Cancer is a serious public health problem in the world, about 8 million people die of cancer worldwide every year, among which colorectal cancer is the most common gastrointestinal malignancy among human beings, with the third highest incidence rate of malignant tumors worldwide, and in western developed countries, colorectal cancer has become the second largest malignancy after lung cancer. Colorectal cancer is the second largest killer among tumors, with 140,000 new cases and 50,000 deaths per year in the United States and the highest incidence in North America and Europe among developed countries, with 15-20 deaths from colorectal cancer per 100,000 people. The incidence rate of colorectal cancer in our country has been rising year by year in the past decade
The incidence of colorectal cancer in our country has been increasing year by year in the last decade, with about 400,000 new cases and 195,000 deaths per year, and the annual growth rate in China is about 4.2%, far exceeding the international average of 2%, and colorectal cancer has jumped from the sixth place to the third place, and is the second place in Shanghai, after lung cancer.
The incidence of colorectal cancer is generally closely related to dietary factors, such as frequent consumption of fried, barbecued and pickled foods, the incidence of colorectal cancer is higher; chronic inflammation of the colorectum, such as patients suffering from Crohn’s disease and ulcerative colitis, the incidence of colorectal cancer is three times higher than normal; related to genetic factors; d, precancerous lesions, patients suffering from intestinal polyps, the incidence of colorectal cancer is generally higher than those without polyps.
Colorectal cancer generally has no obvious symptoms in the early stage, and when there are symptoms, it is mostly middle and late stage tumor, and the clinical manifestations of colorectal cancer in different parts are different.
1. Clinical manifestations of right hemicolectomy colon cancer
① abdominal pain: mostly hidden pain.
②Anemia: 50%-60% of patients have hemoglobin below 100g/L.
③Abdominal mass: Most of the masses are palpated in the right lower abdomen.
2. Clinical manifestations of left hemi-colon cancer
① blood in stool, mucus and blood in stool.
② abdominal pain: mostly occult pain, and colic may appear when accompanied with intestinal obstruction.
③Abdominal mass: about 40% of patients can palpate the left abdominal mass.
3. Clinical manifestations of rectal cancer
Rectal irritation symptoms: frequent bowel movements, change of bowel habits, with a feeling of urgency and
heavy feeling and incomplete defecation.
②Symptoms of intestinal stenosis: cancer invasion causes narrowing of the intestinal cavity, and at first the stool becomes deformed and thin.
The symptoms of intestinal stenosis: the cancer invasion causes the narrowing of the intestinal lumen, and the stool becomes deformed and thin, and in severe cases, intestinal obstruction appears.
Primary prevention of colorectal cancer.
Most of the sporadic colorectal cancer is closely related to environmental factors, especially dietary factors, and dietary intervention can reduce the incidence of colorectal cancer
Most studies have shown that total energy intake is related to the risk of colorectal cancer, and reducing energy intake may reduce the incidence of colorectal cancer.
②Fat and red meat colorectal cancer is closely related to animal fat and meat. Some studies have shown that women with high fat intake have a 32% increased risk of colorectal cancer compared to women with low fat, and reducing the fat content in food can help prevent the occurrence of colorectal cancer.
③Fruit, vegetables and dietary fiber fiber can increase the amount of stool, dilute carcinogens in the colon and adsorb bile acid salts, which can reduce the occurrence of colorectal cancer
④Vitamins and trace elements have shown that proper supplementation of natural vitamins A, C, and E can transform the overgrowth of colonic epithelium in adenoma patients into normal; proper supplementation of folic acid can also reduce the incidence of colorectal cancer
⑤ Dietary anti-carcinogenic dietary garlic, onions, leeks, and shallots contain thioether. Plant phenols contained in grapes, strawberries, apples and carotenoids contained in carrots and watermelon are considered to be able to inhibit mutations and have anti-cancer effects, especially garlic, which has been shown to be the vegetable with the strongest protective effect to save people from distal colon cancer.
2. Change of life habits
Obesity and exercise are independent risk factors of colorectal cancer, especially abdominal obesity, and low physical activity is a risk factor of colorectal cancer, and physical activity can influence colon peristalsis and facilitate fecal discharge, thus preventing colorectal cancer.
Smoking and alcohol consumption are risk factors for colorectal adenoma, and current research suggests that smoking and alcohol consumption are stimulating factors for colorectal cancer gene production
③Reproductive factors American research shows that the incidence of colorectal cancer in single women is higher than that in married women, which may be related to hormones that can affect bile acid salt metabolism.
3. Treatment of precancerous lesions
Patients with colorectal adenoma and ulcerative colitis have significantly increased the incidence of colorectal cancer. Through screening and follow-up, early removal of adenoma and treatment of colitis can reduce the incidence and mortality of colorectal cancer, especially for those with family history, screening out high-risk groups through genetic examination and colonoscopy is an important aspect of colorectal cancer prevention.
Secondary prevention of colorectal cancer.
Secondary prevention of tumor, i.e. early detection, early diagnosis and early treatment to prevent or reduce death caused by tumor, the occurrence and development of colorectal cancer is a relatively long process, from precancerous lesion to invasive cancer, which is estimated to take 5~10 years, which provides opportunities for census to detect early lesions, and census is an important means of secondary prevention.
Tertiary prevention of colorectal cancer.
Tertiary prevention treats tumor patients actively to improve patients’ quality of life and prolong survival. Currently, surgery is the main treatment for colorectal cancer patients, supplemented by appropriate radiotherapy, Chinese medicine treatment and immunotherapy to improve the treatment effect of colorectal cancer.
Timely colonoscopy is recommended for the following groups.
People over 45 years old.
Those with hemorrhoids and long-term blood in stool, which cannot be treated as hemorrhoids only. 80% of rectal cancer patients were misdiagnosed as hemorrhoids or missed in their first visit.
People with colorectal cancer disease in the immediate family.
Those with diarrhea lasting for more than 3 months
Those who have frequent constipation, black blood stools and mucus stools
Those with chronic appendicitis or those who still have right lower abdominal pain even after appendectomy and after cholecystectomy.
Those with anemia, pernicious anemia, and significant weight loss in the last 3 months
Those who find abdominal masses.