Colon Cancer is one of the common cancers in western countries among men and women, but it is becoming more reported in the Middle East as well. In 2007, it was the second reported cancer, according to the UAE ministry of health.
It is not fully well determined what causes colon cancer, but several factors including genetic predisposition, environmental, dietary aspects, and certain long standing chronic bowel inflammatory diseases may play a role or increases its incidence in certain groups.
Though genetic predispositions and syndromes are well-established causes of colon cancer, they represent only a small fraction of the total colon cancer incidence, and the large majority of cases occur in individuals with no family history of colon tumors.
Colon cancer starts as a small pre-cancerous lesion called polyp (small, grapelike growths on the lining of the colon), which may grow in size and may progress with time to become cancerous; this process may take an average of 10 years for the transformation.
Colon cancer is highly preventable. Screening tests like colonoscopy may detect polyps and their removal in early stages before complete evolution to cancer could save lives. Screening starts at age 50 for average risk patients except in some instances of high risk groups, where it is recommended to do the screening at an early age.
Other methods of colon cancer screening include: limited left colon examination (sigmoidoscopy), virtual colonoscopy, Barium enema, and fecal occult blood detection tests. Colonoscopy is more superior as a diagnostic tool and it also offers the therapeutic intervention advantage of removing any existing pre-cancerous colon polyps at the time of the examination.
Colonoscopy can be done by specialists (Gastroenterologists) trained to perform this procedure on an outpatient basis. Patients usually receive some intravenous sedation and mild anesthesia which allow for a pain-free examination. the complication rate in this procedure is rare, especially when conducted by experts.
Patients with colon cancer may present with some common non specific symptoms but usually as a new pattern occurring over weeks to months, which include altered bowel habits, or abdominal pain, and unexplained weight loss.
More alarming symptoms may include rectal bleeding or iron deficiency anemia, and that usually alerts the patient to seek medical advice and do further investigations like colonoscopy to identify the etiology and rectify it, if possible. however, the majority of pre-cancerous lesions, polyps and early cancer are discovered in asymptomatic patients during routine colon cancer screening tests.
Colon cancer has different stages, and when detected and treated in early stages (stage I and II) usually has very good prognosis and cure rate.
Colon cancer is a deadly disease especially in advanced stages, however it is preventable by implementing colon cancer screening tests to detect and treat early lesions and cancer, and achieve long term drop of its incidence, in order to save lives.
—Wael Dahhan, MD, FACG is Head of Department of Gastroenterology, Emaar Healthcare Group