Affects: Large intestine12–48 h
Colorectal cancer: prevention
One of the most common cancers and, at the same time, one of the most preventable: it almost always begins as a polyp that takes years to transform.
Why it is preventable
Most colorectal cancers start as an adenomatous polyp, a small benign lesion that can take 10 to 15 years to become malignant. That window is an enormous opportunity: if the polyp is found and removed, the cancer simply never comes into existence. This is one of the few situations in medicine where screening does not just detect early, it prevents the disease.
When to start screening
The major scientific societies recommend beginning at age 45 for people at average risk. If you have first-degree relatives with colorectal cancer or advanced polyps, hereditary syndromes, or inflammatory bowel disease, screening should start earlier and repeat at shorter intervals.
Screening options
- Colonoscopy: visualises the whole colon and removes polyps in the same session
- Fecal immunochemical test (FIT): annual, non-invasive, detects hidden blood
- Stool DNA tests and CT colonography depending on availability and medical judgement
The best test is the one a person actually completes. An annual FIT done reliably is worth more than a colonoscopy postponed indefinitely.
Reducing the risk
- Not smoking and limiting alcohol
- Maintaining a healthy weight and staying physically active
- A diet rich in fibre, vegetables and legumes
- Limiting red meat and, above all, processed meat
- Ensuring adequate calcium and vitamin D intake
When something goes wrong
- IBSA disorder of gut-brain interaction: the bowel works abnormally and is more sensitive, even though there is no visible damage to its structure.
- Chronic constipationInfrequent, hard or difficult-to-pass bowel movements for at least three months, with straining and a sense of not being finished.
- Chronic diarrheaLoose or liquid stools most of the time for more than four weeks. It is a symptom, not a diagnosis: the point is to find the cause.
