Bowel cancer: symptoms, treatment, population screening

Colon cancer is a malignant tumor in the intestine. Cancer of the small intestine is rare, cancer of the colon and rectum is common in Western Europe. Rectal cancer is more common in men, colon cancer more common in women. What are the causes and symptoms of colon cancer, how can the cancer be treated and what is the prognosis? The bowel cancer population survey will be introduced from 2014; detailed information can be found on the RIVM website.

Article content

  • Intestine
  • Colon cancer
  • Causes of colon cancer
  • Colon cancer symptoms
  • Complications of colon cancer
  • Diagnosis of colon cancer
  • People with a family member with colon cancer
  • Colon cancer treatment
  • Colon cancer prognosis
  • Hereditary colon cancer
  • Bowel cancer population survey from 2014



It is the part of the digestive system that lies between the entrance of the stomach to the anus. The intestine consists of three parts: small intestine, large intestine and rectum. The small intestine is located in the middle of the abdomen, with the large intestine surrounding it. The small intestine is the longest and consists of: duodenum (duodenum), jejunum and ileum. The large intestine consists of: cecum (attached to this is the appendix vermiformis or vermiform appendage) and the large intestine proper.

Colon cancer

Colon cancer is a malignant tumor in the wall of the colon or rectum. Colon cancer almost never occurs under the age of forty and above the age of forty the risk increases with age. Rectal cancer is more common in men, colon cancer more common in women. In some cases the condition is hereditary. If you look at the most common cause of death from cancer in the Netherlands, cancer of the colon and rectum is in second place. It is one of the few types of cancer that can be detected at an early stage by examining people who belong to a higher risk group. Bowel cancer can occur anywhere in the large intestine, but six out of ten tumors develop in the area of the intestine close to the rectum.

Causes of colon cancer

Our food is often low in fiber and contains a lot of meat and animal fats, which seems to increase the risk of colon cancer. In countries that are less developed and people consume more fiber (cereals, fruit, vegetables), colon cancer is rare. It is not entirely clear how dietary fiber can reduce the risk of colon cancer. It could be that dietary fiber ensures that waste products spend less time in the intestines. Substances that could harm the body are removed earlier. Other risk factors are: excessive use of alcohol, smoking, little physical exercise and being overweight. Inflammations of the colon such as ulcerative colitis or Crohn’s disease eventually lead to an increased risk of cancer.
One in twenty cases of colon cancer and rectal cancer is the result of a predisposition to a hereditary form of cancer: hereditary non-polyposis colorectal carcinoma or HNPCC. Hereditary means hereditary, non-polyposis means not many polyps, colorectal refers to the colon and rectum, carcinoma means cancer.
Colon cancer can also be caused by familial adenomatous polyposis (FAP), but this almost never occurs. This colon cancer causes many polyps to develop in the colon and rectum. With FAP there is a ninety percent chance that some polyps will become malignant over time.

Colon cancer symptoms

The symptoms a person experiences depend on the location of the tumor.
Symptoms may include:

  • The number of times a person passes stool can change;
  • The shape of the stool may change;
  • Blood may be seen in the stool;
  • The appetite may decrease;
  • Pain in the abdomen, complaints of pain in the rectum;
  • Having the idea that the intestine is not completely empty.


Complications of colon cancer

If too much blood is lost, anemia due to iron deficiency can result. Someone often has pale skin, headaches and gets tired quickly. If the tumor continues to grow larger, it can cause intestinal blockage. Colon cancer and rectal cancer can spread through the blood to lymph nodes, liver and other organs. Go to the doctor immediately if there is blood in the stool!

Diagnosis of colon cancer

If colon cancer is suspected, a rectal examination can be performed. The tumor can then be felt. You can also look for blood in the stool. Blood can be tested for anemia. You can be referred by your GP for a colonoscopy. During this examination, a flexible tube is inserted to observe the colon. Biopsies can also be taken for microscopic examination. Another examination: contrast X-rays. Barium porridge is inserted to detect abnormalities in the large intestine. If a malignant tumor is found, an ultrasound or CT scan is often performed to see whether the cancer has spread to the liver.

People with a family member with colon cancer

People who have a close family member with colon cancer before the age of 50 or two family members with colon cancer are offered a colonoscopy every three to six years. If you are a close relative of someone with HNPCC, it is recommended to have a colonoscopy every two years.

Colon cancer treatment

The treatment depends on where the tumor is located. If the tumor is detected early, in most cases the affected part of the intestine can be removed and the remaining parts are connected together. If most of the rectum has been removed, a colostomy may be necessary. An opening is then made in the abdomen (stoma), through which the stool can come out. If the cancer cannot be cured, treatment is aimed at relieving the (pain) complaints. A tumor that occludes the intestine can be removed by surgery. If the cancer has spread to other parts of the body, chemotherapy, radiation, or a combination may be necessary.

Colon cancer prognosis

Most people who undergo intervention at an early stage live longer than five years. If affected tissue is removed at an advanced stage, four out of five people are successful. If the cancer spreads to other parts of the body (metastases), the prognosis is not good. But developments are moving fast, who knows what the future will bring us.

Hereditary colon cancer

Several types are known, Lynch syndrome (formerly HNPCC) and Familial Adenomatous Polyposis (FAP) are the most common. If two of the following symptoms occur, there is a greater chance that Lynch syndrome (HNPCC) exists:

  • If three or more relatives in successive generations have (had) colorectal cancer, at least two of whom are first-degree relatives.
  • If colon cancer or uterine cancer is discovered before the age of 50.
  • If, in addition to family members with colon cancer, there is also a female family member who has (had) uterine cancer.
  • If an intestinal polyp (a benign tumor) is discovered before the age of forty.


Bowel cancer population survey from 2014

The bowel cancer screening program will be introduced from 2014. It is one of the most common types of cancer and population screening can prevent approximately 2,400 deaths per year in the long term. If colon cancer is detected early, the treatment is often less severe. The population survey is intended for all men and women aged 55 to 75. In the long term that will be more than 4 million people. On the RIVM website you can find out when people from a certain year of birth are called up and what exactly the research entails. You can of course decide for yourself whether or not you want to participate in the study.

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