colon cancer| 有名人の最新ニュースを読者にお届けします。

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私たちは、何年もの間、日本のエンターテインメント ニュースを生き、呼吸してきた情熱的なエンターテインメント ニュース ジャンキーの小さなチームです。

colon cancer, 2021-09-01, Colon Cancer Prevention Tips and Screening Recommendations, Colorectal Health, Neil Parikh, MD, Gastroenterologist, Hartford HealthCare Digestive Health Center, discusses colon cancer and prevention tips, colorectal cancer screening recommendations at 45, better survival rate if caught earlier., Hartford HealthCare

Overview

Colon cancer is a type of cancer that begins in the large intestine (colon). The colon is the final part of the digestive tract.

Colon cancer typically affects older adults, though it can happen at any age. It usually begins as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time some of these polyps can become colon cancers.

Polyps may be small and produce few, if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying and removing polyps before they turn into cancer.

If colon cancer develops, many treatments are available to help control it, including surgery, radiation therapy and drug treatments, such as chemotherapy, targeted therapy and immunotherapy.

Colon cancer is sometimes called colorectal cancer, which is a term that combines colon cancer and rectal cancer, which begins in the rectum.

Symptoms

Signs and symptoms of colon cancer include:

• A persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
• Rectal bleeding or blood in your stool
• Persistent abdominal discomfort, such as cramps, gas or pain
• A feeling that your bowel doesn’t empty completely
• Weakness or fatigue
• Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on the cancer’s size and location in your large intestine.

When to see a doctor

If you notice any persistent symptoms that worry you, make an appointment with your doctor.

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Diagnosis

Screening for colon cancer

Doctors recommend certain screening tests for healthy people with no signs or symptoms in order to look for signs of colon cancer or noncancerous colon polyps. Finding colon cancer at its earliest stage provides the greatest chance for a cure. Screening has been shown to reduce your risk of dying of colon cancer.

Doctors generally recommend that people with an average risk of colon cancer begin screening around age 45. But people with an increased risk, such as those with a family history of colon cancer or African-American heritage, should consider screening sooner.

Several screening options exist — each with its own benefits and drawbacks. Talk about your options with your doctor, and together you can decide which tests are appropriate for you. If a colonoscopy is used for screening, polyps can be removed during the procedure before they turn into cancer.

Diagnosing colon cancer

If your signs and symptoms indicate that you could have colon cancer, your doctor may recommend one or more tests and procedures, including:

• Using a scope to examine the inside of your colon (colonoscopy). Colonoscopy uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found, your doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis and remove polyps.

• Blood tests. No blood test can tell you if you have colon cancer. But your doctor may test your blood for clues about your overall health, such as kidney and liver function tests.

  Your doctor may also test your blood for a chemical sometimes produced by colon cancers (carcinoembryonic antigen, or CEA). Tracked over time, the level of CEA in your blood may help your doctor understand your prognosis and whether your cancer is responding to treatment.

Determining the extent of the cancer

If you’ve been diagnosed with colon cancer, your doctor may recommend tests to determine the extent (stage) of your cancer. Staging helps determine what treatments are most appropriate for you.

Staging tests may include imaging procedures such as abdominal, pelvic and chest CT scans. In many cases, the stage of your cancer may not be fully determined until after colon cancer surgery.

The stages of colon cancer are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating cancer that is limited to the lining of the inside of the colon. By stage IV, the cancer is considered advanced and has spread (metastasized) to other areas of the body.

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From Mayo Clinic to your inbox

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.

To provide you with the most relevant and helpful information, and understand which
information is beneficial, we may combine your email and website usage information with
other information we have about you. If you are a Mayo Clinic patient, this could
include protected health information. If we combine this information with your protected
health information, we will treat all of that information as protected health
information and will only use or disclose that information as set forth in our notice of
privacy practices. You may opt-out of email communications at any time by clicking on
the unsubscribe link in the e-mail.

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Signs and symptoms[edit]

The signs and symptoms of colorectal cancer depend on the location of the tumor in the bowel, and whether it has spread elsewhere in the body (metastasis). The classic warning signs include: worsening constipation, blood in the stool, decrease in stool caliber (thickness), loss of appetite, loss of weight, and nausea or vomiting in someone over 50 years old.^[13] Around 50% of individuals with colorectal cancer do not report any symptoms.^[14]

Rectal bleeding or anemia are high-risk symptoms in people over the age of 50.^[15] Weight loss and changes in a person’s bowel habit are typically only concerning if they are associated with rectal bleeding.^[15][16]

Cause[edit]

