Colorectal cancer is a common malignant tumor. It is a collective term for rectal cancer and colon cancer, and it mostly occurs in middle-aged and elderly people. In 2007, there were 1.2 million new cases worldwide and 630,000 deaths from colorectal cancer, and the incidence rate continued to rise, increasing by 2% every year.
Due to the effectiveness of preventive measures and health education, the incidence of colorectal cancer in the United States is currently in a declining stage, and most of it is early: In 2006, there were 140,000 cases and more than 50,000 deaths; while in China, it was on the rise, and most of them were diagnosed It is late: in 2005, there were 172,000 cases and 99,000 deaths. There are 3706 new cases in Hong Kong, China, which is an increase of 124 cases from 2004. It is second only to lung cancer among all cancers. This shows that most cases in China are found in the late stage, while the United States has more cases in the early stage. The cure rate of early detection is very high.
In China, Shanghai has the highest incidence of colorectal cancer, the second highest among all tumors, with an annual growth rate of 4.2% in recent years. This is related to the westernization of lifestyles. Meat consumption has increased rapidly, which is similar to that in the United States. excess. The incidence of Guangzhou ranks third among all tumors.
Why is the incidence of colorectal cancer in modern people getting higher and higher?
The following reasons have caused the increase in the incidence of colorectal cancer:
Bad lifestyle-more meat, less vegetables, less fruit, less exercise (According to the immigration epidemiological survey, the incidence of bowel cancer was low in the original Chinese and Japanese, but after immigrating to the United States, it became more common due to lifestyle changes.
Precancerous lesions-intestinal adenoma, ulcerative colitis.
Inheritance-familial adenomatous polyposis, a family history of this disease or more than 100 intestinal polyps in the family is a familial inheritance, most of these patients are younger, and the most found in this hospital is more than 3,000 polyps. There is also a type of HPNCC (hereditary non-polyposis colorectal cancer), which accounts for 10%-15% of colorectal cancer patients. This type of patients has three characteristics: There are three or more colorectal cancer patients in the family, and one of them is First-class relative, onset before 50 years old. This type of genetic disease is dominant. About 50% of the next generation of patients will develop colorectal cancer. (Doctors find that such patients will generally "check three generations", that is, the previous generation and offspring, as well as the patient itself. The dominant inheritance is not For men and women). If familial adenomatous polyposis is not treated, colorectal cancer occurs almost 100% before the age of 50.
Other reasons: obesity; diabetes, hypertension and other diseases; endemic factors (such as schistosomiasis, etc.).
The onset of bowel cancer in humans is 12 to 18 years earlier than Westerners. Therefore, the United States proposes that the first colonoscopy should be performed at the age of 50 regardless of symptoms, while in China it is 40. However, due to fear of pain and other reasons, the compliance of colonoscopy is poor. About 25% of those who refuse to do colonoscopy in the United States, and China even more.
The incidence of colorectal cancer is so high, why are many people already at an advanced stage when it is discovered? Are the symptoms not obvious? What are its symptoms?
Generally speaking, the symptoms of colorectal cancer are more obvious, and people are diagnosed at an advanced stage because of carelessness. The symptoms of colorectal cancer include the following 5 common symptoms:
1. Changes in bowel habits: increased stool frequency or constipation, or constipation and diarrhea alternately;
2. Blood in stool: Blood in stool, usually bright red or jam-colored, is the most common symptom of colorectal cancer;
3. Intestinal obstruction: usually accompanied by abdominal pain, because the tumor grows very large and blocks the intestine;
4. Abdominal mass: common in the right colon, that is, ascending colon cancer is more common in abdominal mass;
5. General weakness, anemia, weight loss, fatigue, fever, and even cachexia (more common in late stages).
In China, if you have unexplained bloody stools, mucous stools, and changes in bowel habits, you must go to the hospital for examination.
If you have the above symptoms and seek medical treatment in the hospital, is there any way to accurately check whether you have colorectal cancer?
There are many ways:
1. Digital rectal and anus examination, because more than 50% of colorectal cancers in China occur in the rectum, and 80% of rectal cancers are in the middle and low position, which can be detected by digital rectal and anus examination.
2. Stool examination: Although the fecal occult blood test has no specificity for the diagnosis of this disease, the method is simple and easy to implement. It can be used as a screening method for census, or can provide clues for early diagnosis.
3. Barium enema X-ray examination: If the lesion is in the upper part of the sigmoid colon or higher, X-ray barium enema is required. Ordinary barium enema X-ray examination is easy to miss the diagnosis of small colorectal cancer. It is best to use air-barium double contrast, which can improve the correct rate of radiological diagnosis and show the location and scope of the cancer.
4. The most clear examination method is colonoscopy, commonly known as colonoscopy, which is divided into fiber colonoscopy and sigmoid colonoscopy.
5. Sigmoidoscopy: 77.7% of domestic colorectal cancers occur in the rectum and sigmoid colon. The commonly used sigmoidoscopy tube is 30cm long and can directly find tumors below the middle of the anal canal, rectum and sigmoid colon.
6. Fibrocolonoscopy: It can clearly observe the entire colon, and can clamp suspicious lesions for pathological examination under direct vision, which is conducive to the discovery of early and small colon cancer and the diagnosis of cancer, and further improves the diagnosis of this disease The correct rate is the most important inspection method for colorectal cancer.
