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/