly reduces the incidence and mortality rates associated with this disease.
In our country, national standards for colorectal cancer screening have been established and implemented. Women and men aged 50-70 are offered free screening every two years using the Fecal Occult Blood Test (FOBT) at Community Health Centers (TSM), Cancer Early Diagnosis, Screening and Training Centers (KETEM), Healthy Life Centers (SHM), and Family Health Centers (ASM). Additionally, colonoscopy is recommended once every ten years for individuals in this age group. Those with a positive FOBT result are referred to secondary or tertiary healthcare institutions for further examination.
Risk Factors for Colorectal Cancer:
Being overweight or obese
Physical inactivity
High consumption of processed (sausages, salami, etc.) or unprocessed red meat (beef, lamb, liver, etc.)
Use of tobacco and tobacco products
Alcohol consumption
Presence of diabetes and insulin resistance
Cholecystectomy (gallbladder removal)
Gender (both incidence and mortality rates are significantly higher in men than in women)
Advanced age
Race and ethnicity
Personal history of colon polyps or colorectal cancer
History of inflammatory bowel disease
Family history of colon polyps or colorectal cancer
Presence of a hereditary syndrome (e.g., Lynch Syndrome, adenomatous and hamartomatous polyposis syndromes)
Type 2 diabetes
Presence of acromegaly
History of kidney transplantation
Androgen deprivation therapy
Presence of cystic fibrosis
History of abdominal or pelvic radiation
Symptoms of Colorectal Cancer:
Colorectal cancer symptoms vary depending on the tumor's location within the intestine, and in some cases, it may be asymptomatic. If symptoms do occur, they may include:
Changes in bowel habits such as diarrhea or constipation lasting longer than a few days
Feeling of incomplete bowel emptying
Rectal bleeding characterized by bright red or dark blood
Presence of blood in the stool, giving it a dark brown or black appearance
Abdominal bloating, cramping pain, or gas complaints
Unexplained weight loss
Anemia (low red blood cell count), fatigue, weakness
Painful defecation
Presence of a mass
Diagnosis of Colorectal Cancer:
Similar to some other cancers, colorectal cancers generally remain asymptomatic until they reach an advanced stage. Therefore, the primary goal should be to detect the tumor before symptoms appear. Screening individuals for cancer before symptoms develop helps in the early detection of polyps and cancer. Identifying and removing polyps at an early stage can prevent the development of colorectal cancer. Early diagnosis also improves the effectiveness of colorectal cancer treatment. For this reason, screening should begin at age 50 for the general population, while individuals at increased risk should begin screening at an earlier age.
Detecting fecal occult blood and performing a colonoscopy can identify tumors in their polyp stage before they become cancerous, thereby preventing cancer development. In cases where cancer has already developed, early diagnosis increases survival rates and improves quality of life.
Treatment of Colorectal Cancer:
The primary treatment for early-stage colorectal cancer is surgical intervention, in which the affected portion of the intestine and adjacent lymph nodes are removed.
Depending on the stage of the disease, chemotherapy, radiotherapy, targeted therapies, and immunotherapy are also available treatment options.
Strategies for Preventing Colorectal Cancer:
While screening programs are the most crucial step in preventing colorectal cancer, adopting the following healthy lifestyle behaviors is also important for reducing the risk of colorectal cancer, as well as other types of cancer:
Maintaining a healthy weight
Limiting the consumption of red and processed meat while increasing the intake of fresh vegetables, fruits, and whole grains
Consuming high-fiber foods (foods richest in fiber include legumes, grains, and fruits/vegetables)
Engaging in moderate physical activity for 30-60 minutes daily (e.g., brisk walking, cycling)
Avoiding smoking and alcohol consumption
"Preventing Colorectal Cancer Is in Your Hands; Eat Healthy, Exercise, and Do Not Neglect Your Screening Tests."