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HIGH RATES OF CANCER OF THE COLON IN MEN

Cancer of the colon (large intestine), also referred to as colorectal cancer, is a common

form of malignancy in many developed countries but occurs much less frequently in the

developing world.

The cancer affects both men and women. The occurrence of the cancer is strongly related

to age, 84% of cases arising in people who are 60 years or older. However until age 50,

men and women have similar rates for bowel cancer but later in life male rates

 predominate. In numerical terms, there are more male cases of bowel cancer in all age

groups up to the age of 80.

In women colorectal cancer is the second most common cancer after breast cancer 

whereas in men it ranks third after prostate and lung cancers.

Colorectal cancer is the third most common cancer worldwide after lung and breast

cancers, with 60% of all colorectal cancers occuring in the more development regions.

It is also noticed that countries that had a rapid westernisation of diet have seen a rapidincrease in the incidence of colorectal cancer.

Since colorectal cancer is closely linked to western-world lifestyle, it is possible to

 prevent the majority of colon cancers by simple modification of the ways we live.

RISK FACTORS FOR CANCER OF THE COLON

Alcohol

Heavy alcohol consumption may be associated with increased risk of 

colorectal cancer. Depletion of body vitamins including folic acid may play a

role in the development of colorectal cancer but the direct effect of alcohol on the colon

may also be responsible for the increased risk. The risk is higher with high quantity

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consumed. Those that consume spirits and beer have high risk while people that drink 

wine had a lower risk. Drinking may be a cause of earlier onset of colorectal cancer.

Smoking

Smoking may increase the risk of developing colorectal cancer by as much as 40%.

Smokers may swallow some of the cancer-causing chemicals and this may be an

explanation for the increased risk of colorectal cancer in smokers.

Some of these substances are also absorbed into the bloodstream thus causing increased

risk of many cancers.

Diet

The development of colorectal cancers appears to be associated with diets that contain

high amount of fat and calories. Diets high in red meat (e.g. beef) and low in fresh fruit

vegetables, poultry and fish increase the risk of colorectal cancer. Also vitamin B 6 intake

is inversely associated with the risk of colorectal cancer.

Age

The risk of developing colorectal cancer increases with age. Most cases occur in the 60s

and 70s.This doesn’t mean that it can’t occur at younger age. More than 90% who

develop colorectal cancer are older than 50years.

Lack of Exercise

People who lead sedentary life, with not much of physical activity may have a higher risk 

of developing colorectal cancer.

Obesity

Overweight by itself may be a risk factor for colorectal cancer; the chance of dying from

colorectal cancer is higher in obese individuals.

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Large intestinal polyps

Polyps are non-cancerous growths, which may develop on the inner wall of the colon and

return. Some types are risk factors for colon cancer. The removal of colon polyps reduces

subsequent risk of colorectal cancer 

Family History

Close relatives (parents, siblings, and children) of colorectal cancer patients are at higher 

risk of developing the disease. This risk is higher if the relative had the cancer at young

age. If several family members have had colorectal cancer, the chances increase even

more.

Diabetes mellitus

Diabetes mellitus may increase the chance of developing colorectal cancer by as much as

40%.

Genetic or family predisposition

Some inherited disorders may increase a person’s risk of developing colorectal cancer.

The two main ones are:

1) Familial Adenomatous polyposis (FAP)

2) Hereditary Non-Polyposis Colorectal Cancer (HNPCC).

SYMPTOMS OF CANCER OF THE COLON

Abdominal pain and pain in the lower abdomen

Blood in stool

Diarrhea/constipation

 Narrow stools

Unexplained anaemia

Weight loss

In summary the high rate of colorectal cancer can be linked to the presence of one or 

more of the risk factors that predispose to its development.

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Men, who smoke, drink alcohol (especially spirits and beer) in large quantities alongside

some other factors, stand a very high risk of developing colorectal cancer especially as

they advance in age.

It is however noteworthy that most of these factors can be modified or avoided and thus

the agony of coming down with cancer can be prevented.

