Colon cancer is becoming more common, and can be deadly if it grows undetected.

 

Screening and early detection is key to effective treatment.

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WHO GETS COLON CANCER?

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You are at a higher risk of developing colon cancer if you have some risk factors.

Risk factors that you can change are related to your lifestyle.

 

If you smoke, drink alcohol regularly, and do not exercise often, your risk of developing colon cancer is higher.

 

Your diet also plays an important role. If you eat a diet low in dietary fiber (i.e., low in fruits and vegetables), your risk of developing colon cancer is higher.

 

This risk is also higher if you consume a lot of preserved and processed meats (such as ham and sausages).

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There are some risk factors that you cannot change, like you having a strong family history of colon cancer, or you having inflammatory bowel disease.

 

However, even though you cannot change these risk factors, they should at least push you to get yourself screened regularly.

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HOW DO I GET

SCREENED FOR IT?

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There are a few tests that can be done to screen for colon cancer.

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The simplest and safest one to do is to go for a faecal occult blood test (FOBT: where a small sample of your stool is tested to look for the presence of blood). You should do this every year, from the age of 50 years old onwards. 

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In addition to this, you can also ask your doctor to include a 'Full Blood Count' in your health screening test panel, to look for a low 'Haemoglobin' value, which should trigger investigations for anemia (anemia means a low red blood cell count, and is something that happens in cancers due to bleeding from the unhealthy tumour cells).

 

Beyond the age of 50 years old, adults should undergo a colonoscopy every 10 years.

 

However, some individuals may have to do a colonoscopy earlier and more frequently if they have certain risk factors. 

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There are alternatives to doing a colonoscopy, such as using a barium enema (which involves inserting a liquid contrast into your intestines, then doing an x-ray), a sigmoidoscope (a short, rigid camera), and a CT scan (which uses a contrast medium to look for irregularities in your intestinal wall).

 

However, a colonoscopy is still widely considered to be the best modality to detect a colonic tumour.

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Some clinics offer a 'tumour marker panel' as part of their health screening. The common tumour markers checked include AFP (alpha-feto protein, which is elevated in liver cancers), CEA (carcinogenic embryonic antigen, which is raised in certain cancers including colonc cancer, liver cancer and thyroid cancer) and CA-125 (which is raised in ovarian cancers). 

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While these sound like a good way to help you check for cancer, they are actually not diagnostic. Even if you do this blood test and it is normal, you should still go ahead with getting yourself screened with a colonoscope or FOBT test.

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WHAT IS A COLONOSCOPY?

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A colonoscopy involves sedating you for a day procedure, then inserting a scope (flexible camera) in through your anus to view the insides of your intestines.

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Preparing for a colonoscopy can be uncomfortable because it involves you drinking large amounts of a laxative liquid that helps you to clear your intestines of all food and faecal matter, for the doctor doing your endoscopy to have a good look at your intestines lining.

 

You'll also have to fast from after dinner on the night before your scope to keep your intestines empty for the procedure. 

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However, this discomfort is well worth the benefit of being able to detect a tumour early. A colonoscopy is uncomfortable, but is the best way to look for a colon tumour.

 

The endoscopist can also take a sample from any unhealthy tissue he or she finds, and send it for testing to check if you have an early tumour, or any inflammation in your intestinal wall.

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WHAT IS A POLYP?

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A polyp refers to an outgrowth of tissue from the intestinal wall. 

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There are different kinds of polyps. Some are benign and some are cancerous, and the only way to tell is to remove the polyp and send it for testing.

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One of the advantages of doing a colonoscopy is that any polyps detected can be removed and sent for further tests.

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AM I AT A HIGH RISK OF GETTING COLON CANCER?

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There are certain risk factors that indicate that you are at a significantly higher risk of developing colon cancer, and should push you to go for screening tests at an earlier age, and at more frequent intervals.

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If you have a family member who was diagnosed with colon cancer at a young age (below the age of 60 years old), you will need to go for a colonoscopy 10 years prior to the age at which your relative was diagnosed with colon cancer, and go for repeat colonoscopies every 5 years.

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Inflammatory bowel disease like Crohn's disease and colitis drastically increase your risk of developing a colon tumour. Your doctor will send you for a colonoscopy from a set interval from the year of diagnosis, and this colonoscopy will have to be repeated every 1 to 2 years. The interval to doing your first colonoscopy depends on the extent of inflammation going in your intestines.

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There are some genetic conditions that greatly increase your risk of developing colon cancer. They include Familial Adenomatous Polyposis (FAP), and Hereditary Non-Polyposis Colorectal Cancer (HNPCC). Both have their own diagnostic criteria, looking at the colonoscopy findings and the pattern of cancers happening in your family. If you have either of these conditions, you will have to start screening colonoscopies at a young age (in early adulthood), and repeat the colonoscopy every 1 to 2 years.

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Your doctor can go through your risk factors with you and decide on the screening profile that best suits you.

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WRAP IT UP!

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Colon cancer can happen in anyone. You can get it, even if you live a healthy lifestyle, do not smoke, and do not have relatives who have colon
cancer. You must get screened regularly!

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