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Dr. Susanta Kumar Paikaray

Colorectal cancer (CRC) is a formidable health problem worldwide. It is the third most common cancer in men (6,63,000 cases, 10.0% of all cancer cases) and the second most in women (5,71,000 cases, 9.4% of all cancer cases).

Almost 60% of cases are encountered in developed countries. The number of CRC-related deaths is estimated to be approximately 6,08,000 worldwide, accounting for 8% of all cancer deaths and making CRC the fourth most common cause of death due to cancer. In India, the annual incidence rates (AARs) for colon cancer and rectal cancer in men are 4.4 and 4.1 per 1,00,000, respectively. The AAR for colon cancer in women is 3.9 per 1,00,000. Colon cancer ranks 8thand rectal cancer ranks 9thamong men. For women, rectal cancer does not figure in the top 10 cancers, whereas colon cancer ranks 9th.

Symptoms of colon cancer

  1. A change in bowel habits, such as diarrhoea, constipation, or a change in the consistency of stool lasting for longer than four weeks
  2. Rectal bleeding or blood in stool
  3. Persistent abdominal discomfort, such as cramps, gas or pain
  4. A feeling that the bowel doesn't empty completely
  5. Weakness or fatigue
  6. Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages. When symptoms appear, they'll likely vary, depending on the cancer's size and location in the large intestine.

Stage I cancers have a survival rate of 80-95%. Stage II tumors have survival rates ranging from 55 to 80%. A stage III colon cancer has about a 40% chance of cure and a patient with a stage IV tumor has only a 10% chance of cure.

Chemotherapy is used after surgery in stages II, III, and IV, as the same has been shown to increase survival rates.

Carcinoembryonic antigen or CEA is a protein which can be measured in the blood. In many colon cancers, the CEA level is elevated. Nearly 50% of patients with stage II and III cancers have elevated CEA levels. With a curative resection of the cancer, the CEA level is normalized in one to four months.

Colon cancer is curable in the early stages, especially if it is diagnosed in a precancerous condition such as a polyp.

Although surgery and chemotherapy have improved cure rates for colon cancer, it should be the goal of physicians and patients to diagnose colon lesions before they become malignant. Therefore, yearly physical examinations, checking the stool for occult blood, sigmoidoscopy and colonoscopy are the best tools for preventing colon cancer.

This article has been written by Dr. Susanta Kumar Paikaray, MBBS, MD Pediatrics (PGI, Chandigarh), DM, Medical Oncology, AIIMS, New Delhi.