Carcinomas of the colon and the rectum are discussed under one heading of colorectal carcinoma. Carcinoma of the colon is more common as compared to carcinoma of the rectum. Colorectal carcinoma usually occurs during 40 to 60 years of age. Its incidence is higher in industrialised and densely populated areas than the rural areas. It has been observed that diet and nutrition play an important role in genesis of the colorectal carcinoma. Fast food items, which are rich in fat and poor in fibre, may cause colorectal carcinoma. Fried and grilled food is another cause of the colorectal carcinoma.
Risk factors of colorectal carcinoma include:
Studies have revealed that there is a much higher risk of the colorectal carcinoma in those women, who have a positive family history of the breast cancer.
Symptoms of the colon carcinoma are variable, depending on site of the tumour, for example carcinoma of the ascending colon presents with fatigue and weakness (due to iron deficiency anaemia), whereas carcinoma of the descending colon presents with altered bowel habits and colicky pain. Carcinoma of the colon may lead to intestinal obstruction and perforation resulting into peritonitis. Carcinoma of the rectum usually presents with bleeding or mucus discharge per rectum. There may be abdominal distension, tenesmus, urgency and incomplete bowel clearance. Sometimes, there is formation of an abscess or fistula. Colorectal carcinoma is usually localised at the time of diagnosis. In advanced stages of the disease, there may be palpable mass in the abdomen. Colorectal carcinoma usually metastasises to the liver.
Staging of the colorectal carcinoma is done as follows:
Procedures used in diagnosis of the colorectal carcinoma include digital rectal examination, proctoscopy, sigmoidoscopy, stool examination for occult blood, CEA estimation, CT scan, colonoscopy and biopsy.
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