Colorectal cancer: The importance of understanding risk groups

23/10/2017

Cancer and Prevention

Nowadays, cancer is more and more common in the population. Since people has been dying less and less of infectious causes and preventable deaths, there’s been an increase of chronic-degenerative diseases. Because of this, planning health promotion actions and early detection, especially in regards to cancer care is of great importance.

Very often, the diagnosis of cancer occurs in later stages of the disease, worsening the prognosis, making it difficult to treat and increasing mortality rates. Due to this, prevention of these diseases is key, as well as the early diagnosis, reducing the consequences of the disease and improving the quality of life of people affected.

One of the components that helps the most in the early detection of cancer, as well as of any disease, is the knowledge of the risk factors for its development. Because the causes of cancer are diverse, and many factors are commonly involved in generating the disease, it is difficult to determine its causes in a direct and specific way.

Thus, in order to reduce the impact of cancer, one must first reduce the occurrence of risk factors that can be altered, such as lifestyle and environmental factors, as well as guarantee access to screening programs and early diagnosis, in order to prevent most cases or at least to choose the most suitable treatments in time.

Colorectal cancer

Colorectal cancer is the fourth leading cause of death in our country according to estimates by the National Cancer Institute (INCA).

This follows the worldwide trend of increasing the prevalence of this disease in developing countries, mainly due to the lifestyle of more economically developed societies, following the world-wide trends of urbanization, sedentary lifestyle, obesity, diet rich in processed foods and hyperalgesia, increased longevity, and reduced mortality from preventable causes such as accidents and infectious diseases.

It is currently one of the most common killer cancers in the world, and it is considered a public health problem since its prevalence is increasing in Brazil and around the world.

Colorectal Cancer Risk Factors

  • Genetic factors: they are associated with the familiar forms of the disease. With the advent of new technologies, it was possible to perform researches and studies that detected several genetic conditions that are risk factors not modifiable to the appearance of Colorectal Cancer.
  • Age: the most important risk factor in sporadic colorectal cancer. The onset of the disease increases significantly in people over 40 years of age, increasing progressively every decade. The advancement of age, coupled with genetic conditions that favor the onset of the disease, greatly increase the risk of its development.
  • Life habits: such as sedentary lifestyle, obesity, inadequate diet (high consumption of red meat and sausage, for example), smoking and alcoholism.
  • Other factors: use of certain medications, some diseases, such as diabetes mellitus and hyperinsulinemia, and even geographic factors.

Risk Groups

Based on the risk factors above, risk groups were created, divided as follows:

  • Low risk: individuals under 50 years.
  • Moderate risk: men and women over 50 years. Generally, programs for the early detection of the disease are directed to this group;
  • High risk: family history positive for the disease, findings in colonoscopy, such as adenomas or previous colorectal cancer, and individuals with chronic inflammatory bowel disease, such as ulcerative colitis or long-term Crohn’s disease (more than eight years of diagnosis);
  • Very high risk: a positive history of hereditary transmission in the family (hereditary syndromes), the most common being familial adenomatous polyposis (PAF), Peutz-Jeghers syndrome and juvenile polyposis syndrome.

Colorectal Cancer Screening

Because of the high relevance and prevalence of Colorectal Cancer, there is a need for a well-defined screening program for the early detection of the disease. For this, it is fundamental to have the knowledge of each patient’s risk factors.

Regarding the tests used for screening and diagnosis, research has shown that colonoscopy has reduced the incidence and mortality rate of colorectal cancer.

Several patients also benefit from a strategy that interpolates colonoscopies at longer intervals with the combination of annual fecal occult blood screening and periodic rectosigmoidoscopy.

Methods using molecular biology still need to be better investigated and have their utility routinely used for validated screening.

The Brazilian Society of Coloproctology, together with the National Cancer Institute, the Brazilian College of Surgeons and other medical societies, recommend screening programs for Colorectal Cancer as follows:

  • Moderate-risk subjects should perform annual occult blood fecal screening and rectosigmoidoscopy every five years. From the age of 60, perform colonoscopy every 10 years. Alternatively opaque enema may be done, although it is an outdated test.
  • High risk individuals should start screening at age 40, including colonoscopy.
  • For individuals at very high risk, the screening program should be individualized.
  • For individuals with a family history of colorectal neoplasia, it is recommended to start a screening routine at age 50 or 10 years younger than the youngest case in the family, whichever occurs earlier.

The fight against Colorectal Cancer is mainly done through early detection, which increases the possibility of cure, allows for prompt diagnosis and better definition of treatment. In addition, it makes it possible to remove polyps in a timely manner to prevent the progression of the disease and reduce its incidence and mortality.

At Colono, we have a specialized team and state-of-the-art technologies applied in the detection and treatment of Colorectal Cancer. Make an appointment and do not waste time.

We are together in the fight against Colorectal Cancer!

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