Colorrectal cancer is on e ot the most frequent neoplasias. In Spain it is the most frequent malignant tumor when we include both male and female patients, with a high incidence of 40000 new cases a year.
Colorrectal Cancer Prevention
Cómo prevenir el cáncer de colon
- There are several risk factor sable to promote colorrectal cáncer. Among them, the most known ones are:
- Age: above 50 year
- Sex: There are no clear differences between male and female , although it seems to be Little more frequent in men at early ages.
- Relatives diagnosed by colorrectal cancer : First degree relatives are at higher risk to develop colorrectal cáncer. The same way, the more affected relatives and the younger the age at diagnosis appear to establish a higher risk for colorrectal cancer.
- Familial polyposis síndromes colonic adenomas found in prior colonoscopies.
- Other tumors, such as ovarian, endometrial, gastric or pancreatic neoplasias, offers a higher risk for colorrectal cancer.
- Chronic diseases of the colon, like inflammatory bowel disease.
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A very frequent belief, although not always true, is to think that colorrectal cáncer and colonic adenomas always are symptomatic. In fact, most patients are completely asymptomatic. This fact makes quite important to offer an active prevention in people at risk. One big advantage is that we have tools and enough scientific knowledge to detect precancerous states (mainly polyps) or even cancer at early stages. The survival rates of colorrectal cancer increases dramatically when it is early detected. The identification and removal of polyps before they become malignant is the main preventive act we can perform.
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Fortunately, we have several tests to detect polyps and cáncer at early stages. The election of one or other one will depend on risk factors and individual . The gastroenterologist will decide which kind of preventive action is better for such patients. These tests are:
- Occult fecal blood test
- Double-contrast barium enema
- Sigmoidoscopy
- Colonoscopy
- TAC and/or MRI colonography
Thus several strategies exist to carry out an active prevention of colorrectal cancer:
Individuals at average risk need to be tested by the age of 50, and the most effective test is to perform a colonoscopy every 10 years (if no polyp have been found). As an alternative, fecal occult blood test (FOBT) can be offered anually of each two years. Although it is not routinely carried out in our country, sigmoidoscopy each 3-5 years can also be an alternative.
It is mandatory to alert people at high risk for colorrectal cáncer to be tested by colonoscopy at closer intervals, including people with personal history of prior colorrectal cáncer or polyps, relatives with colorrectal cáncer, familial polyposis síndromes and chronic colonic diseases such inflammatory bowel diseases.
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