According to the World Health Organization (1), colorectal cancer is the third most common cancer worldwide, with nearly 2 million cases diagnosed in 2020 (2).
Colorectal cancer is also the second leading cause of cancer deaths worldwide. It was responsible for nearly 1 million deaths in 2020.
As with all types of cancer, the prognosis and chances of survival depend on the stage of the disease at diagnosis. If the disease is diagnosed early, the prognosis is very good. Unfortunately, this cancer is often diagnosed at a late stage, often with metastases, and the 5-year survival rate is very bleak.
That’s why screening for colorectal cancer is crucial to finding this cancer early. In the US, the US Preventive Services Task Force (USPSTF) recommends screening for CRC starting at age 50 years and continuing until age 75 years (3). This recommendation is also common in many other countries, where screening is typically recommended for adults between the ages of 50 and 75. Some countries are lobbying to bring the recommended screening age to 45 years.
The importance of colorectal cancer screening
Colorectal cancer screening is crucial for detecting and preventing the development of colorectal cancer, which can have a significant impact on a patient’s prognosis (4). Screening tests include stool tests, colonoscopies, and virtual colonoscopies, all of which aim to identify abnormal growths or polyps in the colon or rectum that may indicate the presence of cancer or a precancerous condition. Early detection of these abnormal growths allows for their removal before they become cancerous, preventing the development of colorectal cancer (5).
Among the screening tests, a colonoscopy is a common procedure that involves the use of a long, flexible tube with a tiny camera and light on the end, called a colonoscope. The procedure is typically performed under sedation to minimize discomfort, and it allows doctors to carefully examine the lining of the colon and rectum for any abnormalities. If any abnormal tissue or polyps are detected during the colonoscopy, the doctor may take a biopsy for further analysis or remove them altogether. These tests are designed to detect the presence of abnormal growths or polyps in the colon or rectum that may indicate the presence of cancer or a precancerous condition. If detected early, these abnormal growths can be removed before they become cancerous, thus preventing the development of colorectal cancer.
The importance of screening for colorectal cancer cannot be overstated. It is estimated that if everyone over the age of 50 underwent regular colorectal screening, deaths could be reduced by up to 60% (6). In addition, because colorectal cancer often develops without symptoms, regular screening is the only way to detect it before it becomes advanced and more difficult to treat.
Raising awareness of the importance of colorectal cancer screening is crucial to improving screening rates and reducing the incidence of this cancer. This includes educating people about the risks of colorectal cancer, the benefits of early detection and the different screening options available. It is also important to address common misconceptions and fears that may prevent people from being screened, such as discomfort during the procedure.
How to test?
Colorectal cancer is typically screened using a combination of different tests, which may include a stool test, a colonoscopy, a sigmoidoscopy, or a virtual colonoscopy.
Stool tests can detect the presence of blood in the stool, which may indicate the presence of colorectal cancer, while colonoscopies and sigmoidoscopies allow doctors to examine the inside of the colon and rectum for any abnormal growths or polyps.
Virtual colonoscopies use specialized X-ray technology to create images of the colon and rectum, allowing doctors to identify any potential abnormalities. The type and frequency of recommended testing may vary depending on a person’s age, family history, and other risk factors. It is recommended that individuals talk to their doctor about the appropriate screening tests and schedule regular screening appointments as advised.
In some countries, you can purchase a home test kit to collect a small sample of poo and send it to a lab.
Why should you do physical activity?
In addition to the early detection discussed above, it is also important to pinpoint the positive impact of physical activity on the development of colorectal cancer.
Numerous medical studies have established a significant association between regular physical activity and a reduced risk of developing colorectal cancer (7, 8). In fact, it has been demonstrated that regular physical activity may decrease the incidence of colorectal cancer by up to 50%. Various hypotheses have been proposed to explain this association, including the potential for physical activity to reduce chronic inflammation and insulin resistance, both of which are well-established risk factors in the development of cancers.
Furthermore, physical activity has been shown to improve outcomes for individuals who have already been diagnosed with colorectal cancer, including an improvement in survival rates and a reduced risk of recurrence. These findings suggest that physical activity should be considered as an important modifiable lifestyle factor in the prevention and management of colorectal cancer.
March is Colorectal Cancer Awareness Month and is often used to raise awareness of all screening options. By detecting and removing abnormal growths before they become cancerous, colorectal cancer screening can save lives (9). During this month, communication and education campaigns are launched to raise awareness among adults, particularly young adults, about the importance of undergoing screening for colorectal cancer.
Raising awareness of the importance of colorectal cancer screening is crucial to improving screening rates and reducing the incidence of this cancer. By educating people about the benefits of early detection and addressing common misconceptions and fears, we can encourage more people to undergo this important test and ultimately save lives.
In addition to raising awareness of the importance of colorectal cancer screening, it is also crucial to educate the public on the benefits of regular physical activity in the prevention of colorectal cancer. By promoting physical activity as a key modifiable lifestyle factor, we can reduce the risk of developing colorectal cancer and improve overall health.
By increasing public awareness and understanding of the importance of physical activity in colorectal cancer prevention, we can work towards reducing the burden of this disease and improving population health.
For more information on this topic, you can visit the DICE (Digestive Cancers Europe) website at the following address https://eccam2023.digestivecancers.eu
3) Jennifer S Lin, Leslie A Perdue et al. Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021 May 18;325(19):1978-1998.
4) Chyke A Doubeni, Douglas A Corley et al. Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study.
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5) Hermann Brenner, Matthias Kloor et al. Colorectal cancer. Lancet. 2014 Apr 26; 383(9927):1490-1502.
6) Ann G Zauber. The Impact of Screening on Colorectal Cancer Mortality and Incidence – Has It Really Made a Difference? Dig Dis Sci. 2015 Mar; 60(3): 681–691.
7) Krasimira Aleksandrova, Mazda Jenab et al. Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort. International Journal of Epidemiology, Volume 46, Issue 6, December 2017, Pages 1823–1835
8) K Y Wolin, Y Yan et al. Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer. 2009. Feb 24; 100(4): 611-616
9) Haddon J Pantel, David A Kleiman et al. Has National Colorectal Cancer Awareness Month increased endoscopy screening rates and public interest in colorectal cancer? Surg Endosc. 2021 Jan;35(1):398-405.