Dr. B.S Ankit Nehra, Consultant Medical Oncology, HCG Cancer Centre, Jaipur

Colorectal cancer is the fifth-most common cancer in India.  It refers to cancer of large intestine. Usual age of development of this cancer is sixty years and above. However, in developing countries including India there has been an increase in incidence among younger people. Current literature suggests that most of the patients diagnosed under the age of 50 are symptomatic at diagnosis and associated with more advanced stage at diagnosis & poorer outcomes.

Consumption of high caloric diet, red meat & high saturated fats, excess alcohol intake, cigarette smoking, sedentary lifestyle, obesity, and diabetes are known risk factors of colorectal cancer.

Blood or mucus in the stools, an unexplained change in bowel habits with prolonged diarrhea or constipation, loss of appetite, unexplained weight loss, excessive gas, abdominal cramps, and abdominal pain could be few of the indicators of colorectal cancer.

The cancer can be diagnosed with the help of physical examination by a medical professional, abdominal imaging (Ultrasonography, CT scan or MRI Scan), serum CEA level, colonoscopy, fecal test, and biopsy.

Colorectal cancer can be treated using a combination of surgery, chemotherapy, and radiotherapy in localized stage. In advanced stage, use of targeted therapy and immunotherapy along with chemotherapy have shown longer survival and better quality of life.

Since most cases tend to develop symptoms at later stages, it is advisable to do timely screening and diagnosis. Screening of asymptomatic individuals for colorectal cancer is advocated by major societies and preventive care organizations.

Fecal Occult Blood Test (FOBT), Fecal Immunochemical test (FIT) and Colonoscopy are methods of screening. Every adult should undergo screening fecal test and colonoscopy at regular interval from the age of 50 years. Adults with family history or known hereditary cause should undergo screening at earlier age depending on risk. Screening has been shown to detect asymptomatic cancer at early stage and can be treated successfully with less aggressive treatment and good outcomes.