Understanding and Preventing Colorectal Cancer: A Growing Concern in India

Colorectal cancer has emerged as a significant public health concern in India, with a steady increase over the past two decades. Despite still having a lower incidence compared to Western countries, urban areas in India are experiencing a rise, particularly among individuals under the age of 50. According to the Indian Council of Medical Research, colorectal cancer accounts for 7-8% of all cancer cases, with over 70,000 new cases diagnosed annually. Unlike Western nations, where lifestyle factors such as obesity and processed foods play key roles, India faces unique triggers like genetic predisposition and an increase in inflammatory bowel diseases (IBD). Additionally, low fiber consumption remains a critical issue. The lack of routine screening contributes to delayed detection, leading to lower survival rates. Early detection and lifestyle changes are crucial in reducing colorectal cancer’s mortality rate.

What is Colorectal Cancer?

Colorectal cancer affects the colon (large intestine) and the rectum. These organs are vital for absorbing water and nutrients from food and containing waste. Generally, this cancer starts as non-cancerous polyps that, over time, can become malignant. Timely detection is vital as it greatly improves the prospects of successful treatment.

Recognizing the Signs of Colorectal Cancer

In the early stages, colorectal cancer may not show any symptoms. Regular screening tests are essential, as even subtle signs could indicate early disease. As the cancer progresses, individuals may experience:

• Changes in bowel habits, such as diarrhea or constipation lasting several days.
• Blood in stool, appearing red or dark in color.
• Abdominal discomfort including cramping and gas pain.
• Incomplete evacuation, feeling the urge to defecate without success.
• Inexplicable weight loss.
• Fatigue and general weakness, possibly due to anemia from internal bleeding.

Consult a physician if these symptoms persist. Early intervention can make a critical difference in the outcomes.

Strategies to Prevent Colorectal Cancer

Routine Check-Ups

Recent trends indicate rising incidences of colorectal cancer in younger Indians. As a result, screening should start earlier than in Western countries. The U.S. Preventive Services Task Force suggests lowering the screening age to 45 due to the increase in young-onset cases. However, in India, awareness and access to screening are limited, particularly in rural areas. For individuals with a family history of colorectal cancer, inflammatory bowel diseases, or hereditary conditions like Lynch syndrome, screening should begin at age 40 or younger if within high-risk groups. Annual stool tests and occasional colonoscopies can help identify early signs.

Healthy Diet

A balanced diet rich in fiber helps reduce the risk of colorectal cancer. Processed and red meats, low fiber intake, and high-fat diets increase the risk. Changing dietary habits is a significant factor; in urban areas, Westernized diets are becoming prevalent, contributing to higher CRC incidences. Diets富含 fiber, particularly whole grains, legumes, green vegetables, and fruits, support gut health and discourage polyp formation. Turmeric, known for its anti-inflammatory properties, also contributes to a healthy gut environment.

Furthermore, avoiding excessive fried food, sugary drinks, and limiting dairy intake can aid digestive health and reduce cancer risk.

Regular Exercise

Long hours spent sitting at desks contribute significantly to colorectal cancer in urban Indians. Engaging in moderate-intensity exercises for at least 150 minutes per week can lower the risk by 30-40%. Exercise improves bowel function, reduces inflammation, aids weight management, and increases insulin sensitivity. Activities like yoga, brisk walking, and strength training are accessible alternatives for maintaining colon health.

Limit Alcohol and Avoid Smoking

Excessive alcohol consumption and smoking are major risk factors. Long-term smoking increases the risk by 18%, while heavy drinking raises it by 50%. Alcohol can irritate the colon’s lining, causing cellular damage. The Asian flush reaction suggests a genetic tendency for inefficient alcohol metabolism, increasing cancer risk. Smoking accelerates polyp formation and causes mutational damage. Cutting down or eliminating these habits can significantly reduce colorectal cancer risk.

Younger Generations and Colorectal Cancer

The diagnostic trend of colorectal cancer among older people has shifted. Young Indians between 30 and 40 are increasingly affected by this disease. Contributing factors include unhealthy diets, high consumption of ultra-processed foods, low fiber intake, high sugar content, sedentary lifestyles, and obesity. Additionally, incidence of inflammatory bowel diseases has risen, raising the risk of CRC. Imbalances in gut microbiomes, chronic stress, and overuse of antibiotics are also emerging risk factors. Experts emphasize the need for early screening, lifestyle changes, and increased awareness among young adults.

Rising Concerns Among Younger Populations

Colorectal cancer is increasingly prevalent in India, linked to lifestyle changes, dietary habits, and urbanization. Processed and fast foods, deficient in fiber and dominated by unhealthy fats, harm gut health and increase CRC risk. Sedentary lifestyles, obesity, and higher inflammatory bowel disease rates are additional contributors. Unlike in Western countries, where colorectal cancer mainly affects older adults, India faces increasing CRC incidences among younger people. These trends are driven by dietary shifts, reduced physical activity, higher antibiotic use, and imbalances in the gut microbiome. The lack of regular screening programs and delayed diagnosis complicates the issue, resulting in more advanced diagnoses and lower survival rates.

The Role of Education and Awareness

Colorectal cancer poses a substantial health challenge, but informed and proactive steps can mitigate its impact. Regular screenings, monitoring your body for changes, and maintaining a healthy lifestyle are foundational in preventing this disease. Together, we can reduce colorectal cancer burden in India and globally, through mutual awareness and vigilance.

Dr. Rajesh Shinde, Consultant HPB, GI, Thoracic Oncology & Robotic Surgery, Apollo Hospitals Navi Mumbai

We invite you to engage with us! Share your thoughts, ask questions, and stay informed. Together, we can make a difference in raising awareness about colorectal cancer and promoting healthier lifestyles. Let’s fight this disease, one informed individual at a time.

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