Warning Signs and Risk Factors for Colorectal Cancer

That test is the only early reading that can be done at that level; genetic-level investigation is not available in that setup. For colonoscopy, the patient has to go to a tertiary hospital and bring the results back. At least the fecal occult blood test is available, and even though it is not very specific, it can help catch some cases.

Yes. Rectal cancer spreads upward along its natural embryological lymphatic supply rather than downward, so staying strictly within that anatomical plane allows the tumour to be removed completely, following guidelines that show even a minimal distal margin of one centimetre is adequate. An intraoperative frozen section can confirm all microscopic cancer cells have been cleared, and this makes it possible to go between the internal and external anal sphincter even for the lowest-lying tumours, preserving a normal passage instead of requiring a permanent stoma.

Follow the natural avascular surgical plane, doing sharp dissection between the internal and external sphincter. On gross examination, aim for about one centimetre of margin at the lowest extent of the tumour, or three to five centimetres higher up depending on where the tumour is located. Stay within the correct surgical plane and the margin should come back clear; the final histopathology report, once it arrives, confirms this.

Do whatever is genuinely achievable under your own control. If something cannot be done locally, it is better to refer the patient to a centre where it can be done with precision, because cancer gives only one real chance to get the treatment pathway right.

It is called complete mesocolic excision with central vascular ligation, sometimes shortened to CME with CVL. The feeding blood vessels of the tumour are ligated right at their origin so that all the draining lymph nodes and the complete mesocolic fascia are removed together; this has been published in international journals and is associated with better survival than the standard technique.

Fresh rectal bleeding or a change in stool colour, an unexplained drop in haemoglobin, and constipation or diarrhoea lasting more than three weeks are the clearest signs that warrant evaluation.

Sixty to seventy percent of patients present at stage three or four because warning signs are often dismissed or evaluation is delayed; detecting the disease earlier shortens treatment and improves outcomes.

Yes. Changing lifestyle habits mean colorectal cancer is now being diagnosed in patients in their thirties and even their twenties, not only in older adults.