Diagnosed in both men and women, colorectal cancer (CRC) is the third most common cancer worldwide, with an estimated 1·8 million new cases recorded in 2018. According to Health Authority Abu Dhabi (HAAD), this is the second most common cancer and the second highest cause of cancer deaths in the UAE.
As March is observed as the colorectal cancer awareness month globally, we speak to gastroenterologists at Dr Sulaiman Al Habib Hospital Dubai to learn more about the disease and how to lower your risk of colon cancer.
What is colorectal cancer?
This originates either in the cells of the rectum or the large intestine (colon). As both the organs are parts of the large intestine and the digestive system, colon and rectal cancers are often grouped together.
Colorectal cancer, in most cases, starts with benign tumors or polyps – abnormal growth of tissues – on the lining of rectum and colon. Over time, some polyps change to become cancerous.
What are the common symptoms?
“CRC often has no symptoms and is detected during a routine examination,” says Dr Muhanad Mustafa, Head of Gastroenterology, Dr. Sulaiman Al Habib Hospital Dubai. “That’s why we recommend regular screening for people from the age of 40 or 45.”
CRC often has no symptoms. That’s why we recommend regular screening for people from the age of 40 or 45.
However, if you experience any of the symptoms, such as abdominal pain, changes in bowel habits, rectal bleeding, rectal mass, sudden loss of weight and anemia, seek medical help, suggests Dr Mustafa. “Intestinal obstruction, peritonitis and/or acute gastrointestinal (GI) bleeding can also be signs of concern.”
What are the risk factors?
“The risk of colorectal cancer usually increases with age, usually occurring in people who are 50 years and older,” says Dr Ihsan Kommouna, Consultant Gastroenterologist, Dr. Sulaiman Al Habib Hospital Dubai. Recent data, however, points to a growing incidence of colorectal cancer globally in patients younger than the age of 50.
A study published last year in the Lancet Gastroenterology & Hepatology journal discussed the rising burden of the disease in younger people over the last year 10-year, explaining that the rise in incidence among younger generations was likely to be driven in part by the changing prevalence of risk factors, such as obesity and poor diet.
Some of the common risk factors are inflammatory bowel disease like Crohn's disease and ulcerative colitis; family history of cancer or polyps; familial adenomatous polyposis (FAP), a genetic syndrome; and Lynch syndrome, an inherited condition that increases your risk of colon cancer.
HAAD also notes that more than 80 per cent of patients in the UAE are above 40 years.
“Some of the common risk factors are inflammatory bowel disease like Crohn's disease and ulcerative colitis; family history of cancer or polyps; familial adenomatous polyposis (FAP), a genetic syndrome; and Lynch syndrome, an inherited condition that increases your risk of colon cancer,” says Dr Kommouna.
Many lifestyle issues are also among the critical risk factors for colorectal cancer. “Lack of regular physical activity, a diet low in fruits and vegetables, low fiber and high fat diet or a diet high in processed meat may increase your chances of getting colorectal cancer. If you are overweight or obese, your risk of developing cancer becomes higher. Excessive consumption of alcohol and tobacco raises the risk of colon and rectal cancer significantly,” he says.
How is it diagnosed?
“Colonoscopy remains the gold standard for colon cancer screening,” says Dr Kommouna. “During the colonoscopy, if we spot anything abnormal, we collect a small tissue sample to conduct a biopsy for histopathology.”
Once diagnosed, treatment for colorectal cancer largely depends on the stage, location and the overall health of the patient. However, treatment options can include surgery, chemotherapy, radiation, and targeted therapy.
Is it preventable?
“Colorectal cancer is not entirely preventable. But you can reduce your risk by getting yourself routinely checked, starting from the age 40,” says Mustafa.
“All colorectal cancers start as precancerous polyps in the colon or rectum. They may not cause any symptoms in the early stage. For this reason, we always recommend regular screening tests to prevent the development of colon cancer. We can easily remove these polyps, if necessary, through the polypectomy procedure before they turn into cancer,” he explains, adding, “Daily moderate physical activity, and eating a balanced diet with fruit and vegetables, whole grains and foods containing fiber reduce your risk of the disease.”
What can you do now?
The best way to beat any cancer is by regular screening tests and early detection. If you are 40 and older, book an appointment with a gastroenterologist at Dr Sulaiman Al Habib Hospital Dubai to discuss your health concerns and your screening plans. Dr Sulaiman Al Habib Hospital Dubai has a team of experienced gastroenterologists who can deal with any disorders and diseases of the digestive system.