Bowel Cancer

How common is bowel cancer?

Cancer of the large bowel (colon and rectum) is the third common cause of death from cancer. Cancer of the small bowel (duodenum, jejunum and ileum) is quite rare.

In Palliser Health Region (PHR), about 44 new cases of colon and rectal cancers are diagnosed each year. And about 20 patients die from this disease each year.

The incidence of colon and rectal cancer between the ages of 20-49 years is less than 0.18 cases per 1000 population. Between 50-59 years of age, it is less than 0.66 cases per 1000 population. After this the incidence of colon and rectal cancer jumps from 1.74 cases/1000 population at 60 to 3.85 cases/1000 population at age 90.

According to the statistics published by the Alberta Cancer Board, the incidence and death rates for all cancers in PHR are similar to provincial rates. Exception being the female breast cancer incidence rate – it appears to be lower than the provincial rate.

The statistics also show that number of new cases of cancer (all cancers) among males in PHR is consistently higher than females.

What symptoms and signs one should look for?

Rectal bleeding is the most important symptom. It should never be ignored at any age. Most rectal bleeding is due to benign disease. But one can never be sure until the symptom has been investigated and cause of the bleeding is identified.

A person over 60 with rectal bleeding, anemia, weight loss, and mass in the abdomen or rectum probably has colon or rectal cancer – unless it can be proven otherwise.

Other symptoms of significance are: change in bowel habit, change in caliber of stool, and sense of incomplete defecation.

What investigations are required to check for colon and rectal cancer?

A good history and physical examination is very important in all patients. This includes a rectal examination. A blood test may be ordered to check if you are anemic. If there are bowel symptoms without obvious rectal bleeding then stool can be checked for hidden blood (fecal occult blood test – FOBT).

Further investigation depends on your age and risk factors. Patients with low risk factors can be investigated with a flexible sigmoidoscopy (a 60cm flexible instrument). Barium enema may become necessary in some patients. Patients with high risk factors require a colonoscopy (a 160 cm flexible instrument).

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