1.
Understanding Colon Cancer
Dr Chea Chan Hooi
Surgeon
Borneo Medical Centre (Miri)
15th July 2020

2.
Content
• Introduction
• Epidemiology
• Risk factors
• Symptoms
• Investigations
• Treatment
• Screening
• Conclusion

3.
Introduction
• The second most common
cancer in Malaysia
• Usually affects older people
• Begins as a polyp which then
grows over time (between two
to five years) to become cancer

4.
Colon cancer occurence in Asia

5.
Lifetime cancer risk in Malaysia
Male
• General 1 in 15
• Chinese 1 in 39
• Malay 1 in 72
• Indian 1 in 82
Female
• General 1 in 74
• Chinese 1 in 49
• Indian 1 in 91
• Malay 1 in 100

6.
Top 10 most common cancer in Malaysia, 2007 -
2011

7.
Risk factors
Modifiable
• Diet
• Obesity
• Smoking
• Excessive alcohol intake
• Inflammatory bowel disease
Non-modifiable
• Genetic predisposition
• Family history
• Aging

8.
Modifiable risk factors

9.
Non-modifiable risk factors
• Aging
• Genetic
• Family history

10.
What are the symptoms that
might suggest colon cancer?

11.
Tenesmus

12.
Investigations
• Fecal occult blood test
• Cancer marker
• Colonoscopy

13.
Fecal occult blood test
• Test for blood cells in stool
• Falsely raised if taking certain medication (e.g. aspirin) or high-iron
food

14.
Cancer marker
• CEA
• Function
• To assist in screening
• Monitoring response to treatment
• Detect recurrence after treatment
• Not diagnostic
• Levels not elevated in up to 30% colon cancer patients
• Also detected in lung cancer

15.
Colonoscopy

16.
CT scan staging

17.
Surgery - Laparoscopic

18.
Surgery - Conventional open surgery

19.
Chemotherapy and radiotherapy

20.
Five year survival rate for colorectal cancer

21.
Screening
• People with no symptoms
• Population
• Normal-risk
• High-risk
• Family history
• Previous colonic polyp
• Previous inflammatory bowel disease
• Methods
• Fecal occult blood test (FOBT)
• Colonoscopy

22.
Screening schedule
Normal-risk
• FOBT every 1 - 3 years, proceed
with colonoscopy if positive
• Colonoscopy every 5 - 10 years
starting from age 45
High-risk
• FOBT every year, proceed with
colonoscopy if positive
• Colonoscopy every 1 - 5 years
Family history
Previous colonic polyp
Previous inflammatory bowel disease

23.
Development of colon cancer

24.
Conclusion
• Colon cancer is the second most common cancer in Malaysia
• Wide range of treatment options are available
• Early detection will enable higher chance of cure
• Screening is crucial

25.
Thank you
E-mail: cheachanhooi@yahoo.com
WA: 0149972321
Tel: 085329333