An Introduction to Colorectal Cancer

Colorectal cancer, or bowel cancer, is one of the three most common cancers in the
industrial world. It is estimated that 1 in every 20 people will at some stage of their
life suffer from the disease, and additionally 1 in 50 people will die as a direct result
of the cancer. In the UK alone over 375,000 people are diagnosed with the condition
each year, over 100 a day. The majority of cases are detected in the elderly, those
over the age of 60, with 8 out of 10 tumours being found in this group. Despite these
high rates in the Western world, African and South-East Asian countries have far
lower incidence rates.

What is it?

The bowel itself, or gastrointestinal tract (GI tract), forms part of the digestive system.
It consists of the small bowel (small intestine) and the large bowel (colon and
rectum). A cancerous growth in any of the bowel is referred to as colorectal cancer,
although the majority are situated in the large bowel. These usually take 5-10 years to
fully develop, originating as a small polyp-type growth on the bowel wall. Diagnosis
most commonly follows referral from a patients GP. Examination by a bowel cancer
expert through proctoscopy (rectal examination) or sigmoidoscopy (examination of
the lower part of the large bowel), or alternatively full colonoscopy is then usually
conducted. Any abnormal areas or growth can then subjected to biopsy and diagnosis
of the condition confirmed.

Cause of the disease

There are a number of possible factors that increase the risk of developing colorectal
cancer, which include:
o Obesity, or being overweight
o Having a first degree relative suffering from colorectal cancer makes
the likelihood of tumour development twice the average
o Diet consisting of high levels of red and processed meat
o Excessive alcohol consumption (over 4 units daily)
o Lack of physical exercise

o Sufferers of diabetes and Cohns disease also have increased risk of

cancer development

Treatment
The most common treatment, as with the majority of cancerous tumours, is surgery to
remove the infected tissue. This procedure is usually adopted with 8 out of 10
patients. Additionally chemotherapy and radiotherapy may also be adopted in order
to eradicate the cancerous cells. The type of surgery adopted depends on both size
and location of the tumour. The smaller growths detected early on may be removed
through simple excision, known as local resection. Larger growth removal, or
tumours at a later stage of development, often requires the removal of a portion of the
bowel. The remaining ends are then linked together. Removal of large portions of the
bowel can also result in permanent colostomy or ileostomy. Unfortunately of all
bowel cancer sufferers treated with surgery, the cancer has been recorded to return in
approximately 50% of the cases.

Current prevalence

Over the last 30 years there has been a steady increase in the number of colorectal
cancer cases in the UK. This has been mirrored by an increase in survival rate for
those treated for the disease with a decrease in mortality rate of 16% over that period.
During 2006, 20,430 new cases of male bowel cancer were diagnosed, and 17,084
female cases in the UK. This equates to 56 and 36.4 cases per 100,000 respectively.

Additional Reading

For further details regarding colorectal cancer the following websites are particularly
informative: http://www.cancerhelp.org.uk/type/bowel-cancer/index.htm
http://info.cancerresearchuk.org/cancetrstats/

References
The majority of the details contained within the above report were obtained from the
two websites listed above. In addition the website http://www.nbocap.org.uk/ was
also used. The graph was taken directly from and the bowel diagram from
http://www.bhrhospitals.nhs.uk/cancerservices.