Colorectal cancer in Norway

Maria MaiIngvild Hvalby

What is colon cancer?Malignant tumor arising from inner wall of the

large intestine and rectum

98 % of these tumors are variations of adenocarcinomas

The rest are carcinoid tumors, malignant lymphomas or sarcomas

PrevalenceNorway has the highest incidence of colorectal

cancer in the world

More than 2300 new cases every year

1 in 29 Norwegian men and 1 in 24 women develop colorectal cancer during life

Rare before the age of 40-50, except from people with genetic disposition

Incidence of colorectal cancer has increased with 50 % during the last 30 years in Norway

CausesThere is no stated external causes of colorectal

cancer, but:Diet and insufficient physical activity can be a

causeAge increased life expectancy in NorwayChemical substances developed from bacteria

and/or substances from bile can be carcinogenicCan be caused by a rare (dominant) genetic

condition called Familial Adenomatous Polyposis

Development of diseasePolyps can be normal in the large intestine

Can be caused by irritation of mucous membrane or benign tumors (tubular adenoma)

Benign tumors can be harmless, but can also be precancerous

Especially high-graded dysplasia of tubular adenomas can develop into cancer if they are not removed

SymptomsOften the patient will have symptoms for a long

time before the tumor is discovered

Upper part of bowel: Anemia, weight loss, diarrhea

Lower part of bowel: constipation, blood or mucus in stool, colicky pain

Blockage in ileum at later stage due to growth of tumor

Perforation of intestine near tumor

DiagnosisBlood sample

Colonoscopy with biopsy confirmation of cancer tissue

Barium enema X-ray procedure

Normal vs Cancerous

TreatmentSurgical removal of tumor, regional lymph nodes

and parts of the large intestine

Additional treatment can be chemo therapyReduces mortality rate with 30 %

Radiotherapy is rarely used, except when cancer has spread to the bones

PrognosisSurvival rate when the tumor is only in the

intestinal wall is 80 % after 5 years

If there’s no relapse after 5 years, the patient is considered cured

If the cancer spreads to the regional lymph nodes the survival rate is 50-60 % for 5 years. Only 5 % of the patients are alive more than 5 years after detected spread

PreventionScreening of all people over 50 years of age is

done in some areas of Norway

Goal is to detect potential polyps and remove them

By removal of polyps and later check up, the hope is to reduce the risk of colorectal cancer

Sourceshttps://sml.snl.no/tykktarmskreft

http://www.medicinenet.com/colon_cancer/article.htm#colon_cancer_facts

http://www-dep.iarc.fr/NORDCAN/NO/frame.asp

http://www.kreftregisteret.no/no/Generelt/Fakta-om-kreft-test/Tykk--og-endetarmskreft/