Colon Cancer
Colon cancer — cancer of the large intestine — is one of the most common cancers in both men and women, and is also one of the most preventable and treatable when caught early. Together with rectal cancer, it is often referred to as colorectal cancer. The majority of cases develop from small, non-cancerous growths called polyps that form on the inner lining of the colon; over years, some of these polyps undergo malignant transformation.
Risk factors
Age is the most significant risk factor — most diagnoses occur in people over 50, though rates in younger adults are rising. Other important risk factors include a personal or family history of colorectal cancer or adenomatous polyps, certain inherited syndromes (notably Lynch syndrome and familial adenomatous polyposis), inflammatory bowel disease (Crohn's disease and ulcerative colitis), a diet high in red and processed meat and low in fibre, obesity, physical inactivity, smoking, excessive alcohol consumption, and type 2 diabetes.
Symptoms
Early colon cancer frequently produces no symptoms, which is why screening programmes are so valuable. As the disease progresses, symptoms may include a persistent change in bowel habit (looser stools, increased frequency, or constipation), blood in the stools (either bright red or darker, mixed with stool), abdominal pain or cramping, a feeling that the bowel has not fully emptied, unexplained weight loss, and fatigue. Iron deficiency anaemia — detected on a blood test — is sometimes the first indication of a right-sided colon cancer.
Screening
Bowel cancer screening — offered through national programmes in many countries — typically involves a faecal immunochemical test (FIT), which detects tiny amounts of blood in the stool. A positive result prompts a colonoscopy for further investigation. Colonoscopy is also the investigation of choice for symptomatic patients and allows direct visualisation of the bowel lining, with the ability to remove polyps at the same time.
Treatment
Surgery is the primary treatment for colon cancer and is curative in many cases when the disease is localised. Depending on the site and extent of the tumour, this may involve removing a section of the colon (hemicolectomy or colectomy). Chemotherapy is used in higher-risk stage II and stage III disease to reduce the risk of recurrence. Stage IV disease (spread to other organs) is managed with a combination of systemic chemotherapy, targeted biological therapies, and surgery or ablation of metastases where feasible.
Choosing where to be treated
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