Colorectall Cancer Screening Program Helps You Spot Cancer Early

 

 

Colorectal cancer in Hong Kong

 

The Department of Health (DH) announced that colorectal cancer ranked the second most common cancer and had an increasing trend locally and among younger population. In 2021, colorectal cancer resulted in 2,270 deaths, accounting for 15.4 per cent of all cancer deaths.

 

 

Causes and risk factors

 

Medical studies find that there are many factors that may raise the risk of growing colon polyps and can even cause colon cancer. For instance, emotional pressure can potentially lead to health problems. Long periods of sedentary behaviour and lack of physical activity are also strongly linked to obesity, digestive problems and bowel disorders. Eating barbecued and smoked foods, fatty foods, red meat, foods with high sodium content can result in colorectal cancer. Experts do agree that a balanced diet is a cornerstone of health, and typically discourage eating processed meat. Moreover, cigarette smoking and alcohol consuming are both important risk factors for bowel diseases. While people over the age of 50 are at higher risk to get colon polyps and cancer.

 

Risk factors

 

Like other cancers, the risk of developing colorectal cancer depends on a number of risk factors that varies among individuals. In fact, many of the risk factors for colorectal cancer are linked to our diet and lifestyle habits. If you have any of the factors listed below, it does not mean that you will have colorectal cancer, but it means that your risk of developing colorectal cancer may be higher than the average.

Lifestyle risk factors include:
 

-	Low fibre intake, high consumption of red and processed meat		-	Lack of physical activity
-	Obesity		-	Alcohol consumption
-	Smoking		-	Other risk factors include: men at or above the age of 50
-	Some hereditary bowel diseases, e.g. familial adenomatous polyposis or Lynch Syndrome (formerly known as Hereditary Non-polyposis Colorectal Cancer, HNPCC)		-	A long history of inflammation of the bowel, e.g. ulcerative colitis
-	History of colonic polyps		-	Family history of colorectal cancer, particularly in close relatives (parents, siblings or children)

 

Colorectal cancer progression

The colorectal adenoma-carcinoma sequence suggests that a clump of cells form the adenomas polyps that attach to surface of the colon’s mucous membrane, and the adenomas polyps become cancerous. It is believed that environmental factors such as food can alter the way molecules bind to DNA. It takes about 10 years for an adenoma polyp to turn into cancer. Over 90 percent of colorectal cancers begin as a benign tumour and sessile serrated adenoma. Removing the adenomas polyps can help prevent colorectal cancer from developing.

 

Colonoscopy commences with a flexible endoscope, by passing through the anus to the lower bowel to examine if there is any inflammation, polyp or tumour. When any suspicious lesion was found, biopsy will be performed. When polyp was found, polypectomy will usually be performed in the same session. Cancers can be detected during the colonoscopy. Biopsies taken during the procedure are sent to a laboratory for analysis to determine whether they are cancerous, precancerous or noncancerous. The result will facilitate an accurate and timely diagnosis.

 

Colon Cancer Screening

 

There were two types of colon cancer screenings: the stool occult blood test and the colonoscopy. However, fecal occult blood test only detects colon cancer and not the pre-cancerous polyps. This makes a colonoscopy the most effective way of screening at present.

 

Prevention by Screening

 

Most colorectal cancers begin as a small and benign polyp. In the case of colorectal polyps, the doctor may remove them because some types of polyps can later develop into cancer. Removing the polyps can help prevent colorectal cancer from developing.

 

The Cancer Expert Working Group (CEWG), which was set up under the Cancer Coordinating Committee (CCC), recommends individuals aged 50 to 75 to discuss with their doctor and consider screening for colorectal cancer by one of the following methods:

1. faecal occult blood test every one to two years; OR

2. flexible sigmoidoscopy every five years; OR

3. colonoscopy every 10 years.

Individuals in high-risk families can consult their doctor and start screening for colorectal cancer at an earlier age and have screening repeated at shorter time intervals as recommended by their doctor.

 

The Department of Health announced the eligible persons being recruited are individuals aged between 50 and 75. Hong Kong residents who are eligible may receive government subsidy to undergo Colorectal Cancer Screening Programme. Find out more and search for a primary care doctor (PCD) participating in the Programme at official government website. Learn more.

 

Colorectal Cancer Screening Programme : 

Eligible persons must first make an appointment with a primary care doctor (PCD) participating in the Programme. After enrolment in the Programme, the participant will receive a government subsidy to undergo the Faecal Immunochemical Test (FIT). If the FIT result is positive, the participant will be referred to see a colonoscopy specialist who has enrolled in the Programme to receive colonoscopy examination subsidised by the Government in order to find out the cause of bleeding and to remove the colon polyps if there is any. However, no screening test is 100% accurate, so even if the FIT result is negative, we highly recommend the participant continues to watch out for symptoms of colorectal cancer, or schedule for a colonoscopy if there is any concern.

 

Diet that fight Colorectal Cancer

1.    Less processed and red meats

Eating processed and red meats like sausages, canned meat and bacon for a long period can be harmful to health. Researchers have found that eating 50 grams of processed meat every day (which is equivalent to one hot dog or four strips of bacon) may increase your risk of colon cancer by 18 percent. If you would not give up processed and red meat entirely, you may consider swapping red meats for poultry and fish. You may try it out once or twice a week at first.

 

2.    More whole grain bread and oats

Just like processed meats, processed grains can also increase your risk of colon diseases. A milling process removes much of its nutrition, including fibre, vitamins, and minerals. Refined grains in white bread and other white flour foods are high in carbs and can increase blood sugar levels. Choosing whole grain bread and oats can increase the fibre intake and reduce the colon cancer risk.

 

3.    Drink with less Sugar

Studies have shown the link between sugary drinks and obesity, they may cause cancer as well. The sugar in drinks can lead to chronic inflammation, and inflammation can lead to different cancers throughout the body. We would recommend you to replace your sugary drinks with water to keep healthy.

 

4.    Whole-grains, beans, fruits and vegetables

There is consistent evidence showing that diets rich in fruits and vegetables can reduce the risk of many cancers, for example, colorectal cancer, gastric cancer, oesophageal cancer, and oral cancer.

 

5.    Yogurt

Yogurt consumption can promote the growth of healthy bacteria in the gut. But less is known about how yogurt might impact the potential for people to develop adenomas.

 

Regarding lifestyle habits, you should exercise more, drink in moderation, and quit smoking.

 

The causes of colorectal cancer remain unknown. However, according to statistics, colorectal cancer is closely related to our dietary habits. Even without any symptoms, people aged 50 or above should undergo examinations to evaluate the condition of their colon. Regular colonoscopies can detect colorectal polyps early, prevent colorectal cancer, and greatly reduce the risk of developing colorectal cancer.

 

References

Centre for Health Protection. Colorectal Cancer. Available at : https://www.chp.gov.hk/tc/healthtopics/content/25/51.html

Department of Health. Centre for Health Protection. Cancer Expert Working Group on Cancer Prevention and Screening. Available at : https://www.chp.gov.hk/files/pdf/cewg_crc_professional_hp.pdf

Mayo Clinic. Colon cancer. Available at https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669

 

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