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Understanding the Risk Factors and Importance of Screening for Colorectal Cancer

On Monday, June 26th, 2023 at 7:45 am, colorectal cancer, also known as colon and rectal cancer, remains a prevalent issue both nationally and globally. Data from 2020 indicates that approximately 20,000 Thai people are currently battling this form of cancer, placing it as the 4th or 5th most common cancer among the Thai population. Additionally, the same year saw a devastating loss of around 10,000 lives to this disease. These numbers illustrate the significant public health problem that colorectal cancer poses on a national scale. Therefore, it is crucial to educate the public about the importance of self-care and raise awareness in order to reduce the morbidity and mortality rates associated with this cancer.

The risk factors for colorectal cancer can be divided into two categories: modifiable and non-modifiable. Understanding these risk factors is essential in assessing an individual’s current level of risk and determining the necessary monitoring for symptoms. Non-modifiable risk factors include age, especially when surpassing 50 years, the presence of polyps or a history of colon and rectal cancer, chronic inflammatory bowel disease, certain hereditary diseases such as Lynch Syndrome and familial adenomatous polyposis, and a family history of colon cancer. Additionally, individuals with diabetes also face an increased risk.

Modifiable risk factors are those that individuals can change through their behavior and lifestyle choices. These factors include being overweight or obese, leading a sedentary lifestyle with little to no exercise, consuming excessive amounts of certain foods like red meat and processed meat products, smoking, and excessive alcohol consumption. It is worth noting that the last two factors are recognized risk factors not only for colorectal cancer but also for other cancers such as lung and liver cancer, as well as various chronic diseases.

Early detection is key to successful cancer treatment and maximizing patient survival rates. Detecting the disease at its earliest stages, before it advances, significantly improves treatment outcomes. Consequently, professional public health associations strive to publish recommendations for timely screening before cancer becomes symptomatic.

The Association of Gastroenterologists of Thailand recommends that individuals aged 50 and older, classified as medium risk, undergo colon cancer screening. However, due to the increasing incidence of colorectal cancer among younger individuals, some guidelines suggest that screening should begin as early as age 45. Moreover, individuals with a higher risk than the general population, such as those with genetic diseases predisposing them to colon cancer, those with first-degree relatives diagnosed with colon cancer or polyps, and those with a history of colon polyps or chronic inflammatory bowel disease, should be screened earlier based on their specific risk factors.

There are three primary screening methods for colon and rectal cancer: occult bleeding tests in the stool conducted every 1-2 years, colonoscopy exams every 10 years (if no abnormalities are detected), and computed tomography of the colon.

Recognizing the significance of this screening, the public sector, through the NHSO, offers cancer screening benefits not only for colorectal cancer but also for cervical cancer and oral cancer. These services are conveniently accessible through various healthcare facilities within the National Health Security system, including National Health Security Hospitals, health centers, and urban health centers. Taking advantage of these services is essential in proactively maintaining one’s health and reducing the likelihood of encountering advanced-stage cancer that is more challenging to treat.

In conclusion, it is crucial for individuals to be informed about the preventive measures against colorectal cancer. By staying vigilant and taking necessary precautions, individuals can minimize their risk and increase their chances of detecting cancer in its early stages, enabling more effective and successful treatment.

-By Professor Dr. Nattada Areepiam and Assistant Professor Dr. Bodin Tiwasuwan, Chulalongkorn University Faculty of Pharmacy.

Monday, 26th June, 2023 7:45 am

Colorectal cancer, or colon and rectal cancer, is a common cancer nationally and globally. According to statistics in 2020, about 20,000 Thai people are ill with this cancer, having ranked as the 4th-5th cancer among Thai people. In the same year, there was a loss of Approximately 10,000 people die from this cancer. From the data, it can be seen that colorectal cancer is a major public health problem at national level. that we must educate the public to take proper care of yourself To reduce morbidity and death from this cancer.

The risk factors for colorectal cancer can be divided into two main categories: modifiable risk factors; and unadjusted risk factors

First, let’s consider the non-modifiable risk factors in order to know how much risk you currently have. and at what level they must be monitored for their own symptoms These risk factors include:

(1) Old age, which is inevitable aging It increases the risk of colon and rectal cancer. Especially the age that increases more than 50 years

(2) Polyps were found in the colon and rectum. or has a history of colon and rectal cancer

(3) chronic inflammatory bowel disease

(4) The presence of certain hereditary diseases such as Lynch Syndrome (hereditary non-polyposis colorectal cancer or HNPCC), familial adenomatous polyposis (FAP), etc.

(6) have a family history of colon cancer

(7) with diabetes

Modifiable risk factors for colorectal cancer that people should be aware of in order to change their behavior to reduce the chance of getting sick Especially in people who are already at risk that cannot be changed, by include:

(1) being overweight or obese

(2) does not exercise or likes to be in a still state

(3) Excessive consumption of certain foods, such as red meat and animal fat Processed meats such as sausage, bacon, etc.

(4) Smoking

(5) drinking alcohol

Items 4 and 5 are known risk factors associated with morbidity and mortality from other cancers such as lung cancer, liver cancer, and other chronic diseases.

The key to successful cancer treatment Extending the patient’s life as long as possible The earliest detection of disease At least before the disease is in its advanced stage. Because when cancer spreads beyond the beginning of the disease, treatment becomes much more difficult.

Therefore, professional public health associations strive to publish recommendations to ensure timely screening. before cancer shows symptoms

Association of Gastroenterologists of Thailand The recommendations for colorectal cancer screening are as follows: Everyone aged 50 and over Classified as medium risk group. He should go for colon cancer screening However, the incidence of colorectal cancer has been found to be higher among younger people in recent years, so some guidelines recommend screening as early as age 45.

who are at greater risk than the general population should be screened earlier according to the risks, including patients with genetic diseases who are at risk of developing colon cancer People with first degree relatives (parents, siblings, blood relatives) with colon cancer or colon polyps found to be at high risk of developing cancer Patients with chronic inflammatory bowel disease or (Inflammatory bowel disease (IBD)) Patients with a history of colon polyps. or have had colon cancer before

There are three main screening methods for colon and rectal cancer:

(1) Check for occult bleeding in the stool every 1-2 years.

(2) a colonoscopy exam which is done almost every 10 years if the results do not detect abnormalities (3) Computed tomography of the colon

The public sector through the NHSO sees the importance of this screening as well. It’s not just colorectal cancer. People with gold patents can enjoy 3 cancer screening benefits: cervical cancer, colon cancer. and oral cancer conveniently by using the service in service units or medical facilities in the National Health Security system, such as the National Health Security Hospital, health centers, urban health centers, hospitals that are regular service units in accordance with their rights or the hospital where you are going to use the service regularly

That’s all, you will be able to know the way to keep your life away from colorectal cancer. And also reduce the chance of finding cancer at a stage that is difficult to treat as well

Professor Dr. Nattada Areepiam and Assistant Professor Dr. Bodin Tiwasuwan

Chulalongkorn University Faculty of Pharmacy

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