Colorectal Cancer: Pathogenesis, Management and Prevention

Colorectal cancer (CRC) is termed as a civilization disorder, with high incidence in Australia, NewZealand, Europe and US, with lower rates in Africa and Central Asia.Risk factors for CRC include genetic disorders, diet, red meat, smoking, alcohol and lack of exercise is associated with increased risk. Individuals with inflammatory bowel disease (IBD) have an increased risk of CRC.Genomic analysis have revealed that eventually cell acquires a mutation in the TP53 gene and transforms the tissue from a benign epithelial tumor into an invasive epithelial cell cancer.CRC can be categorized into hypermutated and non-hypermutated tumor type. Field defects and epigenetic changes play an important role. Common symptoms include: constipation, blood in stool, weight loss and anemia in people over 50 years. Diagnosis is by colonoscopy, sigmoidoscopy, and CT scan of chest, abdomen and pelvis. Cancer staging by TNMsystem. Treatment of CRC aimed at cure or palliation. Surgery,radiation, chemotherapy, palliative care and follow up is important. Prevention through surveillance, stool DNA screening test, fecal occult blood test,sigmoidoscopy,andcolonoscopy. CT colonoscopy cannot remove any abnormal growth.Prevention include consumption of whole grains, fruits,vegetables, calcium supplement vitamin D,and lactic acid bacteria(probiotics) have beneficial effect.