What are the signs and symptoms of early colorectal cancer?

  Colorectal cancer including rectal cancer and colon cancer is one of the common malignant tumors, and the incidence of colorectal cancer ranks third among male malignant tumors and second among female malignant tumors, and basically about 80% of colorectal cancer is already in the middle and late stages when it is found. The treatment effect of colorectal cancer is directly related to the early and late detection. The five-year survival rate of early colorectal cancer can reach 90%-95% after resection, while the five-year survival rate of late colorectal cancer is less than 20% after surgery, so the early detection of colorectal cancer is very important. So what distress signals will be issued by colorectal cancer in early stage? How can we detect it at an early stage?  Pre-cancerous lesions of colorectal cancer are the earliest distress signals The occurrence of cancer is a gradual evolutionary process, and some benign diseases of human body are more prone to abnormal cell proliferation with the tendency of malignant changes, and these abnormal proliferation lesions with the tendency of cancer are called pre-cancerous lesions. Therefore, precancerous lesion is the earliest signal of cancer. So what are the precancerous lesions of colorectal cancer?  1、Colon polyposis: polyposis is completely different from multiple polyps. It is generally believed that the number of intestinal polyps exceeds 100 before it is called intestinal polyposis. Among them, familial adenomatous polyposis is the most important precancerous disease. This is a common chromosomal dominant disease, mostly seen in adolescents, with a mutation rate of 88%. The probability of cancer is related to the time of discovery, age, number and volume of polyps.  2, colorectal polyps: colorectal polyps, especially adenomatous polyps, are both precancerous and precancerous diseases, accounting for about 85% of all precancerous colorectal diseases. Therefore, care about colorectal polyps is to attach importance to precancerous colorectal diseases.  3, inflammatory bowel disease (including ulcerative colon and Crohn’s disease): due to the long course of the disease, easy to attack and complex condition, low cure rate and high cancer rate compared with normal population.  Symptoms and signs of early colorectal cancer Early colorectal cancer often does not have any clinical manifestations, or there are some mild clinical manifestations, which are often not noticed. However, if the following symptoms appear, we should still pay high attention to them.  1. Abnormal stool: If there is a sudden change in the habit of stool, and the stool is irregularly shaped or sticky, it means that the stool has become abnormal. Patients with rectal cancer may have more frequent stools, but not much stool or even no stool at all, only some mucus and blood are discharged, and there is a feeling of incomplete defecation. If the cancer grows prominently into the rectal cavity, resulting in the relative narrowing of the intestinal cavity, the discharged stool often becomes thin and deformed, which can be flat, and sometimes some blood is attached to the deformed stool.  2、Blood in stool: For patients with colorectal cancer, the most important symptom is the occurrence of blood in stool. Blood in stool may not always be red, but may also appear in black, purple and other colors, and may also appear in some sticky stools. If the lesion is close to the anus, so the blood is mostly bright red or dark red, and often the blood is separated from the stool. Only when the amount of bleeding is high, brownish red and jam-like stools are seen. Blood in the stool visible to the naked eye accounts for 36.5% of patients with right hemicolectasis.  3、Phenomenon of abdominal distension and abdominal pain: In the early stage of colorectal cancer, intermittent abdominal pain can occur, especially before and after stool, and abdominal pain caused by colorectal cancer. In most cases, once abdominal pain occurs, it is often obstruction of the intestine or incomplete intestinal obstruction, and if further aggravated and completely blocked the intestine, the pain will gradually increase. Abdominal pain is often mildly relieved by defecation, or after exhaustion.  4. Alternating diarrhea and constipation: Another very significant feature of colorectal cancer patients is that they will have diarrhea, and this diarrhea is alternating with constipation. This is mainly because when the tumor in the large intestine becomes bigger, it will increase the intestinal blockage and thus the phenomenon of constipation will occur.  5. Appearance of anemia: anemia is an early symptom of colorectal cancer, and it should be noted that anemia does not appear suddenly, and chronic anemia is not easy to be detected. Patients with right hemicolectomy cancer have more significant anemia.  How to detect colorectal cancer in early stage Colorectal cancer has no specific symptoms in early stage. Therefore, early colorectal cancer screening is the most important method to detect early colorectal cancer in the asymptomatic natural population, through which pre-cancerous colorectal lesions can be detected or diagnosed in the early stage of colorectal cancer, thus obtaining good prognosis.  Early screening methods of colorectal cancer 1、Non-invasive screening: fecal occult blood test, fecal immunochemical test and fecal deoxyribonucleic acid test.  2、Invasive screening: anal finger examination and colonoscopy. Colonoscopy can perform pathological biopsy on suspicious lesions and determine whether there are malignant changes or cancer cells under the microscope, which is the gold standard of colorectal cancer screening.  Who needs early screening for colorectal cancer 1. People with family history of bowel cancer: Those who have immediate family members who have suffered from colorectal cancer have 8 times higher risk of developing this disease in their lifetime than others. About 1/4 of colorectal cancer patients have a family history of the disease.  2、Patients with colon polyps: Most colorectal cancers develop from colon polyps. Among them, choroidal adenoma-like polyps are more likely to develop into cancer, and the chance of cancer is about 25%; the cancer rate of tubular adenoma-like polyps is 1%-5%.  3、High age group: Most of the patients with colorectal cancer are above 50 years old. As age increases, the time of stimulation of colorectal mucosa by various pathogenic factors also grows, so the age of onset of colorectal cancer is also higher, and there are some patients with earlier onset.  4、Patients with inflammatory bowel disease: Crohn’s disease or ulcerative colitis may increase the chance of colorectal cancer, and their risk of developing colorectal cancer is 30 times higher than that of normal people.  5、Smokers and alcohol drinkers: Studies show that smokers have a higher risk of colorectal cancer than non-smokers. People with family history of colorectal cancer and colorectal polyps who consume more than or equal to 30 grams of alcohol daily will increase the risk of colorectal cancer.  Colonoscopy is the most accurate way to diagnose colorectal cancer Colonoscopy is the most direct and accurate way to diagnose colorectal cancer, and is increasingly being used in the diagnosis and treatment of colorectal cancer, becoming the “gold standard” for colorectal cancer diagnosis. The American Cancer Society (ACS) recommends that people over the age of 50 should undergo colonoscopy once every five years. For high-risk groups, the age of routine screening should be 10 years earlier, and annual colonoscopy should be pursued. People who are at high risk of colorectal cancer, those who show danger signs of colorectal cancer, those who have positive occult blood in stool or those who have abnormalities on rectal examination should undergo colonoscopy early for early diagnosis of colorectal cancer.

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