March is the month of alert against colon and rectal cancer, which is preferred to be called colorectal cancer (CRC). This type of cancer is one of the few that can be prevented and detected early. Today we will look at recent statistics indicating that this cancer is becoming a disease of younger people.
The large intestine is the last part of the digestive system, which begins in the mouth, continues with the esophagus, stomach, and small intestine. The large intestine –also called the colon– measures one and a half meters on average, and is divided into the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anus.
The colon is the organ in charge of forming and storing feces and contains billions of bacteria, distributed in different populations known together as the intestinal microbiota, whose relationship with human health has been well established. The microbiota plays an important role in the metabolism of nutrients and xenobiotics. Xenobiotics include chemicals foreign to the body, such as drugs, pesticides, cosmetics, flavorings, fragrances, food additives, industrial chemicals, and environmental pollutants.
In addition to these metabolic functions, the microbiota is responsible for the structural integrity of the intestinal mucosa, immunomodulation (the way the defense system reacts) and protection against various microorganisms.
He colon cancer – which occurs with almost equal frequency in men and women – is the third most diagnosed cancer and the third leading cause of cancer death in men and women in the United States. In Peru, it is the fifth most frequent cancer. Every year 4,636 cases are diagnosed and some 2,000 people die. As in many countries around the world, this type of cancer is on the rise in Peru.
The location of the cancer It can be in any of the segments described above and the fundamental concept –as a prevention message– is that, for months or years after starting, the Colorectal cancer it is silent and treacherous, that is, it does not give any type of symptoms. The archaic recommendations that a change in bowel habits, rectal bleeding or abdominal pain could indicate the onset of cancer do not make sense. When the cancer shows symptoms, it is already advanced.
“The reasons why this type of cancer is increasing in young people are unknown, although it is suspected that obesity and a sedentary lifestyle play an important role.”
Traditionally, the colon cancer It was considered a disease of the elderly, since approximately 95% of the cases occurred after the age of 50, the vast majority in those over 65 years of age.
But something has been changing in society in the last 20 to 30 years. In the report of the American Cancer Society, released last week, it is documented that 13% of cases of cancer it occurs before the age of 50, 32% between the ages of 50 and 64, and 56% after the age of 65.
That change in statistics prompted the United States Preventive Services Task Force to change, in May 2021, the starting age for preventive exams for colon cancer from 50 to 45 years.
A Peruvian study published in the “Revista de gastroenterología del Perú” in 2017 found that 16.9% of cases of Colorectal cancer between 2006 and 2014 it occurred before the age of 50. Of the 1,261 cases in that age group, 640 were women and 621 were men.
Another Peruvian study published in the same journal in 2016 revealed that of the 2,517 patients with Colorectal cancer diagnosed at the INEN between January 2005 and December 2010, 255 (10.1%) were under 40 years of age. 13.2% had a family history of CRC and the most frequent symptoms were pain (67.9%) and bleeding (67.3%), data that coincides with the fact that 63.1% of cancer cases colon and 34.4% of rectal cancer cases were found in the most advanced stages. Only 44.3% of the cases lived five years or more.
The reasons why this type of cancer it is increasing in young people, although it is suspected that obesity –related to the greater consumption of processed and ultra-processed foods– and a sedentary life in young people play an important role.
Due to this close relationship with obesity, Dr. Arif Kamal, an official of the American Cancer Society, told “The Washington Post” that “as obesity rates continue to rise in the United States, we have to identify colorectal cancer as an obesity-related cancer in the same way that we did when we first began to think of lung cancer as a smoking-related cancer.” “That will help people understand that one thing leads to another.”
He Colorectal cancer it is one of the most silent and treacherous of all cancers. Prevention should start in childhood, encouraging a healthy diet and more physical activity in children and adolescents.
At age 45, people should start early detection tests, which include an annual fecal occult blood test using the FIT (fecal immunochemical test) method. The old Thevenon guaiac method, which was discontinued by the American College of Gastroenterology in 2008, should be abandoned.
The other recommended method is colonoscopy, which can be done every ten years. This procedure has the advantage of removing polyps that may be growing in the colon, thus the disease can be prevented.
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