1 in 5 colon cancer cases are young adults

In Singapore, colorectal cancer (also known as colon cancer) continues to be the most common cancer affecting men. It is the second most common for women after breast cancer. It has been overall the most common cancer in Singapore over the last 10 years. It is a cancer that may be prevented or treated if discovered early.

“Most types of colorectal cancer arise from polyps which start out as benign or non-cancerous growths from the cells lining the inside of the colon or rectum. The change from being benign to becoming cancerous may take years but once a polyp becomes cancerous, it can grow and invade surrounding organs,” says Associate Professor Tang Choong Leong, Head and Senior Consultant from the Department of Colorectal Surgery, Singapore General Hospital (SGH), a member of the SingHealth group.

Colorectal cancer symptoms

Most cases of early colon cancer hardly present any symptoms. Even during advanced stages, colon cancer can have seemingly benign symptoms:

• Change in bowel habits

• Presence of blood in stool

• Persistent abdominal discomfort, pain or mass felt

• Difficulty or pain with reduction of stool calibre during defaecation

• Unexplained weight loss or decrease in red blood cells (anaemia)

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Colon cancer affects the young too

Although the risk of getting colorectal cancer increases significantly after the age of 50, with most patients being in the 55-65 age group, up to one-fifth of the cases seen by doctors today are young adults.

Furthermore, diagnosis among younger patients is often delayed compared to their older counterparts due to the misunderstanding that colorectal cancer is rare among this group of patients. In most patients, by the time the condition is properly diagnosed, about 50 to 60 per cent already have advanced stage cancer (stage 3 or 4).

Screening methods for colorectal cancer

• Faecal immunological stool test (FIT) or faecal occult blood test (FOBT), which can be done in the privacy and comfort of one’s home, helps detect blood in stool that cannot be seen by the naked eye. The user simply collects stool samples for two consecutive days using a simple test kit and sends it back to a lab for processing. If the results are positive above a certain predetermined level, a colonoscopy is then needed to properly rule out colon cancer. However, when taking the FIT, care must be taken not to consume certain medications prior to the test as they may interfere with the results.

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• Colonoscopy
  In a colonoscopy, after prior bowel cleansing, a fibre-optic flexible tube is inserted up the rectum. Although generally not painful, this test can be uncomfortable; hence a mild sedative is usually given to relieve any discomfort. As these sedatives have a mild amnesic effect, a patient may even forget the specific details of the procedure.

  As a colonoscopy detects both pre-cancerous lesions (such as polyps) as well as cancerous ones, it remains the ‘gold standard’ for colorectal cancer screening. Polyps can be immediately removed during the colonoscopy.

Early detection is your best protection against colorectal cancer

Citing the survival rates for different stages of colon cancer, Associate Professor Tang explains, “In stage 1 of the disease, the cure rate is greater than 90 per cent. In the later stages 3 and 4, the average five-year survival rates are 40-60 per cent and 10 per cent respectively. Hence, early detection is of paramount importance.”

Always remember, when it comes to colorectal cancer:

• If you’re above 50, insist on going for a screening every three years whether you have symptoms or not.

• Don’t dismiss potential colon cancer symptoms, especially if they have been present for more than six weeks.

• Get over any embarrassment you may have when it comes to discussing bowel function with your doctor.

• If the thought of going for a colonoscopy frightens you, consider a non-invasive screening method like FOBT.

Related article: 7 effective ways to lower your risk of colorectal cancer

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By Alvin Chumari for HealthXchange.com.sg.

Health Xchange's articles are meant for informational purposes only and cannot replace professional surgical, medical or health advice, examination, diagnosis, or treatment.