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HIGH RATE OF CERVICAL CANCER 

Cancer: Malignant tumour i.e. swelling or mass that is likely to spread or causedeath.

Cervix: Neck of the womb consisting of a narrow passage leading to the vagina.

Cancer of the cervix is a preventable cancer, meaning it can be avoided bydetecting the early changes that occur before malignant transformation

occurs.

High rate of cervical cancer can be linked to sexual habit or attitude of thewomen population.

Signs and symptoms of cancer of the cervix

It could be asymptomatic i.e. without any sign or symptoms.Symptoms at the early stage include:

1) Vagina bleeding

2) Moderate pain during intercourse

3) Rarely vaginal mass

Symptoms of advanced cancer include;

Poor appetite, weight loss, fatigue, back pain, leg pain, single swollen leg, heavy bleeding

from the vagina, leaking urine or faeces from the vagina, bone fractures.

Risk factors for cervical cancer

The exact cause of cancer of the cervix is unknown.

However, a type of virus called human papilloma virus(HPV 16 & 18) is found in over 

99% of cancer of the cervix patient.

Sexual Activity

Most women that are sexually active will come in contact with HPV 16 & 18, their  body’s immune system gets rid of the infection even without their knowledge. A minority

will develop abnormalities which can lead to cancer if not treated.

Sexual partners

Many sexual partners or partners with many partners are more at risk of developing

cervical cancer. This is because their behaviour is more likely to predispose them to HPV

infection. However, a woman with only one partner could contract HPV if that partner has previously been in contact with the virus.

Immunosuppression

Woman that is immuno suppressed e.g HIV positive patient may be at risk of developing

cervical cancer.

Smoking

Smoking gives 2 times risk compared to non smoking, probably because smoking is

linked with immune suppression that can result in persistence of HPV infection.

Condoms

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Offer very limited protection from transmission of HPV.

Early pregnancy

It increases risk: the higher the number of pregnancies, the higher the risk.

Oral contraceptives

Long term use of oral contraceptives increases risk of developing cervical cancer buttheir benefits outweighs the risk.

Sex before 18 years

This is also associated with increased risk of developing cancer of the cervix.

Screening can prevent 75% of cancer cases.

PREVENTION

Primary prevention1. Vaccination: Vaccine against HPV works if given before infection, so it is

targeted at girls and women 9-26 years. It is up to 90% effective in preventingHPV and effective for more than 4 years.

2. Avoid habits such as smoking

3. Good nutrition especially those high in vegetable diet decrease HPV persistence

 by 54% and this decreases the risk of developing cancer of the cervix.

Secondary Prevention

1. Awareness: Not a good percentage of women are aware of the risk factors even indeveloped countries. More awareness has to be created.

2. Screening: In developing countries Pap smear as a means of screening has helped

in reducing the incidence and mortality (death) from cancer of the cervix.Frequency of screening could be once in a year to once in every five years. It is

recommended to start 3 years after onset of vaginal intercourse and or no later 

than 21 years of age.

In summary it is very obvious that one singular important factor in the development of 

cancer of the cervix is human papilloma virus (HPV), which is transmitted sexually.

Thus factors such as early onset of sexual intercourse, multiple sexual partners, having

sexual partners with multiple sexual partners favour the infection of the virus and thus

high rate of cancer of the cervix

Sexual abstinence before marriage, faithfulness to one partner after marriage and

avoiding habits like smoking all have beneficial effects for every women.

Ignorance and lack of awareness about screening and modification of lifestyle remain the

factors responsible for the present high rate of the disease.

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REFERENCES:(1) http://www.infocancerresearchuk.org

(2) http://www.bitswikipedia.org

(3) http://www.nlm.nih.gov/medlineplus(4) http://www.torontosun.com/life

(5) http://www.imaginis.com/cervical-cancer 

(6) http://wwwcancwescreening.nhs.uk (7) http://www.medicineworld.org

(8) Encarta English Dictionary

Article compiled by Dr Sule F.B.A