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 rapid
increase 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
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.
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.
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.
 HIGH RATE OF CERVICAL CANCER

Cancer: Malignant tumour i.e. swelling or mass that is likely to spread or cause
death.
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 by
detecting the early changes that occur before malignant transformation
occurs.
High rate of cervical cancer can be linked to sexual habit or attitude of the
women 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
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 but
their 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 prevention
1. 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 preventing
HPV 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 in
developed 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.
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