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From polyps to colon cancer: the importance of screening
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Colon cancer (colorectal cancer) is one of the most common cancers in Belgium and affects almost 8,000 people per year. The disease causes more than 2,600 deaths annually. Yet there is also good news: the survival rate five years after diagnosis has increased in recent years to 70.8 percent. Research into colon cancer is also making great progress. This offers hope for better chances of recovery from colon cancer at every stage, even if there are metastases.
Also read: Everything you need to know about colon cancer
How does colon cancer develop?
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Colon cancer develops from polyps – an overgrowth of mucous membrane – in the intestine. There are two types of polyps: type A and type B. Type A is pedunculated, slow growing, and if an average person without a genetic predisposition develops a polyp, it is usually this type. Type B is flat and grows faster than type A. Anyone who develops this type will also develop several in their lifetime.
“Polyps are small and harmless,” says Professor Sabine Tejpar, gastroenterologist and digestive oncologist at KU Leuven. “You don’t feel them. You don’t know you have them. But you still have to have them removed because they are the precursors to colon cancer.”
Polyps can be present in the intestine for years without being malignant. But the longer they are there, the more time they have to grow and become stimulated. A few cells in the polyp become overstimulated and are transformed into malignant cells. This is how cancer arises. If you let the cells grow, the cancer can also grow through the intestinal wall.
Also read: Intestinal polyps: usually harmless, sometimes malignant
Reduce the risk of colon cancer
Since polyps are the precursors of colon cancer, it is important to detect them. This can be done in two ways. The first is via a colonoscopy. “This way you can both see and remove the lesions,” says Tejpar. The second way is via a stool sample. “A sample is abnormal if there is blood in the stool. That means the injury is bleeding.” An abnormal sample will be followed by a colonoscopy to view and remove the polyp.
This whole process takes a lot of time. “It takes ten years before a polyp becomes irritated. During those ten years you will undoubtedly have some time to have the polyp removed,” the professor adds. “If you have the benign lesion removed, you have zero risk of cancer.”
Also read: How can you reduce the risk of colon cancer?
How do you know if you have a polyp?
The important risk factors for developing polyps (and therefore colon cancer) are: little exercise, obesity and an unhealthy diet. These factors influence your immune response, meaning your body cannot fight the polyps sufficiently. The biggest risk factor is inflammatory bowel disease. This means that your intestine is chronically inflamed. Your doctor will therefore recommend that you have your intestines examined regularly.
Furthermore, growing older has an influence. “Our system will then become worn out,” says the professor. “Our body no longer works as well as it used to. Our millions of intestinal cells also age, just like our immune system. The defense against polyps is therefore becoming less and less.” As a final risk factor, the professor mentions a history of having had a polyp yourself, or having someone in your family who has (had) a polyp. But if other types of cancer occur in your family, this is also an indicator. Some cancers, such as breast and stomach cancer, have the same pathogenesis as colon cancer.
Also read: Chronic inflammatory bowel disease: ‘Invisible symptoms, but major impact on daily life’
The right screening
For all forms of polyps/colon cancer, it is very important that you know as much as possible about yourself. For an average person, there is a 5 percent chance that he or she will develop a polyp. That is usually a type A polyp. These types of polyps grow slowly. “These people are advised to have their bowel movements screened between the ages of 50 and 75. They can also have a colonoscopy performed from the age of 50 and repeat it every ten years,” says Tejpar.
In addition, there is a large group of people who have an indirect genetic predisposition to develop polyps. They are more likely than the first group to develop polyps of both types at a younger age. According to Professor Tejpar, people with an average risk of developing polyps should have a colonoscopy performed every five years from the age of 40.
Finally, there are people who will almost certainly develop polyps: people with congenital intestinal abnormalities, namely Crohn’s disease or ulcerative colitis. They will be constantly monitored by a doctor.
Also read: Link between colon cancer and nitrites/nitrates in food
Treatment of colon cancer
The way in which a polyp arises (whether or not due to genetic predisposition, the type of polyp, etc.) determines the behavior, biology and treatment of the cancer. “If the tumor is in the intestinal wall and there are no metastases, then we will operate,” says Professor Tejpar. Depending on the tissue that has or has not been touched by the tumor, chemo may follow. If the tumor has spread through the bloodstream to the lungs or liver, chemo treatment is necessary.”
“Our knowledge of polyps and colon cancer is already very extensive, but the appropriate treatments to intervene on the tumor must evolve accordingly,” concludes Professor Tejpar. “I have high hopes for that. Give us a few more years. My ambition is an empty waiting room in digestive oncology, where I treat the cancer. And I want a full waiting room where I do the endoscopy.”
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Last updated: March 2024
100 Years Foundation against Cancer Foundation against Cancer
In 2024, the Foundation against Cancer will celebrate its 100th anniversary under the High Patronage of Queen Mathilde. From the start in 1924, her main motivation was: turning hope into victory.
100 years of the fight against cancer – Foundation against Cancer
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2024-03-13 23:01:01
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