Colorectal cancer is the second most common cancer in Malaysia and the most common cancer among man. As its name implies, it arises from the colon or the rectum. It usually starts off as a polyp, which is growth on the inner lining of the colon or rectum. Not all polyps become cancerous, but some types do transform into cancer over time.
Early diagnosis and treatment of cancer is important for its outcome. Hence, screening for colorectal cancer is important to detect while it is still at an early stage.
Symptoms
Early stage of the illness may not show any symptoms. Some may present as:
Iron deficiency anaemia
Blood in stool (appear darker than usual)
Rectal Bleeding
Change in bowel habit (prolonged constipation)
Diarrhea or alternating between both
Weight loss and fatigue
RISK FACTORS
Risk factors for colorectal cancer can be divided to modifiable and non-modifiable:
TYPES OF SCREENING FOR COLORECTAL CANCER
TYPES OF SCREENING FOR COLORECTAL CANCER
Stool-Based Screening Tests And Intervals Are as Follows:
Guaiac-Based Fecal Occult Blood Test (FOBT), Every Year
Fecal Immunochemical Test (FIT), Every Year
FIT-DNA, Every 1 Or 3 Years
Direct Visualization Screening Tests And Intervals Are as Follows:
Colonoscopy, Every 10 Years
Computed Tomographic (CT) Colonography, Every 5 Years
Flexible Sigmoidoscopy, Every 5 Years
RECOMMENDED SCREENING AGE
A person with average risk (no family history) or symptoms of colorectal cancer should start regular screening at age of 50 to 75 years.
A person with a family history of colorectal cancer (first-degree relative – FDR) should have a colonoscopy done at 40 years old or 10 years younger or whichever is younger when diagnosed.
If the FDR was affected:
before the age of 60, it is recommended to repeat colonoscopy every 3-5 years; even if normal.
at age >60 years, repeat colonoscopy every 10 years.
For those with inflammatory bowel disease or hereditary colorectal cancer syndrome (or suspected to have), screening will need to start earlier and more frequent.
Colonoscopy is the only screening method used here.
TYPES OF SCREENING FOR COLORECTAL CANCER
Stool-Based Screening Tests And Intervals Are as Follows:
Guaiac-Based Fecal Occult Blood Test (FOBT), Every Year
Fecal Immunochemical Test (FIT), Every Year
FIT-DNA, Every 1 Or 3 Years
Direct Visualization Screening Tests And Intervals Are as Follows:
Colonoscopy, Every 10 Years
Computed Tomographic (CT) Colonography, Every 5 Years
Flexible Sigmoidoscopy, Every 5 Years
RECOMMENDED SCREENING AGE
A person with average risk (no family history) or symptoms of colorectal cancer should start regular screening at age of 50 to 75 years.
A person with a family history of colorectal cancer (first-degree relative – FDR) should have a colonoscopy done at 40 years old or 10 years younger or whichever is younger when diagnosed.
If the FDR was affected:
before the age of 60, it is recommended to repeat colonoscopy every 3-5 years; even if normal.
at age >60 years, repeat colonoscopy every 10 years.
For those with inflammatory bowel disease or hereditary colorectal cancer syndrome (or suspected to have), screening will need to start earlier and more frequent.
Colonoscopy is the only screening method used here.
TYPES OF SCREENING FOR COLORECTAL CANCER
Stool-Based Screening Tests And Intervals Are as Follows:
Guaiac-Based Fecal Occult Blood Test (FOBT), Every Year
Fecal Immunochemical Test (FIT), Every Year
FIT-DNA, Every 1 Or 3 Years
Direct Visualization Screening Tests And Intervals Are as Follows:
Colonoscopy, Every 10 Years
Computed Tomographic (CT) Colonography, Every 5 Years
Flexible Sigmoidoscopy, Every 5 Years
RECOMMENDED SCREENING AGE
A person with average risk (no family history) or symptoms of colorectal cancer should start regular screening at age of 50 to 75 years.
A person with a family history of colorectal cancer (first-degree relative – FDR) should have a colonoscopy done at 40 years old or 10 years younger or whichever is younger when diagnosed.
If the FDR was affected:
before the age of 60, it is recommended to repeat colonoscopy every 3-5 years; even if normal.
at age >60 years, repeat colonoscopy every 10 years.
For those with inflammatory bowel disease or hereditary colorectal cancer syndrome (or suspected to have), screening will need to start earlier and more frequent.
Colonoscopy is the only screening method used here.
TREATMENT
Surgical resection of tumour is the mainstay of treatment. Chemotherapy and radiotherapy are used to reduce tumour size, as an adjunct therapy or palliative therapy.