There is also a newest technology: "Large Intestine Capsule Endoscope". The biggest advantage of this technique is that it is not invasive, but it can directly observe the large intestine wall. The front and back ends of the capsule are equipped with a lens and a wireless receiver, which is more convenient to use. The patient only needs to swallow a vitamin-sized capsule. The capsule transmits a signal to the receiver carried by the patient, and the doctor examines the intestines through photos , The entire inspection takes about 10 hours. This technology is mainly used in Europe, such as France and other places. It was introduced in Hong Kong in April this year. The capsule has no side effects, the risk is lower than traditional colonoscopy, and there is no danger of puncturing the intestine due to inspection, but the price is higher, and It can only suggest intestinal lesions and cannot be diagnosed by biopsy.
Colorectal cancer has a considerable misdiagnosis rate in China, especially in primary hospitals. Why does this happen?
Doctors don't pay enough attention to colorectal cancer. Doctors and patients are reluctant to perform digital rectal and anal examinations, which delays the disease. There is a saying: "It is better to build a seven-level buddha." It shows that in fact, the most basic and simple examination method-digital rectal anus examination can save many patients, and also shows its importance and necessity. However, patients and some non-specialist doctors do not have sufficient knowledge of colorectal cancer and lack the necessary vigilance. They often attribute symptoms such as blood in the stool and changes in stool to hemorrhoids and enteritis, which delays the disease.
If unfortunately suffer from bowel cancer, how to treat it?
Surgical resection is the first choice for the treatment of colorectal cancer, supplemented by radiotherapy, chemotherapeutics and Chinese medicine. Recently, many scholars have adopted endoscopic resection for early colorectal cancer, and have achieved good results. As for how to choose the best plan, it must be based on different clinicopathological stages. The key to the treatment of colorectal cancer is early detection and early diagnosis.
1. Surgical treatment: The only radical cure for colorectal cancer is early removal of the cancer. If cancer metastasis is found during the exploration, but the diseased bowel is still free, in principle, the colorectal cancer should be removed to avoid intestinal obstruction in the future; on the other hand, the cancer often has erosions, oozing, or secondary Infection, after removal, the overall condition can be improved. For patients with extensive cancer metastasis, if the diseased intestinal segment cannot be removed, palliative surgery such as fistula or shortcut should be performed.
2. Chemotherapy: After radical resection of colorectal cancer, there are still about 50% cases of recurrence and metastasis, mainly because the hidden metastases were not found before the operation or the lesions were not completely removed during the operation. Therefore, before laparotomy, systemic chemotherapy or intra-intestinal chemotherapy can be performed first, which can prevent the spread of cancer cells, kill and destroy cancer cells. Continuing chemotherapy after surgery may improve the 5-year survival rate after radical surgery.
3. Radiotherapy: The curative effect is not yet satisfactory. Some people believe that: ①Preoperative radiotherapy can shrink the tumor, increase the resection rate, reduce regional lymphatic metastasis, intraoperative cancer cell dissemination and local recurrence; ②Postoperative radiotherapy: for surgery Radical treatment cases, if the tumor has penetrated the intestinal wall, invaded the local lymph nodes, lymphatics and blood vessels, or the tumor remains after surgery, but there is no distant metastasis, postoperative radiotherapy is recommended; ③Radiotherapy alone: for advanced rectal cancer In cases, low-dose radiation therapy can sometimes provide temporary hemostasis and pain relief.
4. Other treatments such as cryotherapy, cryotherapy is the use of refrigerant liquid nitrogen, after fully exposing the tumor through the anoscope, the use of different sizes of shell-type freezing heads to contact the tumor tissue, can effectively kill and destroy the tumor tissue. When the middle and late stage patients cannot operate, it can be used as appropriate to reduce the patient's pain and avoid artificial anus. With chemotherapy, it can achieve satisfactory results. In recent years, people have explored biological treatments. The cooperation of traditional Chinese medicine and traditional Chinese medicine makes the operation, radiotherapy and chemotherapy more smoothly and improves the effect.
How to prevent colorectal cancer?
The main prevention method for colorectal cancer is to focus on screening. The United States proposes that 50-year-old ordinary people should have their first colonoscopy. The age of onset of people is 12 to 18 years earlier than that of Westerners. Therefore, it is recommended to have the first colonoscopy after 40 years old. If no polyps are found, they can be checked again after 5 to 10 years. If polyps are found, the second after polyp removal It is still necessary to check every year until no polyps are found, and then recheck for 2 to 3 years to ensure early detection, because some adenomatous polyps are signs of precancerous lesions. Early treatment of polyps is an important way to prevent colorectal cancer. At the same time, attention should be paid to the following aspects.
1. Avoid long-term consumption of high-fat and high-calorie foods, and eat more fiber-rich foods to keep stool smooth;
2. Eat more natural cancer-suppressing foods such as fresh vegetables, fruits, garlic, tea, and appropriately supplement vitamin A, B12, C, D, E and folic acid;
3. Actively prevent and treat precancerous lesions. Patients with intestinal polyps, especially familial adenomatous polyposis, must be removed as soon as possible; vigorously prevent haemorrhagiasis and schistosomiasis granuloma;
4. People with genetic susceptibility to cancer and family history of cancer should undergo colonoscopy regularly; those who have had recent progressive weight loss and changes in bowel habits should also undergo relevant examinations as soon as possible in order to detect them as soon as possible;
5. Patients with early bowel cancer after surgery or radiotherapy should be reviewed regularly to find early recurrence and treat them in time.