75–95% of colorectal cancer cases occur in people with little or no genetic risk.^[17][18] Risk factors include older age, male sex,^[18] high intake of fat, sugar, alcohol, red meat, processed meats, obesity, smoking, and a lack of physical exercise.^[17][19] Approximately 10% of cases are linked to insufficient activity.^[20] The risk from alcohol appears to increase at greater than one drink per day.^[21] Drinking 5 glasses of water a day is linked to a decrease in the risk of colorectal cancer and adenomatous polyps.^[22] Streptococcus gallolyticus is associated with colorectal cancer.^[23] Some strains of Streptococcus bovis/Streptococcus equinus complex are consumed by millions of people daily and thus may be safe.^[24] 25 to 80% of people with Streptococcus bovis/gallolyticus bacteremia have concomitant colorectal tumors.^[25] Seroprevalence of Streptococcus bovis/gallolyticus is considered as a candidate practical marker for the early prediction of an underlying bowel lesion at high risk population.^[25] It has been suggested that the presence of antibodies to Streptococcus bovis/gallolyticus antigens or the antigens themselves in the bloodstream may act as markers for the carcinogenesis in the colon.^[25]

Pathogenic Escherichia coli may increase the risk of colorectal cancer by producing the genotoxic metabolite, colibactin.^[26]

Inflammatory bowel disease[edit]

People with inflammatory bowel disease (ulcerative colitis and Crohn’s disease) are at increased risk of colon cancer.^[27][28] The risk increases the longer a person has the disease, and the worse the severity of inflammation.^[29] In these high risk groups, both prevention with aspirin and regular colonoscopies are recommended.^[30] Endoscopic surveillance in this high-risk population may reduce the development of colorectal cancer through early diagnosis and may also reduce the chances of dying from colon cancer.^[30] People with inflammatory bowel disease account for less than 2% of colon cancer cases yearly.^[29] In those with Crohn’s disease, 2% get colorectal cancer after 10 years, 8% after 20 years, and 18% after 30 years.^[29] In people who have ulcerative colitis, approximately 16% develop either a cancer precursor or cancer of the colon over 30 years.^[29]

Genetics[edit]

Those with a family history in two or more first-degree relatives (such as a parent or sibling) have a two to threefold greater risk of disease, and this group accounts for about 20% of all cases. A number of genetic syndromes are also associated with higher rates of colorectal cancer. The most common of these is hereditary nonpolyposis colorectal cancer (HNPCC, or Lynch syndrome) which is present in about 3% of people with colorectal cancer.^[18] Other syndromes that are strongly associated with colorectal cancer include Gardner syndrome and familial adenomatous polyposis (FAP).^[31] For people with these syndromes, cancer almost always occurs and makes up 1% of the cancer cases.^[32] A total proctocolectomy may be recommended for people with FAP as a preventive measure due to the high risk of malignancy. Colectomy, removal of the colon, may not suffice as a preventive measure because of the high risk of rectal cancer if the rectum remains.^[33] The most common polyposis syndrome affecting the colon is serrated polyposis syndrome,^[34] which is associated with a 25-40% risk of CRC.^[35]

Mutations in the pair of genes (POLE and POLD1) have been associated with familial colon cancer.^[36]

Most deaths due to colon cancer are associated with metastatic disease. A gene that appears to contribute to the potential for metastatic disease, metastasis associated in colon cancer 1 (MACC1), has been isolated.^[37] It is a transcriptional factor that influences the expression of hepatocyte growth factor. This gene is associated with the proliferation, invasion, and scattering of colon cancer cells in cell culture, and tumor growth and metastasis in mice. MACC1 may be a potential target for cancer intervention, but this possibility needs to be confirmed with clinical studies.^[38]

Epigenetic factors, such as abnormal DNA methylation of tumor suppressor promoters, play a role in the development of colorectal cancer.^[39]

Ashkenazi Jews have a 6% higher risk rate of getting adenomas and then colon cancer due to mutations in the APC gene being more common.^[40]

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Symptoms of bowel cancer

The 3 main symptoms of bowel cancer are:

• persistent blood in your poo – that happens for no obvious reason or is associated with a change in bowel habit
• a persistent change in your bowel habit – which is usually having to poo more and your poo may also become more runny
• persistent lower abdominal (tummy) pain, bloating or discomfort – that’s always caused by eating and may be associated with loss of appetite or significant unintentional weight loss

Most people with these symptoms do not have bowel cancer. Other health problems can cause similar symptoms. For example:

• blood in the poo when associated with pain or soreness is more often caused by piles (haemorrhoids)
• a change in bowel habit or abdominal pain is usually caused by something you’ve eaten
• a change in bowel habit to going less often, with harder poo, is not usually caused by any serious condition – it may be worth trying laxatives before seeing a GP

These symptoms should be taken more seriously as you get older and when they persist despite simple treatments.

Read about the symptoms of bowel cancer

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Causes

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Colon Cancer